01 Nov Ask the Pharmacist: How to Be an Informed User of Prescription Drugs
A recent study found that only a minority of individuals could state the names, purposes and common side effects of their prescription medications when they were discharged from the hospital. This research joins other studies that have reached similar conclusions. Clearly, opportunities exist for healthcare professionals to improve the quantity and quality of education about prescription drugs provided to patients.
Lack of patient education about drugs results in less than optimal therapy, including decreased effectiveness and increased side effects, as well as greater costs. For example, few migraine sufferers are proactively told that the over-use of acute medications can contribute to rebound headaches. As a consequence, rebound headache remains a condition that affects millions of people in the U.S. Yet with adequate education, this condition could be significantly reduced and needless suffering avoided.
The unfortunate reality of our health care system is that patients often need to be their own advocates to obtain complete, accurate and personalized information about drugs. The most important step patients should take is to ask questions as soon as their healthcare provider suggests a medication. The best time to address problems, discuss alternatives and make changes to drug therapy is before a prescription is on paper. Physicians write the majority of prescriptions, but physician assistants, nurse practitioners and pharmacists can also prescribe in certain situations.
Questions to Ask About Your Prescriptions
- Regardless of which professional is writing a prescription, patients should have a minimum of three questions answered to their satisfaction: What is this medication for?, How should I take this medication? and What should I expect from this medication? This information is fundamental. If the person prescribing a drug cannot, or will not, answer these questions, patients should ask to speak to someone who has the time and ability to provide explanations.
- While the pharmacy is an additional venue for patients to obtain drug information, there are barriers to overcome in this setting, because the person who wrote the prescription is not present. Telephone calls, faxes and other means of communicating with prescribers cause delays.
- Beyond the three basic questions listed above, there are a number of probing questions that most patients would benefit from asking. For example:
- What evidence exists to demonstrate a specific treatment’s efficacy? Is this evidence from only one or two studies with few patients, or from multiple studies with thousands of patients?
- Were the studies done in people of my age, gender and overall health?
- What was the most common reason(s) a particular treatment was stopped during clinical trials?
- What are the costs of this therapy? Are other treatments equally effective, or almost as effective, but significantly less expensive?
- Are there any interactions between the newly prescribed drug and my existing medications?
- Is this a new drug or an older medication? (Newer drugs are not necessarily better and may only be more expensive. A greater amount of knowledge typically surrounds older medications, which tend to have better safety records. Sadly, in the last decade at least half-a-dozen new drugs were discontinued by the U.S. Food and Drug Administration after serious, negative consequences were discovered with widespread use.)
Becoming Fully Aware
Patients should also be aware that many physicians have professional relationships with the pharmaceutical industry (e.g., participating in drug studies funded by pharmaceutical companies). The majority of physicians always prioritize their patients’ well-being, but the intense competition between manufacturers in the billion dollar pharmaceutical industry can cloud the judgment of some individuals. Bear in mind that healthcare professional-industry interactions are not inherently bad; indeed, many treatment advances have occurred as a result of cooperation between these two groups. Yet patients benefit when they are fully aware of all factors that may be influencing drug selection.
The bottom line is that patients should strive to be involved in their care to the greatest extent possible. Knowledge is power and individuals armed with information are more likely to obtain the treatment results they desire.
Call-Outs for How to Be an Informed User of Prescription Drugs
- Lack of patient education about drugs results in less than optimal therapy
- Patients benefit when they are fully aware of all factors that may be influencing drug selection
All questions answered by:
Richard Wenzel, Pharm. D.
Diamond Headache Clinic Inpatient Unit
St. Joseph’s Hospital, Chicago, IL