Do your medications spark joy? For most of us, it is a definite no. A local study in 2012 involving 240 polyclinic patients found that 70% of these patients reported non-adherence to their chronic medications at some point in time. This figure is higher than the rates (ranging from 30-60%) reported by the World Health Organisation for developed countries.

Medication non-adherence is a growing problem due to the increasing number of patients with chronic diseases requiring chronic medications. Medications do not work if they are not administered. Patients who are not adherent to their chronic medications may not receive the full benefit from their treatment and may even be detrimental to their health. It has been found that poor medication knowledge often results in poor medication adherence. With more medications, it can be more difficult to remember important information about them.

The Benefits of a Medication List

A medication list is a useful way to keep all the information about your medications together. Firstly, it empowers you to be in charge of your medications and serves as a reminder to how and when to take your medications. Secondly, a medication list will also ensure that everyone involved in your health care (e.g. caregivers, GPs, hospital doctors and pharmacists) knows which medications you use. A medication list will also help your doctor and pharmacist check and review your medications to prevent side effects and interactions and to ensure that the most optimal medication therapy has been prescribed for you. Lastly, in an emergency, a medication list will also provide vital information about your medications readily.  

Creating a Medication List

It must be accurate, honest and complete – even if it means admitting to not fully adhering to all the medications in the list. It is common for patients to hide their non-adherence to medications from their doctors and pharmacists or some may even practice “white coat adherence” by taking medications as prescribed only for the week before their doctor’s appointment for fear of the disapproving judgment from their doctors or pharmacists. However, this can be dangerous as doctors may perceive that your health condition is still not in control and continue to increase the dosage of your medications. Always be reminded that your doctors and pharmacists are committed to improving your health.

By creating an accurate, honest and complete medication list, your doctors and pharmacists are in a better position to clarify any doubts and fears you may have about certain side effects or adverse experiences you may have been having with your medications. They will also be able to advise and find alternatives to simplify your medication regime or to tailor one that better suits your needs and lifestyle.

Your medication list should include:

1. All the medications you use: prescription, non-prescription, over-the-counter, vitamins, herbal, natural and traditional medicines (e.g. Traditional Chinese Medicine (TCM), Jamu, Ayurvedic)
2. What each medicine is for
3. The dosage form of each medication
   • Oral (e.g. tablets,  capsules, liquid and syrup)
   • Injected (e.g. injections)
   • Inhaled (e.g. inhalers)
   • Topical (e.g. sprays, sublingual tablets (dissolved under the tongue), transdermal patches, creams and ointments)
   • Inserted (e.g. eye drops, nose drops, pessaries and suppositories)
4. How much of each medicine to use (strength, dose and dosage)
5. When and how to use each medicine
6. Any known medication allergies

*Always indicate if you are not taking your medications as prescribed

Here’s two medication list templates that you can download for free. The first is a more detailed A4 size list that you could display at home and bring it along with you for every doctor’s visit, the second is a wallet sized summary list for emergency usage.

The medication in these templates are for reference only and clearly marked as examples.

It is important that your medication list is frequently updated with changes to your medications. Always consult your doctor or your pharmacist if you have any questions about your medications. You should always know what you are taking and why you are taking them.

Always keep your medication list at home and have another copy to take away whenever you visit a doctor or a pharmacist. Knowing as much as you can about your medicines will help you to maximize the benefits of your medications and to minimize potential medication side effects and interactions.

“A journey of a thousand miles begins with a single step” – your medications may not spark joy, but the journey to good health begins with knowing and understanding your medications. May the first step of creating your own medication list spark joy to better health.

If you need further details on section 1-6 of your medication list, Continue reading for “Part II: Understanding your medication list”.

About the Author:
This article is written by Vanessa Ong. Vanessa is a registered pharmacist with the Singapore Pharmacy Council. She spent several years in the inpatient setting in a local hospital. She enjoyed her time spent in the wards working with a dedicated healthcare team passionate about better patient outcomes. She strongly believes that evidence-based health information can be made simple so that the public can find joy in taking ownership of their health and live life to the fullest.

At Jaga-Me, we believe that healthcare should be a social good – it is a basic human need, and should be available to as many people as possible. We aim to deliver the highest quality care through innovation and a commitment to building meaningful relationships.

