A new health diagnosis often means a new prescription from your doctor.
In many cases, people who have one or more health conditions may need to take several different medications.
Wasim Chughtai, MD, is here to help you better understand the effects of taking multiple medications.
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Multiple Medications? Get the Help you Need
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Learn more about Wasim Chughtai, MD
Wasim Chughtai, MD, Holmes Lake Family Medicine, part of Bryan Physician Network
Dr. Wasim Chughtai is an internal medicine specialist with Homes Lakes Family Medicine.Learn more about Wasim Chughtai, MD
Transcription:
Multiple Medications? Get the Help you Need
Melanie Cole (Host): Like many Americans, you may have a few different conditions that require medicational intervention. Dealing with multiple medications each day for you or a loved one can be challenging but it’s not uncommon. What can you do to make it easier and a little safer? My guest today is Dr Wasim Chughtai, MD, with Homes Lake Family Medicine, part of Bryan Physician Network. Welcome to the show, Dr. Chughtai. What typically do you see as conditions that go together that usually require a group of medications?
Dr. Wasim Chughtai (Guest): Thank you, Melanie. In the elderly population, the conditions that we see and they can prevent at the same time within the short period of time are hypertension, diabetes, chronic kidney disease, arthritis, heart condition. It’s not uncommon to see these conditions at the same time in the elderly population.
Melanie: Especially with men, most men come up with some kind of a prostate issue as they get older and a lot of elderly, also, as you mentioned, have arthritis. Now we’re talking about medications for anti-inflammatories and BPH. What do you tell people, Dr. Chughtai, when they say, “Can I take all of these medications at the same time?”
Dr. Chugtai: When we talk about multiple conditions, we are talking about many medications. The thing I’m going to stress is that many of these medications have side effects. They interact with each other. If someone is taking a medication for arthritis, it can have an adverse effect on the kidney. So, you have to make sure that you are monitoring their kidney. Someone who takes a medication for heart and they have asthma or emphysema at the same time, those heart medications can make their asthma bad. Someone who has got a condition like incontinence--many of the incontinence medications can have an effect on the cognition of these patients. So, as a physician, you look at these multiple problems and you have to deal with the problems by giving the appropriate medication, but at the same time, you are looking at the interaction, the side effects of these medications. It becomes a little complex to make, in the sense that you have to have a therapeutic benefit from the medication but, at the same time, monitor and make sure that one treatment for one condition is not affecting the other condition in a bad way.
Melanie: Dr. Chughtai, who do you think the patients – if they’re going to be their own best health advocate – who would you say that they could look to, their internist or their pharmacist? Should they be keeping track of their medications as well? Or, if they have an allergist--somebody along those lines? Who can help them keep all of these medications straight?
Dr. Chugtai: For the best outcome, it has to be teamwork. The patient is at the center, there’s no doubt about it and then comes the patient’s internist, pharmacists. We all should work as a team. An internist is someone who has the knowledge and the experience to help these patients with the different diagnosis, treatment and the care of all of these multiple conditions that we are talking about. If you saying that how we can help the patient, then, yes, the internist is definitely in the picture. He guides the patient, he talks to the patient. He wants to make his patients more knowledgeable about all of these medical conditions, the drug interactions, the medications. That’s how I would put it. It’s teamwork. The patient needs to come and talk to the internist. The internist needs to talk about these conditions and medications.
Melanie: Then, we’re looking at your multiple medications and working with your internist in your medical home. What if you suffer side effects? Statins can have side effects of leg pains. So many of the medications that you have been discussing, Dr. Chughtai, have similar side effects. So, then what? Do tell your doctor about those side effects and how do you doctors determine which of the many that we’re on is causing that particular side effect?
Dr. Chugtai: You talk to the patient. You discuss the side effects. You do the lab tests. You do the diagnostic workup. We come up with the conclusion that if a particular drug is causing the side effect.
Melanie: Now, some advice for people – especially the elderly – some people get their prescriptions filled at many different pharmacies so no one person is keeping track in that line. They use those pill dispensers that we’ve all laughed at over the years but now they really make sense.
