Managing medication for long-term conditions

Swallowing large tablets or handling an insulin pen isn’t always easy. If the dosage form or type of application is causing you trouble, your doctor’s office or your pharmacy can tell you

• whether more information about the correct use is available,
• whether the drug can be used in a different form, such as a capsule or a syrup, or
• whether the medication can be ground up and mixed with food so that it’s easier to swallow.

Certain characteristics of a medication can also make it difficult to use it over the long term: For some medications, it may not be immediately or not at all noticeable if they’re working as intended, such as medicines that are meant to lower blood sugar levels in diabetes. Other medications, like antidepressants, only take effect after several weeks. If you then get the impression that it isn’t working, you might stop taking it. Talking with your doctor can help here as well.

Some people don’t want to take long-term medication out of fear of side effects. But it may make sense to risk some side effects, if the benefits outweigh the harm, especially if the medication can keep a more serious condition from progressing.

When deciding whether or not to use a medication, it’s important to know what your options are and what might happen if you don’t have treatment at all. It makes sense to talk with your doctor about any fears or concerns and ask them for more information so you can decide together. If you’d like to learn about how others who have the same condition handle taking long-term medication, you can contact a support group.

It is very important to keep track of using your medicine properly – especially if you need several different medications. The things may help:

Some drug packages aren’t designed to make it easy to tell how and when to take them or whether you’ve missed a dose. It is usually not easy to tell how and when to take the medication, or whether you have forgotten a dose, just by looking at the package. Pharmacies therefore offer special packaging or containers that show this at a glance. Special containers called dispensers or pill boxes (available from pharmacies) help you to see these things at a glance.

The medications you need for one whole week are sorted into small compartments in your pill box – one for each day of the week, with sections for the morning, midday and evening. So if you need to take drug A three times a day, for instance, one tablet is put into each of these sections. If you also need to take two tablets of medication B in the evening, then two of those tablets are placed into the evening section.

Storing package inserts of your medications together with other important medical documents (like doctor’s letters, diagnostic results or your certificate of vaccination) can make it easier to keep track of things.

Ideally, you should write down which medications you need to take when and at what dosage. You can use a form or a simple notebook to list all of the medications.

Apart from prescription drugs, you should also write down any non-prescription drugs, including herbal products and dietary supplements. Those products can also interact with medication. The list also includes drugs that you don’t take orally but use in a different way, such as asthma inhalers or eye drops.

You can put together your medication list on your own or get some help from someone else.

People with statutory health insurance in Germany are sometimes entitled to have their doctor put together a concise medication schedule for them. This is the case if

• you need three or more prescription drugs,
• the drugs are systemic, meaning they work throughout the whole body, and
• the drugs are prescribed to be taken for at least four weeks.

The medication schedule can be stored on your electronic health insurance card if you like, but you can also request a paper version. The medication schedule includes both the prescribed medications and all other medicine. It has a standard design and includes personal details such as your name and birthday, as well as the following information:

• Name of the medicine: Active ingredient (the drug responsible for the effect) and trade name
• Dose (how much) and dosage form, for example: 100 mg tablet
• When the drug is to be used, for instance: 1 tablet in the morning and 1 tablet in the evening
• Any special instructions, such as: Keep refrigerated
• Reason for using the drug, for example: High blood pressure, pain, or iron deficiency

In Germany, your electronic health records (elektronische Patientenakte, or ePA) includes a list of your medication prescribed using an e-prescription. The medication schedule is planned to also be integrated into the ePA. It will then be possible to record information on intake and dosage as well as non-prescription medication.

It may help to combine your medication with daily routines. Putting a reminder note or the package of medicine next to your toothbrush could help you remember to take your medicine if you always have to take it at the same time you brush your teeth.

Putting notes on the refrigerator door or somewhere else that you frequently pass by is another good way of reminding yourself. If you organize your day using a calendar on your phone, you can set it to remind you with a notification, a ring tone or vibration.

Some people prefer counting on someone else to remind them to take their medication – for example a family member or a nurse who regularly comes to see them.

All medications have an expiration date. If you check every once in a while, you can be certain that the medicine is not expired and remember to get a new package in time. This is particularly important before longer trips. If you use special medication containers, be careful when refilling them so that you don’t confuse different medications.

If you do run out of medication, it’s not a good idea to fall back on other people’s medicine, like your partner’s “heart pills.” These medications may not contain the active substances that you need. And the risk of side effects is also greater because the dose might not be right for you, or you might not tolerate some other drugs. If you can't see a doctor right away, it's better to call the doctor's office or ask at a pharmacy.

One thing that's not only true for long-term medication: If you feel that your medication might be causing a problem, it is important to talk to your doctor or pharmacist about it. Before starting a treatment with new medications, you should let your doctor know if you’ve ever had an allergic reaction to a particular drug or had serious side effects. It's also important to tell your pharmacist about this whenever you buy over-the-counter medications.

You shouldn’t buy medication from dubious sources on the internet, especially prescription drugs. They may be counterfeit (fake copies) that are contaminated with harmful substances or don't work. Signs that this might be the case include unfamiliar side effects or symptoms coming back despite using the medication.

Lastly, using medication safely also means not stopping the treatment as soon as you feel better. For example, if you stop taking antibiotics before using up the prescribed amount, your symptoms may return.