Liam Butler Interviews Gary Chalmers

Liam Butler Interviews Gary Chalmers

22 November 2013

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Proprietor Pharmacist at Collingwood St Pharmacy Nelson www.collingwoodstreetpharmacy.co.nz

Question one.

I sometimes hear the odd horror story of an older person resorting to using a carving knife to access their pills in their blister pack. What can you recommend to people to make it easier for them to open their blister packs?

Gary's answer:

Sadly the foil on Medico packs is designed to be moisture-proof, tamper-proof and generally robust enough to handle quite vigorous use so it can seem to be a challenge. If you don't feel strong enough to push your thumb (for example) through the backing, we provide a little plastic tool that does the job well (free) or the edge of a teaspoon or dessert spoon is usually sufficient to open them up. A reasonable common misconception is that the clear bubble can be pushed in to "pop out" the contents. This will not work and can lead to a very frustrated patient if they think that is the way to do it!

Question two.

When an older person has a lot of prescriptions but they are not in blister packs, have you got any tips to make sure they get the right drug, at the right time and right way?

Gary's answer:

Try to make your system (whatever it is) as logical and repeatable as possible. Simple strategies such as taking them at the same time each day (say with breakfast and/or dinner) may help. Talk to your doctor or pharmacist about making your regime as simple as it can be - I personally take all my medicines (4) in the morning as I kept forgetting the statin in the evening. The very small difference in my cholesterol level was far out-weighted by taking the tablet consistently. Drug companies realise people struggle with 3 or 4 (and even twice) daily dosing and there is often a once-a-day option for the medicines we take. A very important, but sometimes over-looked strategy is to keep your regime up-to-date and aligned. By that I mean try to get everything to run out at the same time. It is confusing for all parties, when the patient has to pick up multiple prescriptions at various times through the regular 3 month "prescription" cycle. We know that factors such as dose changes, hospital admissions etc contribute to the confusion, but we are always happy to try to get things but into line.

Question three.

In the US the National Patient Safety Foundation recommends people ask their health professional three questions...

1. What is my main problem?

2. What do I need to do?

3. Why is it important for me to do this?

As pharmacists are the health professional people see most often would you recommend people as you these thee questions?

Gary's answer: We are always happy to talk to people about their medicines, and their treatment options. Obviously there are times when this is more appropriate, such as when someone starts on a new medicine. We are also mindful that too much information at once is difficult to take on-board. We often hear that people only remember 1 or 2 things during a doctor's consultation, so I imagine the same holds for medicines. If you are taking 10 or 11 medicines (surprisingly common) it is probably best to talk about these in little bites. Like all communicators we try to be aware of our limitations: talking too much, or too little, using jargon or over-technical language, but I think we do try our best to educate and inform. Actually it is one of the best parts of the job, and does make us feel we'll still have a role when the robots arrive!

Question four.

How do you think older people can use medication more efficiently?

Gary's Answer: Using medicine more efficiently ... wouldn't that be great. I think the points that we have discussed above are all valid. Asking questions, taking the advice that is given by doctors, nurses, pharmacists etc - we really are all motivated by a sense of humanity. Being careful with medicines - they are potent agents, and should be treated with respect. Probably the thing that gets people into the most trouble is not taking things as directed. If you stop taking something or start taking more than your doctor etc is aware, just make sure they know. You will not get the best benefit from your medicine if you don't keep everyone informed. People may think that this is their own concern, but you are gambling with your health if you are not honest about how you are going with your medicines. The people you are dealing with here are trying their best to help you.

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