Practical strategies for handling prescriptions, side effects and routines.
Part 2: “The pill box and the non-negotiable meds”
Written by Leigh-Ann Richards, Occupational Therapist
Leigh-Ann Richards is a Senior Clinical Educator in the Department of Health and Rehabilitation Sciences in the Faculty of Health Sciences, Occupational Therapy Division.
When it comes to medication there are quite a few points you should be aware of. The one is sometimes the ingredients inside the medication have got a different name to the name of the medication on the box or on the packet. So, the ingredient name will never change but the name of the medication might change. For example, you might find medication that the ingredient is paracetamol, so paracetamol is the ingredient, but the name might look different. You might have a name like Tylenol, Panado or Block Pain; it comes in different names. That is important to know, and as a pharmacist they will obviously know all of this information, but just be aware of that. You might go to one facility, and they might give you Panado and you might go to another facility, and they give you Tylenol. Please do not think it is a different medication, it is the same medication, has the same ingredient but just has a different name.
Another point is that you get things called original medication, I think that is the right word and then you get generics. Generics are exactly the same as originals, they just have a different name and made by a different company. So, don’t be fearful if a pharmacist says to you, “would you like the generic?”. Generic medication has the same ingredients and is often a little bit more affordable than the original medication.
The next point is taking note of your medication. In this little book that I spoke about earlier on, first thing I said is you ask what your diagnosis is and the second thing you need to know is what is the medication that I need to take.
Now pharmacists and doctors, they have a really secret language that they use, they use numbers and letters and all sorts of things. It is often very difficult to understand their writing so in your book this is where you need to ask the professional in front of you the name of your medication, how often must I take it and how many must I take. Sometimes different medications have different forms, sometimes the doctor may say you need 5 milligrams and that will come in one tablet, maybe the doctor says you need 15 milligrams and that may be 2 and a half tablets. So, all of these things you need to ask, and you need to put it down in your book.
Another point to consider when it comes to medication is to think about what the things are I need to put in place to make sure I can take my medication at the right time, the right amount on a daily basis. A wonderful way in which to do this is to get a little pill box. You get pill boxes in all different shapes and sizes. You get ones that are Monday to Sunday, just one square; you get ones that are Monday to Sunday, a square in the morning and a square in the afternoon. You even get one that come in a huge box like an A4 page where it’s got 30 squares, one for each day and so on and so forth. You can find these everywhere, Clicks, PicknPay, Osmans, China Town, anywhere and they are quite helpful. If you are able to manage your medication on your own, you are able to remember and understand your medication, its unlikely that you will forget to take it.
But if you are taking more than 5 medications per day, I would recommend that you actually see if you can access a service where a professional pharmacist assistant will actually pre-pack your medication for you. Because some medication must be taken in the morning and some in the afternoon and some must be taken at night, you cannot change this. So, it is really important if you can access a service where your medication can be pre-packed. I know that there are some pharmacies that offer this service, it is something that you have to pay for. I know Dischem charges R130 a month and the pharmacy assistant will pre-pack your medication for you and they will actually deliver it to your house once a week. It is very easy to set up, the pharmacist gives you a reference number, the bank details of the Dischem pharmacy and you just need to pay the money upfront, then once a week your medication will be delivered to your door for R130.
For a lot of people that is unaffordable so if you are going to go the other route of managing your own medication, I strongly advise that you use the information you got from the doctor in that book and you study it very closely and make sure you put the right pill in your little container. This is so that you make sure you take the right tablet at the right time, with the right amount of tablets on a daily basis. Another point to consider is that if you don’t have a very good understanding of medication, it can get quite scary when you maybe for some reason you miss a tablet. It is really important that when you have a conversation with your doctor for them to explain to you what each tablet is for. It is important to know this because there are some tablets where it is non-negotiable, it has to be taken every single day at the same time. But there are medications that you can give or take 6 hours or so and so you want to know which tablets are, you know if you took it late it is not going to be a big deal, you are going to get the next dosage the next day. You want to know which tablets you must make a little star next to so that you know that these are non-negotiable, and you cannot miss this dosage.
It is those type of things that really help and make it easier for you to manage at home because sometimes, I know for example with my father, there are some medications that we missed and we were panicking and the doctor said to us don’t stress, even if you skip a day, it is not a big deal. It is important to know upfront the non-negotiable meds that cannot be missed and the ones where there is a little bit of leeway if you miss it. Because life happens, we cannot always remember to do the same thing at the same time. I also know of some public facilities, clinics or day hospitals where they also offer a pre-pack service. I know during Covid they used to deliver to people’s doors, I don’t think that is happening anymore. But I do know there is some sort of service where you don’t have to stand in a normal que, you can actually go straight to the pharmacist, and they have the pre-pack for you ready to just pick-up and go.
So, find out from your local clinic or day hospital what type of services they offer in terms of managing chronic medication, and write it down in your book. Another point is that when you go for checkups with your doctor, your doctor will typically take your blood pressure, maybe your glucose, maybe cholesterol whatever tests they are going to do, and the doctor might come to a decision to adjust your medication and now this is where your book is very important. Because adjusting medication there is often miscommunication between the doctor and the pharmacist, and your book is going to be the thing that could possibly clarify miscommunication. For example, if you were taking 5 milligrams but now the doctor wants to give you 7,5 milligrams and maybe the doctor says you know what I don’t want you to be taking 7,5 milligrams for 6 months, I want to try it out for 2 weeks and doctors often do this, and this is a nightmare for caregivers.
Yeah, so you try it out for 2 weeks but your chronic script says 5 milligrams for 6 months, so what is then helpful is if you put this in your book and when you go and collect your meds in the pharmacy you explain that this is a temporary try out of 7,5 milligrams that you will be reporting back to the doctor to see how it affected you or how it helped and then the doctor will make the final decision whether to stick to 5 milligrams or 7,5 going forward.