Checkup

Managing medications

Pharmacists and physicians like Jen Rothenberg and Bryan Farford, respectively, work together to ensure that patients get the most out of their medications.

Pharmacist consults help patients with their pills

For more than a quarter of all American adults, taking multiple prescription medications each day is a way of life, according to the American Society of Health-System Pharmacists (ASHP). Factor in the millions who also take nonprescription medications like aspirin, acetaminophen and ibuprofen and an herbal supplement here and there, and remembering to take the pills may not be the biggest problem. Drug interactions, side effects and cost start becoming issues the more medication a person juggles.

Jacksonville resident Joan Jacobs, 58, takes more than four prescription drugs in addition to two herbal supplements. Because she was taking several medications, her primary care physician at Mayo Clinic suggested an appointment for a one-on-one consultation with a pharmacist in Mayo Clinic's Pharmacy Department. He wanted her to gain a better understanding of her medications and supplements and how to take them most effectively.

During the one-hour meeting with the Mayo pharmacist, Jacobs learned that the six to eight ibuprofen pills she had been taking each day for headaches had been causing her to bruise easily. She cut back and the bruising stopped. She also learned that one medication could cause another to be less effective if she took them together. The pharmacist also discussed the pros and cons of the herbal medicines Jacobs was taking, pointing out that one of the herbal supplements might be contributing to an elevated laboratory value. Following the consultation, the pharmacist provided a summary of the discussion to Jacobs' physician.

"The consultation was very helpful to me," says Jacobs. "It helped that the pharmacist had my medical records and medications in front of him, too."

Pharmacy director Dr. Deborah Crumb says the consultation service was started to help patients get the most benefit from their medications. By having an opportunity to discuss medications one-on-one with a pharmacist, patients can maximize the benefits and minimize the pitfalls of managing their medications. The pharmacists, she says, are specially trained to provide comprehensive medication therapy reviews.

"These consultations are meant to supplement the information that patients get from their physicians or even local pharmacists," says Crumb. "Research shows that patients who receive individualized medication consultations with a pharmacist have fewer problems with their medications, better treatment results and lower health care expenses."

Mayo Clinic bills insurance plans for the consultations and some plans, such as the Medicare Prescription Drug Plan (Medicare Part D), may cover the cost in certain situations. Crumb says patients are advised to check with their plans for more information on coverage.

The consultations are scheduled through a Mayo Clinic physician.

"Patients have a unique opportunity to become more involved in their health care by meeting with a pharmacist and thoroughly discussing their medications," says Mayo pharmacist Dr. Jennifer Rothenberg. "We work as a team with physicians so we can optimize the care each patient receives, and we communicate with the patient's physician after each consult to provide our recommendations. Spending this time with patients is rewarding for me, and I enjoy helping them improve the use of their medications."

Jacobs says the information she received about her medications has made pilltaking a bit easier to swallow.

"It's really helpful," she says, "especially if you're taking three or four medications. It's good to know what they're all doing to your system."

Consultation Topics

The following topics may be addressed during a pharmacist consultation:

• Individualized counseling related to prescription, nonprescription and herbal medications
• Getting the most benefit from medications
• Identifying and minimizing problems, including possible side effects and drug interactions
• Reducing expenses by using medications correctly, avoiding side effects and using generic drugs
• Developing a customized plan and timetable for taking medications
• Help with drug therapy devices such as peak flow meters, blood glucose meters and blood pressure monitors

Info
Mayo Clinic Pharmacy
(904) 953-0404