Medication Safety at Home

There are a number of factors that can lead to serious and fatal medication errors occurring in the home.  As our population ages and more and more people are taking multiple medications, studies suggest that many errors are directly related to combining prescription medications from different health care providers who were unaware of all the medications – including over the counter medications and herbal or vitamin supplements – being taken by patients.   Studies also show an increase in people taking prescribed medications with alcohol or illegal drugs.  And many medication errors that happen at home are occurring when valid prescriptions are taken the wrong way or when medications are stopped abruptly without consulting a health care provider.

In order to reduce the risk of medication errors and mishaps in your home and with your loved ones, we suggest you follow these tips to keep you and your family safe:

1. Do not share your prescription medications with others.
2. Properly dispose of your expired and discontinued medications. Expired medications can lose their effectiveness, and keeping discontinued medications in your home can increase the risk for medication mix-ups or improper use by others. Drug addictions often begin with the inappropriate use of medications left over from others’ prescription supplies. 
3. Always follow the instructions from your health care provider regarding how much or how often you should take your medications.
4. Read each label on a medication bottle before taking out a dose to ensure you are taking the right dose for that medication.
5. Become familiar with what your medication looks like and discuss any appearance changes with your pharmacist.
6. Don’t chew, crush or break any capsules or tablets unless instructed. Some long-acting medications are absorbed too quickly when chewed, making them potentially unsafe. Other medications either won’t be effective or could make you sick if they are not swallowed whole.
7. For liquid medications, use only the measuring device that came with the medication or is intended to measure medications in the right dose range. Over- or under-dosing can occur if the correct device is not used.  Note that household teaspoons and tablespoons are not very accurate. Ask your pharmacist for an appropriate measuring device (like an oral syringe) if you do not have one or one is not provided.
8. Do not stop any of your medications without first discussing it with your clinician.   Many medications need to be slowly reduced in either the size or the frequency of the dose before stopping to prevent harmful effects.
9. Never combine more than one type of medication in the same bottle. Instead, use a pill-box to keep pills for the same day and time together. Consider making a printed schedule to keep track of multiple medications that need to be taken throughout the day.
10. Keep your medications in set locations so it is easier for you to remember to take them each day.
11. Don’t keep tubes of medicine ointments or creams next to your tube of toothpaste.
12. Keep a list of your current medications (including over-the-counter medications and herbal or nutritional supplements) in your wallet and show it to every health care provider at each visit. Include any medication and food allergies on this list as well.
13. Make sure a family member, friend or neighbor knows what medications you take, and where to find them or a list of them in your home in case of an emergency.  Consider posting this list on your refrigerator or the inside of your dish cabinet door.
14. Use child-proof bottles if possible, and consider locking up your medications to keep them safely away from children and pets.  People with pets should use the same precautions in handling and storing their medications as we recommend for people with children.  Pets are finding access to their owner’s medications, and medication mishaps and even fatalities are on the rise among household pets.

Want to learn more about medication safety? Here are some additional resources you may find useful:

Medication Use Safety Training (MUST) for older adults: http://www.mustforseniors.org/index.jsp

The National Council on Patient Information and Education (NCPIE) tools for general medication users: http://www.talkaboutrx.org/med_users_tools.jsp

The Institute for Safe Medication Practices (ISMP) Consumer Information: http://www.consumermedsafety.org/

Medication Safety: A Tool Kit for Families: http://www.learnaboutrxsafety.org/

Center for Medicines and Healthy Aging (CMHA): www.medsandaging.org

Nicole Allie, PharmD, CGP joined Harvard Vanguard Medical Associates and Atrius Health in 2004.  She is a certified geriatric clinical pharmacist and provides services to Harvard Vanguard, Granite Medical, and South Shore Medical Center.  When not working, she volunteers at her local Council of Aging and is a member of a national pharmacy organization.  She enjoys relaxing weekends visiting Cape Cod with her entire family, taking long walks, listening to music, and reading fiction.