Linda's story: Living with multiple medicines

Linda is manager of a residential aged care facility. She lives in Melbourne with her husband and children.

Some medicines are taken regularly; some are taken only as needed.

• Mesasal (mesalazine): Crohn’s disease
  
• Colifoam enema (hydrocortisone): Crohn’s disease
  
• Lipitor (atorvastatin): high cholesterol
  
• Aspro Clear or generic (aspirin): temporarily until Linda has an exercise stress test
  
• Vitamin D: deficiency.
  

Sulphur.

• Hormone replacement therapy (HRT; Tibolone)
  
• Predsolone (prednisolone): Crohn’s disease
  
• Salofalk (mesalazine): Crohn’s disease
  
• Salazopyrin (sulfasalazine): Crohn’s disease
  

Linda has extensive nursing experience and has seen patients experience serious side effects from long-term use of some medicines. Consequently, she needs strong evidence that a prescribed medicine is necessary for her. She also does not like taking more than two tablets per day, although she acknowledges this is not always logical. Forgetting to take her medicines is another issue; the only way she remembers is if they are stored where they are clearly visible. Linda has recently commenced a slow-release tablet for Crohn’s disease that has reduced the number of medicines she takes, which is more acceptable and easier to manage. As a result, she is better able to control symptoms and is feeling better.

More about Linda

Linda has had high cholesterol since her early 30s, but the condition that has the greatest impact on her life has been Crohn’s disease, which was diagnosed a little more than a year ago. Linda has had significant perirectal bleeding and has tried a number of medicines for this; she started the mesalazine a week before the interview. She is not currently taking statins regularly, although she knows she should be. Having many years’ nursing experience, Linda has seen some of the alarming consequences of long-term medicines which discouraged her from taking statins. Linda has no problem taking vitamin D regularly as she does not perceive the same negative long-term consequences.

The number of medicines she has to take is a major obstacle for Linda: four tablets are harder to take than two and she just does not want to take them. She finds it easier getting used to her medicines if she starts them one at a time and establishes a routine before introducing the next one. Now that she has her medications for Crohn’s disease established, she is thinking about taking statins more conscientiously. She is now postmenopausal and has not altered her diet, so she feels she may not ‘get away with’ avoiding statins for much longer. Another obstacle for Linda is the difficulty, messiness and inconvenience of the Colifoam enemas. Some of her medicines are costly and, as Linda is from the UK, she is not used to having to pay so much for her medicines. Since changing to slow-release tablets she has been able to reduce the number of tablets and can take them all in the morning before the day begins. This has made it easier for Linda to remember to take her medicines, which means she now has some relief from the symptoms of Crohn’s disease. The new medicine also appears to have reduced postmenopausal hot flushes, so she has not taken HRT for nearly a week and feels so much better. Linda also finds the only way she will remember to take her medicines is if she keeps them on the kitchen bench where they are in plain sight.

Linda also finds it difficult to comply with medicines when she cannot see or feel the consequences of not taking them. At times, Linda will decide for herself that she is not going to take a prescribed medicine, particularly if she experiences an unpleasant side effect: she stopped taking Salazopyrin of her own accord when it turned her saliva yellow. Linda does not always discuss these changes with her doctor, but she has discussed some of her medicines with her pharmacist and will often raise things with a pharmacist at work for whom she has a great deal of respect. Linda has particular confidence in pharmacists, as they have specialist knowledge in medicines.

As a nurse, Linda knows that she is not compliant with her medicines and describes this attitude as ‘ridiculous’ at times. However, if she is going to be comfortable taking multiple medicines, she needs a persuasive argument and convincing evidence that each medicine is necessary for her.

View list of other people taking multiple medicines