Table 12: Medications for Noncommunicable Disease Medication Patient Next Steps Patient Insight Acetaminophen Stop
“I’m gonna ask my doctor can I discontinue that because the doctor prescribed it at a time I was having pain . . . on my right knee” “Nasal spray I could get rid of. Nasal spray is just for allergy season, so it is not necessary these days.” “I haven’t had my blood checked for the fall yet, so I may be able to come off that, but for now, I’m going to say magnesium is to potentially stop.” “I have a lotta medications on this list that, apparently, are for the rest of my life. If I could not take some, that would be great.” “I’ve been taking two capsules at bedtime. Hopefully, I can reduce it down when I see him in May, to reduce it down to one a night.”
Fluticasone
Stop
Magnesium
Stop
Allopurinol
Stop
Tamsulosin
Lower
Vitamin E
Stop
“I’ve always had some concerns about taking too many over the counter add ons.”
Calcium
Stop
“Calcium I do need for osteopenia, but I don’t see it making any changes.”
Metformin
Lower
“I’d like the dosage lowered because I’m taking 1000 milligrams twice daily, and with the higher dosage I can’t see any difference.” “I really question the use of the Singulair, so I would like to stop taking that. I push on that every time I see my pulmonologist, but she says keep taking it, so I do. I just think there’s an awful lot of pulmonary kind of medications here, and I just think that the less of a mix that you’re talking, the more effective medications tend to be overall. It’s pretty hard to determine the efficacy of a medication when you’re taking so many.”
Montelukast
Stop
Pharmacology and hyperpolypharmacy—Patient burden In addition to medication specific responses from patients indicating desire to gain deeper understanding of their individual health situation and impact of illness and polypharmacy, there is other insights shared that should be recognized by professionals. Lee et al. (2022) has shared patient reflections: ● I spend a lot of money on medication.
● I believe that one or more of my medications may currently be giving me side effects. ● I am reluctant to stop a medicine that I had been taking for a long time. ● If one of my medications was discontinued I would be worried that I am missing out on the benefits. ● When changes to my medication are made I get stressed out. ● If my doctor recommended stopping a medication I would be concerned that they were giving up on me. ● I have had a bad experience stopping a medication. ● I believe I understand why each of my medications has been prescribed. ● I know all of the medications I currently take, and I know why I take them. ● I keep an up-to-date list of all medications and doses. ● I like to stay informed as much as possible about my medications. ● I think I understand the purpose of all of my medications. ● Healthcare access and quality : Addresses availability and accessibility of quality healthcare services and information. ● Neighborhood and built environment : Refers to physical surroundings, housing, availability transportation, available green spaces, and access to physical activity. ● Social and community context : Includes social support networks and connections, community involvement, and exposure to crime and violence. ● Economic stability : A person’s financial situation, income, employment, and access to supportive resources and information.
● Take medicines every day is very inconvenient. ● I feel that I am taking a large number of medicines. ● I feel that my medicines are a burden to me. ● Sometimes I think I take too many medicines. ● I feel that I may be taking one or more medicines that I may not longer need. ● I want to try to stop one of my medications to see how I feel without it. ● I would like my doctor to reduce the dose of one or more of my medications. ● I think that one or more of my medications may not be working. addressing polypharmacy to ensure that best practices for patient-centered care are implemented. Any reconciliation should be done to ensure seamless transitions supporting patient care and best outcomes (Hoel et al., 2021). It is imperative to consider the impact of social determinants of health for each patient. Social determinants of health are the conditions that directly affect a person’s quality of life, health, and well-being (Figure 1; Healthy People, 2030). The social determinants of Addressing polypharmacy in patient care Reconciling patient medication is a crucial step in health are characterized by the following domains: ● Education access and quality : Level of education influences health literacy, employment opportunities, and recognizing the importance of preventative healthcare and healthy behaviors.
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Book Code: MTX1326
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