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Pharmacists May Help Solve Medication Mysteries

By Dale Blumenthal

When a diabetic patient called her pharmacist, Vern Gideon, to have her prescription refilled, Gideon looked up her records and noted that she still should have an ample supply of the medication. He called his client back, and she told him that her doctor had increased the dosage of the drug. She was taking two additional tablets in the morning and one in the evening. She also mentioned that even at the new dosage she did not feel quite right.

Gideon called her doctor to discuss the medication change and the patient's complaints. The doctor said that he had anticipated that the increased dosage would be more effective in lowering the patient's blood sugar. He didn't know why it wasn't working.

Gideon wondered whether the patient was taking the medication correctly. He repeated to the doctor the medication schedule the patient was following, and he and the doctor then discovered the problem. The patient had reversed the schedule: She should have been taking one additional tablet in the morning and two in the evening.

The patient's blood sugar level is now "back on track," Gideon says.

Simple Solutions

"Answering medication questions is the type of thing we do all the time," says Gideon, owner of Guardian Pharmacy in Arlington Heights, Ill. Many medication problems are common and the solutions simple. For instance, new clients often come in to have a prescription filled for a commonly prescribed arthritis drug. Gideon always cautions them against taking the drug on an empty stomach. And often the response is, "that must be why I felt sick the last time I was on this medication."

Whenever a patient comes in with a new prescription or for the first refill, Gideon discusses with the client how and when to take the medication, common side effects, and foods and drugs (both prescription and over-the-counter) to avoid when on the medication.

Gideon is remodeling his pharmacy so that he will have a special area where he can discuss medication problems with patients. "Patients are entitled to counseling about the drugs they take," he says. Gideon will even have a private room for patients who want to ask him about issues they find embarrassing--such as incontinence products or impotence caused by some medications.

Ask Your Pharmacist

Gideon is not alone in his commitment to patient counseling. According to a recent FDA survey, pharmacists spend about 23 percent of each workday counseling patients about their prescriptions. According to a 1988 survey from the National Association of Retail Druggists, which represents pharmacists who own independent drugstores, the questions patients ask most often concern drug side effects, drug use with alcohol, and how and when to take medications. Pharmacists cover a wide range of medication concerns, including dangers of prolonged use, proper storage, and use in pregnancy.

"Medicines have become a standard part of health care for Americans of all ages," says Bob Bachman, executive director of the National Council on Patient Information and Education (NCPIE). In the past eight years, NCPIE has pulled together 260 private and public sector groups to place prescription medicine misuse on the public health agenda. NCPIE's theme in 1990 was "Break the Rx Silence Barrier: Talk About Prescriptions." The organization provided a kit for health-care professionals with strategies for building medication counseling skills.

"Patients often aren't sure what to ask about their medications," says Curt Barr, owner of Barr Pharmacy in Blair, Neb. "I'll talk to a patient about a prescription, and then all of a sudden the neatest thing happens. The patient starts asking relevant questions about other medications--for instance, whether to take them before or after meals or what interactions to consider."

Provided by FDA Consumer magazine.