Dr. Chugtai: They make sense. We recommend and we advise the patient to use one pharmacy. We recommend patients to bring their list of medications when they come and see the physician. We make sure, at each visit, the medications are reviewed and we’ve reconciled those medications. We talk to the patient, making sure if they are taking their medication the right way. If they are taking the right medication – the doses. That’s what we do with every patient’s visit.
Melanie: What about helping with loved ones because the elderly? Sometimes it’s very hard for them to keep track of all of their medications even if they use a pill box and put their own medications in every single day. What do you tell the family members about helping this person to keep track? Should we be checking the medications? If they are on some kind of a pain management medication along with their arthritis medication or their heart medication. Are we, as the family, Dr. Chughtai, supposed to help them keep track?
Dr. Chugtai: If you have any family member, anyone in the family that can overlook and make sure that the patient is taking the medications the right way, that’s always useful. That’s always helpful. In many cases, we use the home health services where a visiting nurse would go and see these patients on a regular basis and make sure that they are taking the medications the right way. There are many ways that we utilize to make this happen. We use every resource that’s available, just like I mentioned about the visiting nurse. Our pharmacy is another source where we get information – if these patients are taking their medication the right way; if they are requesting the refills the way it should be done. All this helps us to make sure that the patient is compliant with their medication.
Melanie: What if they’re not compliant because adherence to medication is one of the bigger health problems that we have in this country. Give us your best advice, Dr. Chughtai, in managing those multiple medications and making sure that you’re taking them all when they are supposed to be taken, in the doses that they are supposed to and that somebody is helping you keep track of all of these different medications. Give us your best advice.
Dr. Chugtai: The best advice is to see your physician on a regular basis. We recommend a patient’s family to be involved in their care. We ask the patients to use whatever resources they have, like using a visiting home nurse, to make sure that they are complying. Anything that the patient wants to discuss about their medications, they are welcome to come and see us at any time.
Melanie: Thank you so much. It’s really, really great information and so important, Dr. Chughtai. Thank you so much for being with us today. You’re listening to Bryan Health Radio and for more information you can go to BryanHealth.org. That’s BryanHealth.org. This is Melanie Cole. Thanks so much for listening.
Multiple Medications? Get the Help you Need
Melanie Cole (Host): Like many Americans, you may have a few different conditions that require medicational intervention. Dealing with multiple medications each day for you or a loved one can be challenging but it’s not uncommon. What can you do to make it easier and a little safer? My guest today is Dr Wasim Chughtai, MD, with Homes Lake Family Medicine, part of Bryan Physician Network. Welcome to the show, Dr. Chughtai. What typically do you see as conditions that go together that usually require a group of medications?
Dr. Wasim Chughtai (Guest): Thank you, Melanie. In the elderly population, the conditions that we see and they can prevent at the same time within the short period of time are hypertension, diabetes, chronic kidney disease, arthritis, heart condition. It’s not uncommon to see these conditions at the same time in the elderly population.
Melanie: Especially with men, most men come up with some kind of a prostate issue as they get older and a lot of elderly, also, as you mentioned, have arthritis. Now we’re talking about medications for anti-inflammatories and BPH. What do you tell people, Dr. Chughtai, when they say, “Can I take all of these medications at the same time?”
Dr. Chugtai: When we talk about multiple conditions, we are talking about many medications. The thing I’m going to stress is that many of these medications have side effects. They interact with each other. If someone is taking a medication for arthritis, it can have an adverse effect on the kidney. So, you have to make sure that you are monitoring their kidney. Someone who takes a medication for heart and they have asthma or emphysema at the same time, those heart medications can make their asthma bad. Someone who has got a condition like incontinence--many of the incontinence medications can have an effect on the cognition of these patients. So, as a physician, you look at these multiple problems and you have to deal with the problems by giving the appropriate medication, but at the same time, you are looking at the interaction, the side effects of these medications. It becomes a little complex to make, in the sense that you have to have a therapeutic benefit from the medication but, at the same time, monitor and make sure that one treatment for one condition is not affecting the other condition in a bad way.
