Navigating the Health Care System

Advice Columns from Dr. Carolyn Clancy

Former AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.

We take more medicines than ever to maintain or improve our health. But over the last decade, many baby boomers and seniors have ended up in the hospital because the medications they expected to help them actually hurt them.

Many medical problems now can be treated with medicines that were not available just a few years ago. But taking more medicines can also result in some unexpected reactions, especially for people who take several drugs. Bad reactions to medications are on the rise, according to a new report by my agency, the Agency for Healthcare Research and Quality (AHRQ).

Between 1997 and 2008, hospital admissions doubled among Americans aged 45 and older for medication and drug-related conditions. These hospital admissions include the effects of prescription and over-the-counter medicines as well as illegal drugs.

This increase has been driven by three types of medication and drug-related conditions:

  1. Drug-induced delirium, which is general confusion and agitation caused by drugs. Common causes are drugs for sleeping, nausea, and pain. Elderly patients are more sensitive to medicines than younger adults.
  2. Poisoning or overdose from codeine and other narcotic medicines. Bad reactions from narcotic pain medicines are especially common in older adults.
  3. Withdrawal from prescribed medicines or illegal drugs. Drug withdrawal occurs when someone suddenly stops or takes much less of a drug after being on it for a long time.

We're working to prevent hospital admissions due to medication use. Together with the U.S. Food and Drug Administration, AHRQ oversees a program that identifies medication problems and finds solutions.

You can lower your chance of problems with your medication. First, don't take medicine that is not prescribed for you. Also, remember that it is not safe to drink alcohol when you take medicine for sleeping, pain, anxiety, or depression.

As we age, drugs can affect us differently. We may need to change medications or adjust dosages. As an active health care consumer, talk with your doctor about your medications, how they work, and potential side effects. Don't be afraid to ask questions. Many medication errors are discovered by patients.

To reduce your chances of complications from medicine, use this checklist:

  • Bring a list or a bag with all your medicines when you go to your doctor's office, the pharmacy, or the hospital. Include all prescription and over-the-counter medicines, vitamins, and herbal supplements. Remind your doctor and pharmacist if you are allergic to any medicines.
  • Ask questions. Ask your doctor or pharmacist to use plain language. It may also help to write down the answers or bring a friend or relative with you.
  • Make sure your medicine is what the doctor ordered. Many drugs look alike and have names that sound alike. Check with your doctor or pharmacist to be sure you have the right medicine. If you are getting a refill and the medicine looks different, ask the pharmacist about it.
  • Learn how to take medicine correctly. Read the directions on the label and other paperwork you get with your medicine. Medicine labels can be hard to understand. Ask your pharmacist or doctor to explain anything you do not understand. Are there other medicines, foods, or activities (such as driving, drinking alcohol, or using tobacco) that you should avoid while using the medicine? For example, ask if "four doses daily" means taking a dose exactly every six hours or just during regular waking hours. Ask what "take as needed" really means.
  • Find out about possible side effects. Many drugs have side effects. Some side effects may bother you at first but will get better later. Others may be serious. If a side effect does not get better, talk to your doctor. You may need a different dose or a different medicine.

Make your medicines work for you-not against you. By taking steps to get the best results from your medicines, you can help prevent problems.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

More Information

AHRQ Podcasts
Prescriptions: Play it Safe (Transcript)

20 Tips to Help Prevent Medical Errors
http://www.ahrq.gov/patients-consumers/care-planning/errors/20tips.html

Food and Drug Administration
Safe Use of Medicines for Seniors
http://www.fda.gov/Drugs/ResourcesForYou/Consumers/TipsforSeniors/default.htm

Page last reviewed December 2010
Internet Citation: Don't Let Medicines Cause Harm. December 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/120710.html