Are you on drugs?

By LORI EGANNovember 28, 2012

polypharmacy
People expect prescribed medicines to make them feel better, said Lt. Col. Stacey Causey, chief of the Department of Pharmacy at Martin Army Community Hospital. But are they compliant "are they taking the medicine as it was prescribed?

A typical da... (Photo Credit: U.S. Army)
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FORT BENNING, Ga. (Nov. 28, 2012) -- Are you taking Lortab? Wellbutrin? Topamax? Xanax? Demerol? Benadryl? Aspirin?

Do you know how they interact with other drugs? Are they addictive? Should you operate a vehicle or go to the range? Can you drink a beer while taking any of them?

People expect prescribed medicines to make them feel better, said Lt. Col. Stacey Causey, chief of the Department of Pharmacy at Martin Army Community Hospital. But are they compliant -- are they taking the medicine as it was prescribed?

A typical day at Martin Army Community Hospital sees 1,600-1,700 prescriptions filled and there are a number of checks and balances to ensure safety.

Health care is a multidisciplinary effort, from the doctors, nurses and pharmacists to the patient, Causey said, but communication is key. There is a reason why nurses ask patients about allergies and medicines they're taking. It's so the doctor can prescribe the appropriate medicine.

When the prescription gets to the pharmacy, if it's a controlled substance like Lortab, a narcotic used to alleviate pain, the computer will give an alert. It checks to see if there are duplicate prescriptions in the system, not just locally but Army and Tricarewide. It checks to see how the drug interacts with other medications the patient takes. How drugs interact are rated by severity of interactions.

"Level one drug interactions can kill you," Causey said, "and the computer system stops a label from being printed." This prevents the dispensing of the prescription, another safety measure.

Coumadin and aspirin are an example of two drugs that should never be taken together, he said. Both are blood thinners and patients can bleed out, but coumadin patients are very proactive with what they can and can't take.

Patient care is very important, Causey said. He tells the pharmacists and pharmacy technicians to take the time to talk with the patients at the window because "we don't want to lose the opportunity to make sure the patient uses the medicine correctly."

But patients have the responsibility to be compliant with the prescriptions, he said, to read the warnings printed with the prescription label and the information monograph to learn about side effects, allergic reactions, etc.

Although the majority of Fort Benning's Soldier population is healthy, he said. There needs to be a common sense approach between medical privacy and safety.

"When Soldiers get a prescription that can cause drowsiness, let your leadership know. I wouldn't want to be on a range with a Soldier on drugs and armed," Causey said.

Soldiers assigned to the Warrior Transition Battalion who have more than four prescriptions meet weekly with a clinical pharmacist to talk about how the medicines are working, said Terry Beckwith, chief of Public Affairs for the hospital and USAMEDDAC.

But Soldiers who go off post for behavioral health care issues could have prescriptions the Army doesn't know about, which can create problems, she said.

"Although the military health care system provides behavioral health, some Soldiers still feel there is a social stigma and seek care in the local community," Beckwith said.

"The belief is that no one in the command will know they are having problems and it will not harm their military career."

This can be a problem as prescriptions written and filled without being monitored by a military provider could lead to drug interaction or doubling up on medications from two different sources, which may not be healthy or safe, she said.

The military health care system can only track medications issued by the military treatment facility or using Tricare insurance at a civilian pharmacy.

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Fort Benning, Ga.