Allercy and Asthma Health
The Official Publication of AAN - MA

Brown Bag Check-Up: A Great Way To Help Your Doctor Make Sure You're Getting the Most Out of Your Medications

by Melaine Giordano, MS, RN, CPFT


A customer picks up a topical cream prescription and reads the directions: "Apply locally two times a day."

The customer returns to the pharmacy and says to the pharmacist: "I can't apply locally, I'm going overseas."

That may be an old joke, but it points up a very real problem for many people: medications are prescribed to treat our ailments, but only about 50% of us use those medications according to our doctor's orders. Nearly 33% never take the prescribed medication at all.

Health care workers call this "non-adherence," and it's especially troubling for those with chronic lung conditions like asthma because the longer a medication is to be taken, the less likely it is that a patient will adhere to the prescription routine. While short-term medication compliance is approximately 65%-75%, compliance drops to just 25% for long-term medication therapy.

More meds, more problems

Older people with asthma may be most affected by adherence problems because in addition to their asthma meds, they usually have prescriptions for other conditions as well, and the more medications someone takes, the less likely they are to take them correctly. Often these medications are prescribed by a number of different doctors too, who may or may not know what other medications the person is taking — and that can raise a whole host of additional problems.

For example, studies show the risk of drug interactions is about 6% when taking one medication, about 50% when taking two medications, and 100% when taking 10 medications. So older adults who take several different medicines have an increased susceptibility to adverse drug reactions.

Bag them up

How can you ensure you are taking your medications correctly and increase the odds all your doctors know which medications you are on and why?

A good first step is to conduct a "brown bag check-up." Before you go to any doctor's appointment, gather up all of your medications, including any over-the-counter vitamins, teas, herbs, and supplements, and put them into a bag or other container. Then give the bag to your doctor so he or she will have a clear picture of the medications you are taking.

These brown bag assessments will help your doctor decide if each of your medications is still needed and will also prompt him or her to go over medication adherence with you and look for potential drug interactions.

It worked for my mom

I personally saw how well this approach worked with my mother. Her brown bag check-up resulted in several changes in her medications, how she took them, and how often she took them. After her doctor placed a call to her other physicians, my mother was able to decrease her medications from eight down to four.

Her doctor helped her take her medications as directed by suggesting that she time each dose to correspond with a daily activity. Now she takes her medications at breakfast and with dinner rather than three times a day — and that's much easier for her to remember.

At the conclusion of the visit, her doctor also gave her a written list with the name of each medication, why she was taking it, and when she should take it.

Following doctor's orders can lead to a healthier you

Working with your doctor to learn more about your medications, and adopting some proven techniques to take them correctly, will help eliminate adverse drug reactions and trips to the emergency room.

It will improve your quality of their life, too, because now that you'll be taking your medicines just as your doctor ordered, you'll be getting all the benefits they are intended to deliver.

Melaine Giordano, MS, RN, CPFT, is a member of the American Association for Respiratory Care and works in Dallas, TX.

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