When you are chronically ill, managing medications can be a chore. Fatigue often plays a part in brain fog which makes it difficult to manage multiple prescriptions that you take routinely and as needed. Often it can seem like a chore keeping up with refills and the dosing regimen. Having a system that works for you is essential to preventing accidental missed doses and over dosing or running out of medication.
A good way to routinely get your refills that works with your prescribing physician(s) is needed. Many doctor offices request that you have your pharmacy fax the refill request while others ask you use their online patient portal (patient website) while others require a phone call to the office and/or leaving a message on the nurse phone line. If you obtain medications by a mail order pharmacy, you will be required to follow their rules for refills which may require mail in forms, 90 day prescriptions, paper prescriptions.
Who knew getting a refill could be so complicated, right? The game changer here is prescription medications that require a paper prescription. These would controlled substances. Depending on the type of controlled substance, your physician may be limited to a 30 day prescription at a time with no refills and required to send the paper prescription with you to the pharmacy vs. faxing or calling in the order. You will be required to maintain routine office calls to continue to receive this type of prescription. If you take a medication for pain that is on the controlled substance list, such as Lortab, you will have to coordinate with your physician office how to manage subsequent prescriptions of the same drug.
As for non-controlled drugs, ask each medical office what their preferred method for refills is to cut down on confusion and frustration. Since I have multiple specialists, I started out by writing a note like, “Pharmacy to fax refill” in my address book. Now that I have transferred my address book to my smart phone, I write the note in my contact list and it serves as a quick reminder to ease communication for timely refills.
I cannot stress the importance of using ONE pharmacy! There are patients who are addicted to prescription medications who use multiple pharmacies in order to hide that they fill multiple addictive prescriptions. Sometimes, people don’t even realize the danger because they use the pharmacy closest to the prescribing physician office for convenience and/or they use several pharmacies in their home town.
Polypharmacy is a term used to describe the practice of taking multiple medications, usually more than 5 prescriptions a day. Most of us with chronic illness fit that label. When you take a lot of medications, it is a very dangerous practice to use multiple pharmacies as pharmacies check your current medication list against any new prescription for drug interactions and known allergies. There are MANY medications that can be dangerous, even life threatening, when taken in combination!
With the opiate addiction problem in the USA there many states are adopting legislation for pharmacies to share your medication list in a state database so you can’t abuse prescriptions. Sadly, using multiple pharacies even if you are not addicted to prescription medication can get you labeled as someone who is a “drug seeker” as this practice is common among addicted patients.
I personally use a pharmacy that has a drive through located in my home town. I like the drive through because during cold and flu season or an outbreak of infectious disease, I am more protected from illness in my car vs standing in line inside the store. For those of us that are immunocompromised, it is essential we stay away from crowds of sick people. I also know my pharmacist and feel that I can ask him anything about my medication regimen. It is important that your pharmacist have time to consult with you so that you understand your prescription(s). So, in chosing a pharmacy be sure to consider your immune status and think about those pharmacies that have drive through windows, home delivery, or mail delivery.
I hope you have enjoyed this first article on medication management. Be sure to look for the next articles in this series in the coming weeks: Part 2 – Cost; Part 3 – Med Box, Part 4: Injections, Part 5: Infusions.