1. Medication Management

2. Medications and You Know your medications and how to take them

3. Goals for Optimal Medication Management  Create a system that helps you remember to take your medications  Carry an up-to-date list of all your medications  Discuss any medication concerns with your health care team  Understand what your medications are for and how to take them

4. Results of Mismanagement Emergency department visits – Drug safety issues make older adults 2x more likely to end up in the emergency department – 700,000 ER Visits are due to adverse drug effects http://www.redorbit.com/news/health/1287308/more_presc riptions_cause_greater_confusion_for_seniors/#WfDy XjTBVQ4VKAuM.99 http://www.cdc.gov/medicationsafety/basics.html

5. Results of Mismanagement Hospital admissions – Common factor for hospital readmissions – 120,000 hospitalizations are due to adverse drug effects annually http://www.cdc.gov/medicationsafety/basics.html

6. Results of Mismanagement Nursing home admissions – Medication non-adherence accounts for nearly one-fourth of nursing home admissions http://adultmeducation.com/index.html

7. Reducing Medication Mismanagement Adherence Communication

8. Pill Boxes

9. Notebooks

10. Reminder Notes Take your blood pressure medicine!

11. Caregiver Assistance

12. Adherence Aides Reminder Phone Calls SmartPhone Applications

13. Storage of Medications Review storage information on prescriptions (ex: insulin) Do not store medications in the bathroom Keep each family members’ medication separately to avoid mixups Keep medications out of reach from children and pets Check expiration dates routinely and throw out medications past their dates Keep narcotics in a safe place and out of the hands of children and misusers.

14. Disposal of Medications Poison Help Line = 1-800-222-1222 Throw out expired and/or discontinued medications – Take-Back boxes at police department (Thurmont, Brunswick) – 110 Airport Drive (police mall) – 100 West Patrick St (court house) FDA recommends flushing small number of medications (see separate list)

15. Reducing Medication Mismanagement Communication

16. Medication List Include all prescriptions, over- the-counters, herbals, and supplements Keep up-to-date Carry list at all times (wallet, phone) Share with all health professionals including your pharmacist and physicians Ask doctors to print one for you, especially after medication changes.

18. Prescription Medications Try to use one pharmacy. Be careful of automatic refills. Be aware of proper time and use. Look for capsules or tablets that differ from others in the container. Do not combine bottles. Review all your medicines yearly. Do not take medicine in the dark. Do not share prescription medications.

19. Read Your Labels

20. Over the Counter (OTC) Medications Know which OTCs can cause problems with your medications and disease states: – Pain medicine, laxatives, cold medicines, and antacids Compare the active ingredients in OTCs: – Many drugs contain the same active ingredient. – It is easy to take more than is safe Unsure? Ask the pharmacist

22. Medication Questions to Always Ask 1.What is the name of the medication? 2.What is the medication for? 3.How and when do I take the medication? 4.How long do I need to take the medication? 5.Do I need to stay away from any food, drinks, other medicine, or activities while I take this medication? 6.Are there any side effects? 7.What do I do if side effects occur? 8.Is there any special monitoring for this medication? 9.If I can’t afford the medication, what help is available? 10.Where can I find out more about the medication?

23. Managing the Cost of Medications Know your health plan’s pharmacy benefits Know your preferred pharmacy Community pharmacy Mail order pharmacy

24. Affording medications Inquire about lower cost alternatives Ask for samples Know your preferred pharmacy Goodrx.com – Compares pharmacy costs and provides medication coupons Needymeds.org – One stop site for manufacturer coupons and patient assistance applications Medicare recipients – Reassess insurance plan every year – Check into eligibility for Extra Help

25. Community Resources Helping with Cost of Medications – Religious Coalition 27 Degrange Street Frederick, MD 21901 301-631-2670 Hours: Monday, Wednesday-Friday 10am-2pm Tuesday 10am-4pm

26. Community Resources Helping with Cost of Medications – Mission of Mercy 22 South Market Street Suite 6D Frederick, MD 21701 301-682-5683 www.amissionofmercy.org – Community Action Agency 100 South Market Street Frederick, MD 21701 301-600-1506

27. Community Resources Helping with Cost of Medications for those with Medicare Part D – Department of Aging 1440 Taney Avenue Frederick, MD 21702 301-600-1605 Hours: Monday-Friday 8:30am-4:00pm

28. Community Resources Your Community Pharmacist

29. Community Resources Professional services

30. Community Resources Care Coordinators

31. Community Resources Prescribers

32. Internet Resources Information about taking medications http://www.cdc.gov/MedicationSafety/Adult_AdverseDrugEvents.html http://adultmeducation.com/index.html http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm164616.htm http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedi cineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm18618 7.htm#MEDICINES http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedi cineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm18618 7.htm#MEDICINES Saving on medications www.Goodrx.com www.needymeds.org

33. Summary Take medications as prescribed. Don’t self treat, and don’t stop medications on your own. Store your medications safely. Dispose of medications safely. Create and carry an updated list of all medications Share your medication list Know why your take your medications. Talk to your health care team for concerns or questions.

34. Questions