New program helps patients get control of their medicine cabinets
Drug stores sell those handy pill boxes, some as big as tackle boxes, marked with
each day of the week -- and sometimes the
hours of the day. But those boxes are only
as helpful as they are well organized. And
the medication inside them is only effective
if it's taken correctly.
It's easy to get confused when you have
to take several medications each day. That's
why the University of Michigan Comprehensive
Cancer Center is launching a new Medication Management Program as part
of its Symptom Management & Supportive Care Clinic. We talked with Emily Mackler,
Pharm.D., a pharmacist with the program, about what patients should know about
Q: What's the goal of
medication management? Why would patients visit the clinic if they're already
working with an oncologist?
Our team works in concert with U-M
Cancer Center oncologists. I sit down as a pharmacist with patients and review
each and every medication and nutritional supplement they are taking -- regardless of
who's prescribing it. Often, there isn't time for this level of in-depth review of a patient 's
medications during a typical visit in an oncologist's clinic. Many of our patients
are managing multiple diseases as well as symptoms and side effects related to their
cancer. By taking a look at the patient's whole medication profile, we can look for
Q: What kind of red flags?
Sometimes patients who are overwhelmed
may not understand why they take a given medication. We've seen patients who don't realize that they're
taking three different medications for the same thing, which is not necessary and may become a problem. Also, we check for drug
interactions. Often, patients don't realize that a nutritional supplement they're taking to boost their immune system may actually
interfere with cancer treatment.
Do you discourage use of nutritional supplements?
It depends which nutritional supplement
is taken. We understand that many of our patients are seeking ways to make their bodies stronger. We help our patients
understand how the different medications and supplements work in their bodies. Our ultimate goal is to ensure that everything
patients are taking is benefiting them as much as possible -- whether that's by effectively
killing cancer cells or helping to ease pain or some other side effect.
Q: What can patients do to ensure their medications are working effectively?
It's extremely important that patients
follow instructions and take medication properly. We know it can be difficult to remember multiple pills at different times
during the day. To help with that, we provide patients with a few tools. First, we type up a list of all medications a patient is taking
along with the reason they are taking it and any important information about how to take it. For example, we note whether
it should be taken with food and at what time of day. Second, we offer medication calendars to help plan their regimens. We
also offer pain diaries to keep track of how pain medications are working. These diaries are useful to us in making adjustments to
medications and maximizing the treatment of pain and other symptoms. Finally, we are available for frequent phone calls or office
visits to assess how medications are working and discuss any necessary adjustments.
Q: What if it's difficult to swallow many pills in a day?
That's another benefit of working with
a pharmacist in our clinic. For some patients, difficulty swallowing prevents them from taking the medication they need.
Whenever possible, I work with those patients to try to find other formulations -- whether it be a liquid form or even a cream
that could be applied to the skin -- to help them get the medication they need.
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