The Medication Management Challenge

By Julie Fulmer-Mason, PharmD


  • 1.8 billion prescription medications dispensed annually in U.S.
  • Nearly 75% of Americans do not take their medications as prescribed
    • Causes 125,000 deaths per year
    • Accounts for 10% of all hospital admissions
    • Direct result of 23% of new admissions to assisted living-type facilities
    • Costs US health care system about $290 billion per year

The Solutions
8 Ways to Improve Your Medication Adherence

Get Organized

  • Keep ALL active medications in one location and in their original containers.
  • Store medications in dry environment
    • Away from bathroom humidity, heat/steam in kitchen, moisture in refrigerator, direct sunlight
    • Liberate yourself from your pill bottles
  • Use an organizational system (pill box)
    • Promotes mobility
    • Increases awareness of missed doses and need to order refills

Dispose Unwanted/Expired Medications

  • Do not flush down toilet or sink.
  • Mix with unpleasant substance (kitty litter or coffee grounds), put in sealed container and dispose in trash
  • Call your garbage/recycling company for local services
  • Federal Drug Take-Back Program
    • Occurs about twice a year
    • Call garbage/recycling company for nearest location
    • Walgreens medication disposal envelope ($4.00)

Initiate Medication Reminder System

  • Dramatically reduces chance of missed doses
  • Coordinate medication taking with routine daily activities
  • For medication regimens dosed multiple times per day…
    • Utilize medication reminder alarm products
      • Electronic pill boxes or medication organizers
      • Cell phone apps
    • Make medications “mobile”

Limit Physicians Managing Medications

  • Communication between different physicians and different healthcare facilities is poor
  • Patients need to take proactive role of keeping ALL healthcare providers on same “playing field” in ensure quality care
  • Goal: Try to keep each medication under the control of one physician
  • A medication managed by multiple physicians increases risk of…
    • Inaccurate medication records
    • Duplication of therapy

Provide Home Medication List

  • At EVERY visit, provide list of prescription/ over-the-counter medications and vitamins
  • For each medication or vitamin, include…
    • Brand AND generic name
    • Dosage Strength
    • How you take it
    • Use calendar for “as needed” medications
      • Record date, time, and dosage strength taken
      • Helps to assess effectiveness of therapy

Ask Questions

  • YOU are in charge of your health, never be intimidated to question the care you receive
  • Engage your physician/pharmacist to review your medications at every visit…
    • Is it still necessary to continue some medications?
    • Can some medications be replaced with a combination product?
    • Do any of your medications come as a long-acting formulation?
    • Ask for alternatives if you cannot afford medications

Use One Pharmacy

  • Record of all dispensed prescriptions and refill dates in one place
  • Improves a pharmacist’s ability to catch…
    • Drug Interactions
    • Duplications of Therapy
    • Better coordination of refill dates
  • Establishes a personal relationship with a pharmacist
    • Possesses significant wealth of information
    • Offers free consultations, no appointment needed

Keep It Simple!

  • Studies show the incidence of missed doses increases dramatically the more times you take medication per day
  • Unless directed otherwise, take your medications NO MORE than 4 times per day
  • Consult your pharmacist to determine...
    • Which medications can/can not be taken together
    • The best time of the day to take certain medications


Julie Fulmer-Mason, received her Doctorate in Pharmacy from the University of California – San Francisco in 1998, and has practiced as a Clinical Pharmacist in the Veterans Affairs (VA) Healthcare System and the pharmaceutical industry. From her days of working at the VA Hospital in Palo Alto, California, a multitude of patients were referred to Julie with medication compliance issues.  A specific relationship forged with a patient inspired Julie to design and invent the MedFolio medication management device. You can visit her website at



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