The Centers for Disease Control and Prevention estimates that nearly 70% of American adults ages 40 to 79 have used at least one prescription medication in the last 30 days.1 That number may not be too surprising.
But this one might be: More than 22% of U.S. adults have used five or more prescription medications in that same time frame.1 That’s a lot of pills to juggle.
So is there anything you can do to make it easier on yourself?
Thankfully, yes. There are multiple resources that can help you streamline a complex medication regimen, says Nicole Brandt, PharmD. She’s a clinical pharmacist at MedStar Center for Successful Aging. She’s also executive director of the Peter Lamy Center on Drug Therapy and Aging and a professor of pharmacy practice and science at the University of Maryland School of Pharmacy.
What is a medication regimen?
What does Brandt mean by a “medication regimen?” The term medication regimen is used to define the medication plan designed by you and your clinician to address your medical needs. Simplifying your medication regimen can be a crucial step in making your treatment less burdensome.
How to tackle a complex medication regimen
1. Use a medication reminder system
These systems include pillboxes, blister packs, pill packs, and apps.
- Pillboxes: If you’re taking multiple medications, you may want to try using a pillbox — and thanks to modern technology, it can help you in a number of ways. Nowadays, electronic or smart pillboxes can be programmed to alert you to take your medication at set times during the day. Others go even further by recording which pills you took and letting you know when you’ve left your medication at home.
- Blister packs: Some pharmacies will put your medication in blister packs. Usually, these packs put all of the pills you’ll need to take at a specific time of day into one blister together. That way, you’ll have all the meds you need for each time of day, as opposed to just having an individual dose. “Sometimes there’s a small cost, and sometimes it’s free,” Brandt says. Be sure to check with your pharmacy.
- Pill packs: This option is gaining popularity with larger national as well as local pharmacies. Pill packs make medication a cinch — each package includes all the meds you need to take at a certain time of day. They’re even labeled with the date and time to take them. The packs are shipped monthly, so ideally you never run out. Ask your pharmacist if pill packs may be an option for you.
- Medication reminder apps: If you’re tech-savvy (or your caregiver is), apps are a great way to remember to take your medication. But keep this in mind: “They only work if you incorporate them into your day-to-day activities,” Brandt warns. Some of her patients use phone alarms or voice-activated tools such as Google Assistant or Alexa to remind them. Examples of other apps that can assist with medication reminders include Medisafe, Mango Health, and Round Health.
As with anything, you’ll need to find which system works best for you. And it may be a combination of resources. Brandt says what helps you most may depend on how comfortable you are with technology and what sort of support system you have.
2. Stick with a single pharmacy
If your prescriptions are coming from more than one pharmacy, it could help to get them all transferred to one.
“By working with one pharmacy, it can help to not only avoid drug-drug interactions, but it can also establish a relationship with a pharmacist and their staff,” says Brandt.
Your pharmacy can also help you synchronize your medications.
“Medication synchronization is a simple service where the pharmacy coordinates your refill schedule so you can pick up all of your medications at once,” Brandt explains.
This is especially helpful for older adults with limited mobility or limited access to pharmacies. You can pick up all your refills at one time or have them mailed or delivered to you.
3. Explore automatic refills
Some pharmacies offer automatic refills, in which a patient gets their refills sent to them on a recurring basis. While these can be extremely helpful, Brandt offers a caveat: If you change any of your medications, make sure your pharmacy knows not to deliver the old one.
“We’ve helped patients get automatic refills, but some of them stockpiled the medicines they weren’t using,” she says. “Their families would visit and find six months’ worth.”
If your doctor changes your dosage or prescribes you a different drug, make sure to update your automatic refill information with your pharmacy. You could wind up with a cupboard full of pricey prescriptions you don’t need, and this may even present a danger to other adults, children, or pets in your household.2
4. Do an annual medication checkup
At your annual wellness checkup, Brandt says it’s crucial to review your medication regimen with your healthcare provider. It’s a good idea to go over your prescriptions with your pharmacist too. Ask yourself questions like these ones before you sit down with them:
- What are your health care goals?
- Has your financial situation changed?
- Do you still need all your medications?
- Could some symptoms you’re having be related to medication side effects, drug-drug or gene-drug interactions?
- Are you experiencing any other negative side effects?
- Could your lifestyle or eating habits influence your response to your prescription?
A thorough medication review “helps us as the health care team to better understand the medication-related needs of our patients,” says Brandt.
5. Talk with your doctor about potential risk factors like drug-gene and drug-drug interactions
If you’re regularly taking multiple prescription drugs, it could put you at a higher risk of experiencing an adverse drug event (ADE), or a harmful reaction to one or more drugs.3 For example, this could happen when one drug adversely impacts the way your body metabolizes another one.
You could also experience an ADE because of something you are probably less familiar with: your genes. “Certain medications may be metabolized differently based on your genetic makeup,” Brandt explains. “We have been utilizing [genetic testing] as yet another tool to improve medication safety and optimization.” How quickly you metabolize a medication can help determine whether it will work well for you, says Brandt. Your metabolism rate may also affect your risk of negative side effects.
Below are examples of medications that can have a potential drug-gene interaction:4
- Blood thinner or antiplatelet medications (such as warfarin and clopidogrel)
- Antidepressants (such as escitalopram, sertraline or paroxetine)
- Antiseizure medications or mood stabilizers (such as carbamazepine)
- Tamoxifen (treats breast cancer)
- Statins (such as simvastatin)
- Opioids (pain relievers, such as codeine or tramadol)
So how can you avoid experiencing a drug-drug or drug-gene interaction? Ask your doctor about assessing your medication plan for these types of interactions on a regular basis. One way to do this could be through pharmacogenomic testing (it’s also referred to as pharmacogenetic or PGx testing) by companies like Genomind. It tests how your genes may affect the way your body responds to certain drugs.
Another way could be through your doctor utilizing tools such as Genomind’s precision medication management software. It’s a medication management platform designed to work with PGx testing and help doctors evaluate potential drug-drug-gene interactions in one composite view. The database includes 99.8% of prescriptions written annually in the US. Ask your provider if Genomind’s services could be right for your treatment plan.
- 70% adults have used 1+ prescription medication in <30 days; 22% adults have used 5+ prescription medications in <30 days: Prescription Drug Use Among Adults Aged 40–79 in the United States and Canada (2019)
- Background information on stockpiling drugs: Medication Stockpiling (2019)
- Information on Adverse Drug Events: Adverse Drug Events in Adults (2017)
- Drugs that can cause drug-gene interactions: Pharmacogenetic Tests (2021)