Overmedication with cancer and other conditions

1socalgal
You are so right. My sister in NY sees a doctor for skin, one for her rheumatoid arthritis, one for her new heel sprain from her job and i do not believe all share info. Sometimes she will stop a drug because she does not like the side effects. Crazy. I remind her before she stops, to alert each dr all the meds she is taking. She needs to be an advocate for herself.

I find the coordination and communication between doctors for multiple health issues, which have treatments that may impact each other to be very challenging. Especially when new issues pop up and the list of all the exams and conditions becomes very long....who is going to read that? I now provide new doctors with a written summary of my conditions, and a list of all the relevant exams and tests for the last 1-2 years. I fear for people who don't have backgrounds that help them do such a thing.

I am a Kaiser patient and several weeks ago I got an email asking me if I wanted a pharmacist to go over my medications with me. I said yes and a week later I got a call from a pharmacist. She and I reviewed my medications and my supplements and in the process she moved a couple of my morning meds/supplements to evening because they were conflicting with other meds. I now take my multivitamin in the evening. It's a small change, but an effective one (so says the pharmacist).
It just seems to me that most patients need that kind of oversight, but how to get it when you have meds prescribed by different doctors spread across town or in different cities? It's a conumdrum that puts a lot of pressure on patients untrained in the field of medicine. How come no one talks about it? It's actually the same situation where patients have different doctors spread around town. The patient becomes the case manager, another situation most of us are unprepared to handle. If I weren't a Kaiser patient, both situations would drive me crazy.

That was an excellent patient service by Kaiser. My pharmacy has never said anything about my drugs, and even my doctors have not. I take prescription potassium because I am low on potassium. I had to take Bactrim alone after surgery, and later for a different medical reason I was prescribed Bactrim together with Prednisone for 2 months. Bactrim drives up your potassium and Prednisone drives potassium down. I called my Primary who prescribes the potassium, and we adjusted my dose intake at these two times. I also did blood work to be sure I was in correct range. I always check the drugs they give me so I knew about the Potassium issue, otherwise neither the pharmacy nor prescribing doctors mentioned it.

@1socalgal, anyone who has taken care of an older relative can tell you about the problems with trying to make sure the Old Ones are not being overmedicated or, worse, being given a combination of medications that causes physical or mental impairment. I have a good friend who made her living consulting with various hospitals for that purpose. It's a hard question.

After my brain surgery to remove my lung cancer metastasis, my "muscle spasm incidents" were rebranded as mini-seizures, so a neurologist put me on Keppra. At the same time, my oncologist started me on Tagrisso. Neither doctor claimed to know anything about the other medication! I went to my cancer institute's pharmacy and asked to speak with the head pharmacist, who did some research before telling me there was likely no interaction.

With new targeted therapies being created seemingly every week, it's very hard to tell how they will interact with the 4 or 5 medications someone's already taking. Any pharmacist will likely be willing to go over your medication list with you if they're not busy at the moment. As to the best time to take a medication, I always ask the pharmacist what time of day I should take it for maximum effectiveness.

In the American health system, you have to be your own number one patient advocate. My British and Canadian friends say it's different in their country.

@1socalgal, thank you for recalling the older and still relevant discussion that @alpaca started. For anyone interested here is the discussion:
- Overmedication with cancer and other conditions
https://connect.mayoclinic.org/discussion/overmedication/
While not specifically cancer-related, this is another helpful discussion:
- Medication reconciliation: Who do I talk with to review all my meds?
https://connect.mayoclinic.org/discussion/stop-all-medicine/