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FAM I LY M E D I C IN E Communication Between Patient and Physician Is Essential to Manage Medications for Chronic Conditions People with one or more chronic conditions often are prescribed medications to manage their illnesses but may not be aware of the serious problems that can result if they don’t take the drugs as directed. “A large percent of patients have questions about their medications,” says UCLA family medicine specialist Gerardo Moreno, MD. “One of most important things I can do for my patients is to provide clear information and instructions about their prescribed medicines, including the trade and generic name for each drug, its purpose and the potential for side effects or interactions with other drugs.” He explains that when patients and their healthcare team do not communicate clearly about the purpose and appropriate use for each drug, patients may unintentionally misuse or overuse prescribed medicines. For example, some patients may see multiple providers for chronic illnesses and receive duplicate prescriptions for the same condition. Other patients may face difficulties paying for their medications and begin to skip or split doses as a way to manage drug costs. UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) At UCLA, primary-care physicians and their patients at highest risk for medication non- adherence may receive help with this process through the MyMeds program, currently available in 14 office locations in Westwood and Santa Monica and scheduled to expand soon to other locations. “It is not uncommon to see older patients and those with multiple chronic conditions being prescribed six or more medications,” explains Jeffery Fu, PharmD, BCPS, a clinical pharmacist with UCLA MyMeds. “There just isn’t time for physicians to thoroughly review so many medications during an average patient visit.” MyMeds pharmacists spend 40 minutes in one-on-one consultation with new patients, with the goal of identifying potential barriers to medication adherence and taking steps to remove those barriers. Pharmacists continue to work with patients, in consultation with their physicians, during follow-up visits as necessary. Information technology, including UCLA Health’s electronic health record, is also an important part of managing patient medications in both inpatient and outpatient settings. The electronic health record facilitates patient-provider communication about medication changes that may occur during or after hospitalization and features tools such as computerized physician-order entry to enable real-time communication among clinicians to ensure medications are being correctly prescribed and administered. “We can verify right away if the drug ordered is appropriate according to evidence-based guidelines and check for potentially adverse side effects based on the patient’s medical history or tests taken while in the hospital,” says Jason Madamba, PharmD, a pharmacist at UCLA Medical Center, Santa Monica. “It’s a natural system of checks and balances.” Patients also can access their personal medical records, communicate with their medical team and view and download their current medication lists through the online patient portal, myUCLAhealth. This access helps patients to keep an up-to-date list of their medications; such a list should be available in case of an emergency. Drs. Moreno, Fu and Madamba also recommend that patients bring medication bottles to scheduled visits, read their medication bottles carefully for instructions and warnings, and regularly discuss questions or concerns about prescribed medicines with their physicians or pharmacists. Patients should also ask their pharmacists about drug discount programs.