A couple of medications at a time are easy for a doctor to prescribe and for nurses from places like Above & Beyond Home Health Care to keep an eye on.
But things get trickier when patients are prescribed a larger amount of medicines to treat many ailments. These can not only trigger side effects but possibly negative interactions with other meds, something increasingly likely in a world where there is access to plenty of pharmaceuticals.
In a home health care environment, patients could have a wide spectrum of mental and physical conditions that they receive prescriptions for, sometimes from different specialists who each may prescribe something, but not necessarily knowing what else has been prescribed by others.
So is anyone really keeping track of everything that someone is taking?
It may not necessarily be the patients, who can have a hard enough time scheduling when to take their pills and remembering what to eat and drink with them, so they may not really keep track of what they’re taking, how much and what it’s for.
It may not necessarily be the pharmacists, even though they could flag possible dangerous interactions or contact a primary provider with questions. It’s not necessarily home health care nurses or specialists either, who may be more focused on the patient’s comfort, well-being and current state, rather than questioning doctor’s orders.
It’s not necessarily even physicians or medical specialists who are also trying to do the right thing for their patient.
Trying to get everyone on the same page has actually led to a new focus in modern medicine – pharmacopalliation. This approach encourages physicians and others connected to specific patients, such as nurses, to be more aware of what the medications their patient are taking, possible interactions, and desired outcome.
Looking for ‘just right’
Pharmacopalliation even has a nickname that’s much easier to pronounce and easier to understand: the “Goldilocks approach,” based on the old tale of the girl in the bears’ house experimenting with chairs, beds, and food to discover what doesn’t work and what works just right.
The analogy is a nice way to refer to members of a patient’s medical team trying to find the ideal balance of medication for that individual, instead of relying on a one-size-fits-all approach. This not only includes types of medications and possible interactions but dosages. For instance, perhaps one medication could be decreased while another increased, or one changed, or completely eliminated.
Pharmacopalliation has its roots in hospice communities, where the focus is less on improving health and possible curative benefits of medication, and more on increasing comfort and pain relief in the patient’s final days. There’s also less concern about long-term damage or addiction from certain medications as well, so riskier items like opioids may be prescribed.
But now the approach has moved into general care, where physicians and other medical professionals are encouraged to work closely with their patients to find smarter solutions for balancing their prescriptions and providing pain relief beyond simply writing more prescriptions, doing more tests and making more appointments.
It takes a little more effort for some practitioners to look beyond fixing only the patient’s current ailment, and more communication with other professionals who interact with the same patient, but it’s a good way to think long-term and keep the goal of finding the best to benefit the patient.
Physicians who specialize in palliative care have already been interested in finding the ‘just right’ solution for hospice patients, which often can be quite different than the focus of their general physician prior to the patient entering the hospice system.
Because end-of-life care is a growing field, in terms of patient population and medical training, physicians and pharmacists interested in palliative care are encouraged to network and reach out to others to discuss current issues.
Likewise, hospice nurses, such as the ones at Above & Beyond Hospice, can also be an important part of the pharmacopalliation discussion.
They can observe the patient and their regular medication schedule and dosages, and also talk with their family, any other caregivers, their physician, and even the pharmacist if needed. Nurses can be important eyes and ears to assess a patient’s condition and their need for pain relief. Plus, they can spot possible side effects, and maybe even recommend discontinuing or changing certain drugs or reducing their dosage.
There’s never a bad time to learn more about pharmacopalliation, since it can be an exciting and novel approach to patient care that has a lot of potential to teach good communication habits and improve general best practices with medication management.
The month of July is actually considered Herbal/Prescription Interaction Awareness Month. Though people should have this awareness every month, people are encouraged to learn more about both areas, how they can work together, and some potential areas of concern.
For instance, some herbal supplements may conflict with certain medications. And while the American pharmaceutical industry is heavily regulated about what ingredients and dosages must be disclosed, the herbal supplement area doesn’t have to be as transparent.
So potentially some vitamins or supplements could conflict with prescription medicine or even over-the-counter remedies and even cause harm.
For more information about medication management options or to find experts to discuss the differences between herbal remedies and prescription remedies, visit Above & Beyond Home Health Care.