Dr Susan Connelly: Problems with multiple medicines (II)
Listen to patients and health professionals speak about their experience with taking multiple medicines.
Dr Susan Connelly
Main occupation: Geriatrician (specialist in aged care)
Years in clinical practice: 20
Qualifications: MBBS, FRACP
Dr Susan Connelly, geriatrician, describes some of the most common problems she sees in her older patients.
Dr Connelly:
I guess one of the most difficult ones is probably eye drops after eye surgery, in an older person who may have dexterity problems. They actually can't, because they may have arthritis or whatever … where they can't actually squeeze the eye drops. They can't coordinate the drops. Just on a purely practical level, there's not always someone that can do it for them. I find that quite fascinating. I think with the move these days to minimise time spent in hospital ... these sort of patients, once upon a time, would have been in hospital for the first two days after their operation, where there four or five times a day eye drops could actually be put in by a nurse. That's now translated to being done at home. That's a problem.
That's, I guess, a very specific example, but certainly from a resource point of view, like, a district nurse can't pop in five times a day. What else? I guess applying creams to inaccessible areas is another one. I guess, again, it relates to dexterity ... actually being able to open some of the containers, and I know that's an issue that a lot of the pharmaceutical companies try and address, like making packets easier to open. A lot of the packets are not that easy to open, even for those of us that are a bit younger. Even patients popping their medicines out of the Webster-pak is not that easy, in some instances.
Swallowing large tablets, for example the calcium tablets. They're massive! Often referred to as ‘horse tablets’ by patients! There are so many things and so I'll listen to my patient ... what's their biggest gripe? There'll often be something that they'll have a gripe about. So it's, ‘OK. Can I do something about this? Can I change this somehow, to make it more manageable?’ It's very much an individual scenario …
Jacqueline:
So what would be your take-home message to people who were having problems with managing all their medicines?
Dr Connelly:
I guess, number one, define what is the problem you're having. Is it a dexterity problem? Is it a memory problem? Is it an access problem? Is it you feel like you are taking too many tablets? What is the problem that you're actually having? Is it [that] you feel like the tablet's making you feel sick? Is it a specific tablet or it's since you commenced on that tablet? Is it a side effect of that tablet or is it that tablet interacting with the tablets you're already on?
So, I guess, number one is define the problem and then go and talk to your doctor about it, because it may be that a tablet's not absolutely necessary, perhaps we can try an alternative formulation; perhaps we can rationalise things.
The Living with multiple medicines project was developed in
collaboration with Healthtalk Australia.