Melanie: Dr. Chughtai, who do you think the patients – if they’re going to be their own best health advocate – who would you say that they could look to, their internist or their pharmacist? Should they be keeping track of their medications as well? Or, if they have an allergist--somebody along those lines? Who can help them keep all of these medications straight?
Dr. Chugtai: For the best outcome, it has to be teamwork. The patient is at the center, there’s no doubt about it and then comes the patient’s internist, pharmacists. We all should work as a team. An internist is someone who has the knowledge and the experience to help these patients with the different diagnosis, treatment and the care of all of these multiple conditions that we are talking about. If you saying that how we can help the patient, then, yes, the internist is definitely in the picture. He guides the patient, he talks to the patient. He wants to make his patients more knowledgeable about all of these medical conditions, the drug interactions, the medications. That’s how I would put it. It’s teamwork. The patient needs to come and talk to the internist. The internist needs to talk about these conditions and medications.
Melanie: Then, we’re looking at your multiple medications and working with your internist in your medical home. What if you suffer side effects? Statins can have side effects of leg pains. So many of the medications that you have been discussing, Dr. Chughtai, have similar side effects. So, then what? Do tell your doctor about those side effects and how do you doctors determine which of the many that we’re on is causing that particular side effect?
Dr. Chugtai: You talk to the patient. You discuss the side effects. You do the lab tests. You do the diagnostic workup. We come up with the conclusion that if a particular drug is causing the side effect.
Melanie: Now, some advice for people – especially the elderly – some people get their prescriptions filled at many different pharmacies so no one person is keeping track in that line. They use those pill dispensers that we’ve all laughed at over the years but now they really make sense.
Dr. Chugtai: They make sense. We recommend and we advise the patient to use one pharmacy. We recommend patients to bring their list of medications when they come and see the physician. We make sure, at each visit, the medications are reviewed and we’ve reconciled those medications. We talk to the patient, making sure if they are taking their medication the right way. If they are taking the right medication – the doses. That’s what we do with every patient’s visit.
Melanie: What about helping with loved ones because the elderly? Sometimes it’s very hard for them to keep track of all of their medications even if they use a pill box and put their own medications in every single day. What do you tell the family members about helping this person to keep track? Should we be checking the medications? If they are on some kind of a pain management medication along with their arthritis medication or their heart medication. Are we, as the family, Dr. Chughtai, supposed to help them keep track?
Dr. Chugtai: If you have any family member, anyone in the family that can overlook and make sure that the patient is taking the medications the right way, that’s always useful. That’s always helpful. In many cases, we use the home health services where a visiting nurse would go and see these patients on a regular basis and make sure that they are taking the medications the right way. There are many ways that we utilize to make this happen. We use every resource that’s available, just like I mentioned about the visiting nurse. Our pharmacy is another source where we get information – if these patients are taking their medication the right way; if they are requesting the refills the way it should be done. All this helps us to make sure that the patient is compliant with their medication.
Melanie: What if they’re not compliant because adherence to medication is one of the bigger health problems that we have in this country. Give us your best advice, Dr. Chughtai, in managing those multiple medications and making sure that you’re taking them all when they are supposed to be taken, in the doses that they are supposed to and that somebody is helping you keep track of all of these different medications. Give us your best advice.
Dr. Chugtai: The best advice is to see your physician on a regular basis. We recommend a patient’s family to be involved in their care. We ask the patients to use whatever resources they have, like using a visiting home nurse, to make sure that they are complying. Anything that the patient wants to discuss about their medications, they are welcome to come and see us at any time.
Melanie: Thank you so much. It’s really, really great information and so important, Dr. Chughtai. Thank you so much for being with us today. You’re listening to Bryan Health Radio and for more information you can go to BryanHealth.org. That’s BryanHealth.org. This is Melanie Cole. Thanks so much for listening.