Many people, especially older people, take multiple medications every day. How well they get along can be clarified by an analysis in the pharmacy – it is now paid for by the health insurance companies. How does the medication analysis work and what happens afterwards?
Two tablets in the morning, three in the evening: Anyone who takes a whole handful of different medications a day may be wondering: are all these preparations compatible at all? Older people in particular are affected by so-called polymedication. A quarter of patients over the age of 70 take five or more medications. This is shown by a Forsa survey commissioned by the Federal Union of German Associations of Pharmacists (ABDA).
But there is an offer that puts the contents of the pill box to the test – a medication analysis in the pharmacy. The good news: since mid-June, the health insurance companies have been bearing the costs. Once a year for everyone who takes at least five medically prescribed medications on a long-term basis.
Questions and answers at a glance:
Why is a medication analysis useful?
“Several doctors are often involved in the medication,” observes Alexander Schmitz from Dannenberg, who runs a total of five pharmacies. The family doctor prescribes one drug, the cardiologist two more. And without anyone having an eye on the medication as a whole.
It is true that there are also regular, attentive pharmacists who become suspicious of the combination of medicines that they release over time. “However, many patients go to different pharmacies and do not even have a point of contact to fill their prescriptions,” says Schmitz.
This is where medication analysis comes into play. A pharmacist gives a professional assessment of whether the medication as a whole is optimal. In the best-case scenario, undesirable, possibly even dangerous, interactions can be avoided or side effects mitigated.
The more drugs there are, the more important it is to have an overview. Because for some people there are not five preparations that are on the plan. But sometimes ten or fifteen. “It is obvious to everyone that this can be dangerous,” says pharmacist Schmitz.
What’s the first step?
Go to the pharmacy around the corner and put the pill box on the counter? It’s not that easy. “The first step is to make sure that your own pharmacy even offers a medication analysis,” says Schmitz. When in doubt, the only thing that helps is: ask at the pharmacy around the corner or look on the website.
The Federal Union of German Associations of Pharmacists does not have any figures on how widespread the offer is. But: “The number of pharmacies offering a medication analysis is likely to continue to rise in the medium term,” according to ABDA President Gabriele Regina Overwiening’s prognosis.
That might take a little while though. The pharmacists must have undergone appropriate training for this offer. Because a medication analysis goes far beyond the advice that you know from filling a prescription, says Overwiening.
A pharmacy is found. How does the analysis work now?
The procedure is not so dissimilar to a visit to the doctor. “You make an appointment first,” says pharmacist Schmitz. This also includes drawing up a contract with the pharmacy. So that the health insurance company knows that the medication analysis is being used there.
Bring a bag to the appointment itself, which can be full to bursting. According to pharmacist Schmitz, you don’t just fill them with all the medicines prescribed by a doctor. You should also bring food supplements, self-medication, doctor’s letters, discharge letters from the hospital, medication plans or laboratory values.
Only medicines that have to be stored in the refrigerator should stay at home. According to the advice of the ABDA, it is best for patients to write down the exact name and potency.
The contents of the bag are then documented in the pharmacy. Schmitz, who himself offers medication analyses, asks patients various questions in this context: “Are there any complaints or pain? Sleep disorders? What are your eating habits? Do you smoke and to what extent do you drink alcohol?” All this information helps to get a complete picture.
How are pharmacies doing?
“In the second step, the pharmacist checks the medication for any drug-related problems that may arise,” explains Overwiening. These include alternating or side effects or double prescriptions from different doctors. This results in recommendations on how the medication plan can be adjusted.
By the way: Anyone who thinks that software simply does all the work in the pharmacy is wrong. “Pharmacy is complex – it always takes a thinking and acting pharmacist,” says Schmitz. And depending on the procedure, also databases, reference works and other aids.
What happens after the analysis?
There is usually a second appointment to discuss the results of the analysis. “If the patient agrees, the doctor will also be informed,” says Overwiening. “The patient receives an updated and complete medication plan.” It can contain various changes. “A common consequence is that certain medications are discontinued,” says Schmitz. “Often these are relics that remain in patients’ medication schedules after they’ve been in the hospital.”
Background: There is often no time for a detailed handover between the hospital and the family doctor’s practice. Patients then simply continue to take medicines, even though they may no longer be necessary.
Sometimes, however, smaller adjustments follow from the analysis. For example, taking a pill at a different time in the future. “Cholesterol-lowering drugs, for example, can cause pain in the legs if they are taken at the wrong time,” says Schmitz. A small adjustment can bring a lot of improvement.
(This article was first published on Tuesday, July 26, 2022.)
