FRIDAY, July 9 (HealthDayNews) -- Before breakfast, it's one of the white oval pills. But only on Mondays.

Every evening, it's the other white oval one. Or is it the buff-colored trapezoid?

If you know an older American who has difficulty keeping track of her medications -- a parent or grandparent, perhaps -- it may be time to lend a hand. With a little assistance, she can stay healthy and avoid potentially harmful drug errors.

"One of the things that really causes the greatest difficulty is just the complexity of the medication regimen," said Daniel J. Cobaugh, director of the Section of Home, Ambulatory and Chronic Care Practitioners for the American Society of Health-System Pharmacists.

Research shows the average senior takes four prescription medications daily and fills 18 a year. Of course, people with multiple chronic conditions may take many more medicines each day. And when you add in any over-the-counter remedies or nutritional supplements that seniors rely on to relieve symptoms or improve their health, it's no wonder they sometimes get confused or have drug interactions that could pose serious health threats.

Complicated dosing regimens don't help matters.

People taking the blood thinner Coumadin, for instance, must be constantly monitored to ensure they're getting enough of the drug to keep their blood from clotting but not so much that they experience any unusual bleeding. Physicians may fine-tune the dosing by switching patients, say, from one tablet daily to one tablet four days a week and one-and-a-half tablets three days a week, Cobaugh explained.

There's also the risk that patients being treated by more than one physician will be prescribed a double dose of the same active ingredient or two drugs that interact negatively with one another.

Seniors having trouble understanding or remembering or whose health is declining are particularly vulnerable to medication errors.

The key, Cobaugh said, is communication: "Patients and caregivers need to make sure they're not afraid to ask questions of their physician or their pharmacist so their concerns are being addressed."

That's as true for people taking medicines at home as it is for seniors when they are being treated in the hospital.

More than a third of hospital medication errors that reach patients involve people who are 65 or older, according to a study released last November by the United States Pharmacopeia (USP), a non-profit group that promotes safe and proper medication use.

Almost 10 percent of those prescribing errors were harmful to seniors. The most serious mistakes involved medications administered by the "wrong route," for example, when oral medications were given intravenously.

"We often tend to take what's said by health-care professionals as a directive," noted Diane Cousins, vice president of USP's Center for the Advancement of Patient Safety. Instead, seniors and their families should be participating more with their medical team and asking questions.

"One of the things seniors can do is just state their name: I'm Diane Cousins. What do you have there for me today?" Asking questions forces the health-care professional to think twice. "We've seen errors avoided because the nurse stopped and looked at it," she said.

To avoid drug errors at home, USP urges seniors to fill all of their prescriptions at the same pharmacy. Pharmacists can watch for harmful drug interactions among multiple medications, for example. Seniors also should consider keeping a current list of all the prescriptions, non-prescription medicines and nutritional supplements they take.

Caregivers can help by looking over that list. If something's missing, ask about it, Cousins said. "Maybe there's some way you can intervene."

One way that caregivers can help is by making sure seniors receive the full therapeutic benefit of their medication, Cobaugh suggested. A once-daily version of a medication may be easier to manage -- and less likely to be forgotten -- than one taken three times daily, for example. Ask the pharmacist if there is a sustained-released formula that would simplify the regimen a bit, he said.

Caregivers also can help by tossing out expired medications and making sure new medications are stored in a cool, dry place -- away from heat or moisture that could cause them to deteriorate.

More information

To learn more about how you can help a loved one avoid harmful drug errors, see the Family Caregiver Alliance's Caregiver's Guide to Medications and Aging.



SOURCES: Daniel J. Cobaugh, Pharm.D., director, Section of Home, Ambulatory and Chronic Care Practitioners, American Society of Health-System Pharmacists, Bethesda, Md.; Diane Cousins, R.Ph., vice president, Center for the Advancement of Patient Safety, United States Pharmacopeia (USP), Rockville, Md.; USP's 2002 MEDMARX report and senior tip sheet

Last Updated: Jul-09-2004