There’s a patient-focused shift taking place in medicine today: some physicians are looking beyond prescribing drugs, drugs, and more drugs to treat every patient’s problems, and instead trying to create better longer-term treatment plans that can include seeking input from nurses and other specialists, including home health care staff, such as the team at Accredited Home Care.
The concept is called pharmacopalliation, which may seem like a mouthful to non-medical folks but generally, means that extra effort and attention is being put into keeping better track of all the medications a specific individual is taking or has been prescribed.
Their primary health care provider can try and look at a bigger picture of what conditions all the medications are trying to address, including dosages, and what side effects could potentially be showing up.
Then, he or she can look at possible interactions between the different medications, and if the balance should be altered, such as increasing or decreasing the dosages of certain ones; switching to similar drugs in the same family; or eliminating some of them completely, either immediately or gradually phase them out, depending on possible reactions or withdrawal concerns.
A good pharmacopalliation strategy can take into consideration any observations from nurses, other caregivers, and specialists, plus family members and pharmacists. Let’s not forget the patient themselves: they may be able to share how different medications can make them feel, especially if the dosage or type of medication may need to be modified.
It does require some different ways of thinking from the traditional physician model that sometimes is accused of involving little interaction beyond a prescription pad, and not knowing what other physicians or other specialists are prescribing.
Instead, the pharmacopalliation approach requires better communication between a whole team and a focus on the patient’s positive outcome – in short, it’s like “Goldilocks and the Three Bears,” an analogy used by UTHealth/Health Science Center at Houston to describe how an appropriate medication management plan is really about experimenting with dosages and types until you find what’s ‘just right.’
Initial discussions about the pharmacopalliation approach to medication management took place in hospice communities, especially since a patient’s medication often needs change.
Since most patients don’t have a lot of time or medical options left when they move to hospice care, medical providers’ roles need to be less curative-focused and more about providing comfort, pain relief, and a better quality of life.
Doctors who focus on palliative care may not be as concerned about prescribing medications that could cause long-term damage or have high addiction potential, but at the same time, they would try to figure out ways to minimize any withdrawal symptoms and continue regimens that reduce pain.
In a non-hospice setting, the physicians also try to look for a customized solution for every patient rather than a one-size-fits-all approach. They may ask questions like “Does he or she still need this particular medication?” “Can we slowly wean him or her off it and try something different?” “When should we look at everything again?”
Home health nurses can be part of these discussions too, as they likely will interact more frequently with the patient than the provider. In addition to making sure they’re taking their proper medications in the right timeframes, they can also observe any changes or side effects, and also hear how different medications make the patient feel.
When planning a proper pharmacopalliation strategy that considers possible interactions with other medications, patients also need to be advised about other possible interactions with herbal supplements.
Companies that produce vitamins and other supplements often boast of all sorts of wonderful claims about what their products can do to boost general health or aid specific symptoms. So it’s natural that people who want to feel better and who are already on other medications will gravitate toward them, especially the products that say they’re natural.
Various official studies show that the amount of interaction can vary by brand and product, and sometimes a supplement may actually have a complementary role or do nothing all.
However, the FDA still warns consumers to be careful mixing both types, especially during critical times for your health such as directly before or after surgery or during chemotherapy. They also emphasize that the word “natural” in packaging and advertising doesn’t necessarily mean “safe.” So some may actually cause dangerous interactions.
The National Center for Complementary and Integrative Health, part of the U.S. Department of Health and Human Services, said that some of the concerns about large-scale negative interactions between supplements and medication may be exaggerated, but it is truly difficult to know for sure since there are so many combinations of supplements, prescribed medications and even over-the-counter remedies on the market. But it does offer some general guidelines about what to look for and what to avoid.
Doing some of this research in July is perfect, as it’s actually Herbal/Prescription Interaction Awareness Month, a time when people are encouraged to learn more about both areas, how some can work together, and potential areas of concern.
Accredited Home Care is always happy to provide accurate information and answer questions about medication management and the differences between herbal remedies and prescription remedies.