Keep track of pills for doctor's, your own sake

Published by Contra Costa Times

Posted on Sat, Mar. 06, 2004

By Dr. Stephen Daniels

"I take the pills you give me, doc. Isn't it in my medical record? Well, I don't take them every day, but most days ..."

This man has been my patient for a number of years. At each of his last three visits, I've encouraged, then asked, then warned him to bring his pill bottles to his office visits.Still he doesn't, and has numerous reasonable excuses: He came straight from work, he was running late and left them on the kitchen counter.

The patient has a number of serious illnesses: diabetes (high blood sugar), hypertension (high blood pressure), arthritis, high cholesterol and low thyroid levels. I've prescribed him eight different medications over the past few months, and other doctors he's seen have prescribed at least four more. And, he's been to emergency rooms twice in the past six months. I think they've prescribed him additional medicines, or changed his medication, but I'm not sure.

His illnesses are still not well controlled, which is dangerous. But I don't know exactly which medicines he is taking, so I'm afraid to change the doses or prescribe others.

He is busy and has lots of problems at home. He starts to tell me that he takes "half of the yellow pill, two white ones, one blue one ..." But that's little help.I don't know what color your pills are. The same medicines from different manufacturers have different colors. What if I prescribe you more medicine, but you aren't taking as much medicine as I think, or you are taking pills I don't know about? Then, if I give you new medicine or higher doses and you actually take them, you could overdose or mix medicines that conflict with each other. You've been to the emergency room, and you said they told you to change some of your medicines. I'm just not sure what's going on.

"Inaccurate or incorrect prescriptions are a major cause of mistakes that doctors make. But often these are a result of inaccurate communication between doctors and their patients. So bring your medicine bottles to all doctor visits, not just a list, and certainly not just your best recollection. You'd be amazed, and perhaps frightened, at the dangerous prescription misunderstandings that occur between patients and their doctors.

Another important practice is for patients to use a pill box with a separate receptacle for each dose of their regular medicines, for each day of the week. If you load your pill box once a week, or better yet have enough pill boxes for two or three weeks, it's easy to take the right pills. And, it gives you some indication if and when you forget to take your medicine. If it's Wednesday, and some Monday and Tuesday receptacles are still full, you've got a problem you need to fix. Otherwise, you may not even know you've forgotten to take them.

Something as simple as bringing all your medicine bottles to all doctor visits can improve your health care, by helping your doctor avoid making mistakes about you. And, using a pillbox makes taking your regular medicines quick, and helps you know if you are forgetting to take them.

Do your part to help your doctor avoid medical errors.

Dr. Daniels practices family medicine at the Pittsburg Health Center, and is the former chair of the Department of Family Medicine at the Contra Costa Regional Medical Center.