Putting Adverse Reactions Back on the Shelf

Four out of every five Americans take a daily medication, and one out of three take more than one, so MUSC Health incorporates pharmacists to help patients take their medications appropriately and avoid adverse reactions.
Four out of every five Americans take a daily medication, and one out of three take more than one, so MUSC Health incorporates pharmacists to help patients take their medications appropriately and avoid adverse reactions.

Health care teams at MUSC incorporate pharmacists to help with medication safety and adherence

Blood thinners can be vital to a person’s health after a heart attack, but they cannot be taken alongside certain over-the-counter painkillers like ibuprofen or aspirin. Both medications affect the blood’s ability to clot and in conjunction can increase the risk of bleeding.

If not taken correctly, they can make a minor injury much worse.

As the population continues to live longer and as we continue to discover more uses for certain medications while also developing new ones, the risk for adverse reactions increases. Four of every five Americans take a daily medication, and one in three take more than one, according to the Centers for Disease Control and Prevention.

In an effort to improve the medication safety of its patients, MUSC Health incorporates pharmacists into its interdisciplinary health care teams. Gus Katsanevakis, Pharm.D., an outpatient pharmacy coordinator at MUSC, works with each patient to ensure that the dosage of a medication is appropriate and that each new medication can be taken with a patient’s current medications.

Some medications are dosed based on the patient’s weight. With the most current weight, Katsanevakis can double check the dose needed and be sure they go home with the right dosage. In addition to weight-based dosing, Katsanevakis checks other factors, such as a patient’s kidney function or the potential for interactions with other medications he or she is already taking.

Cat Rigdon, Pharm.D., works alongside Katsanevakis as a clinical pharmacist at MUSC, and she points to medication administration as another important avenue for patient safety. Injectable medication, for example, can lead to poor outcomes if not used correctly or disposed of appropriately, so health care teams at the hospital work with their patients to teach them the right procedure. When prescribing a new medication, Rigdon and her team look for each patient’s skill set and adapt towards that, often repeating training with their caregiver to ensure success.

“By counseling patients and their families on the right time to take a new medication in conjunction with their preexisting regimens, we can limit drug-drug interactions as well as decrease side effects that could cause the patient to stop taking their medications,” Rigdon said. “We want to keep our patients healthy by optimizing each therapy and providing the ideal environment for absorption into the body.”

These unique practices are part of hospital pharmacies like that at MUSC. MUSC pharmacists work as part of the patient’s medical team and have immediate access to their physicians. Katsanevakis and Rigdon can also work with their team to find a less expensive medication or one covered by the patient’s insurance. If a patient is unable to afford a medication, they are less likely to continue taking it, so it is important to find a medication that works for their health that they can also afford.

Another way MUSC helps patients with medication safety is by filling their prescriptions before they leave the hospital, which is part of a larger national program known as Meds-to-Beds. Sending a patient home with their medications provides an easier and healthier transition to normal life after their hospital stay. There could be many reasons for a delay in picking up a medication after leaving the hospital. An outside pharmacy might be closed or need more time to fill a prescription. There could be issues with insurance or needing extra physician authorization, or a patient may be unable to drive themselves to that pharmacy.

By incorporating pharmacists into their health care teams, MUSC can resolve these issues before a patient is discharged, which allows a patient to ask any questions and take their first dose of medication immediately and appropriately.

Katsanevakis points to insulin as an example. There may be multiple reasons a patient is unable to pick up a prescription after leaving the hospital, but if they don’t take their insulin as prescribed that day or the next day, they could end up back in the hospital. With a program like Meds-to-Beds, patients are more likely to take their medication as prescribed. Patients will also often have more than one doctor taking care of them in the hospital, so hospital pharmacists will review their medications to make sure they all work well together and will contact the doctors to make any needed changes.

Patients can help their health care teams prescribe the correct medication by knowing the names of the prescriptions they already take each day. If a patient takes multiple medications, Katsanevakis suggests writing them down so that any new physician knows exactly what is already in their system. It’s also important for patients to take medications as prescribed, whether that be with food or twice a day. Following these prescribed instructions allows the medication to be as effective as possible and helps health care teams take better care of their patients.

“Medication safety is incredibly important for patients,” said Katsanevakis. “It’s a continuous problem, but we are moving in the right direction by giving pharmacists a seat at the table.”