Save travelling and long wait times at the hospitals. Get specialised medical treatments:
– Urinary Catheterisation
– Complex Wound Care
– Nasogastric (NG) Feeding Tube
– IV Infusion Therapy

Jaga-Me: Your Trusted Medical Home Care Professional

To get the most out of your medication list, it is important to understand it completely. Always speak to your doctors or pharmacists if you have any doubts or queries when filling out the list.

This is the part II of ‘The Life-Changing Magic of Tidying Up Your Medication. Click here for Part I: It begins with creating a medication list.

Listing out all the names of the medications you use

In Singapore, it is common for government hospitals to provide generic versions of medications once the original brand comes off patent to bring the costs down for patients. This may mean changes in the appearance of your medication when different companies produce the same medication. Hence it is always important to remember the name of your medications instead of just the appearance of the medications. If you need help with identifying the name of your medications, always check with your doctors or pharmacists.

Also, it is important to list out all the names of the medications you use especially non-prescription items such as over-the-counter medications, vitamins, herbal, natural and traditional medicines. You may not take them on a regular basis; however they are still vital information to your doctors and pharmacists. As the number of medications you take increases, the potential for possible medication interactions increases. For example, there are medications that are affected by iron and calcium supplements and may require you to be taking it a few hours apart. Also, there are certain over-the-counter medications or even natural and herbal products that are readily available that may not be suitable for patients with certain health conditions. With a complete medication list, your doctors or pharmacists will be able to help you better in identifying possible medication-related problems and provide you with the best advice.

Listing out what each medication is for

In the same local study done in 2012 involving 240 polyclinic patients, it found that almost 85% of the patients did not know the purpose of at least one of their medications. All the patients in this study had 5 or more regular medications being prescribed. As the number of medications you use increases, it is more difficult to keep track of them especially if the medications were prescribed by different doctors. Knowing what your medication is for empowers you in understanding your medical conditions as well. It also enables your doctors or pharmacists to identify possible medications that may be unnecessary or may not be essential for your current health condition. Always clarify with your doctor or pharmacist if you are unsure about what your medication does for you.

Listing out the dosage form of each medication

Medications can be administered in many different ways. It is important that you list out the form your medication comes in as well. This can help highlight to you or your doctors or pharmacists if there are potential difficulties in using the particular dosage form. For example, you may have swallowing difficulties and you need to crush your medications into powder form before taking it. This may pose a problem as not all medications can be crushed as it may affect the effectiveness of certain medications. Always highlight potential difficulties you may have to your doctors or pharmacists as they can provide advice on alternative dosage forms that may be available, like the same medication but in liquid or syrup form.

Listing out how much of each medicine to use

How much of each medicine to use is often referred to as the strength, dose and dosage. The strength of your medication is often printed in grams or milligrams. It is commonly printed beside the medication name or on the packaging of the medication. It usually refers to the strength of one tablet or one capsule or one puff (for inhalers); depending on what dosage form your medication comes in. The dose of your medication is how much you are taking. For example, you may be prescribed to only take half of a tablet. The dosage refers to the dose with a time frequency. For example, you may be prescribed to take half a tablet twice a day (in the morning and in the evening).

Let me illustrate this clearer with an example. Metformin is the name of a common medication used to treat diabetes. A common strength of one tablet of the medicine is 500 mg. A common dosage of Metformin for patients with newly diagnosed diabetes can be one 500 mg tablet (the dose) twice a day (the time frequency).

It may be quite tricky to figure this out, always consult your doctor or pharmacist to clarify any doubts you may have. It is also important to note in your medication list if you are not taking your medication as prescribed as it helps your doctors or pharmacists to identify certain concerns you may have and how they can adjust your medications to suit your lifestyle or needs better. For example, you may have difficulties adhering to your medications as they require you to remember taking them multiple times a day, always consult your doctor about your concerns as they may be able to provide you with an alternative treatment or a change in dosage.

Listing out when and how to use each medicine

The reason why certain medications have to be used at certain times of the day or before or after food is usually to maximize their effectiveness.  For example, there are some medications with special instructions for it to be taken first thing in the morning before food. This is because the absorption of some medications is greatly interfered by food, rendering them less effective as lesser of the medication is being absorbed by the body. On the other hand, there are some medications with special instructions for it to be taken with or after food as they may have an unpleasant taste which can be masked by taking the medication with food. Always check with your doctors or pharmacists if you have difficulties adhering to special instructions that are prescribed with your medications as they can provide you with the best advice.

Listing out any known medication allergies

It is important that information about your allergies is listed so that your doctors do not prescribe the same or similar medication again. It is important to understand the difference between an allergy and intolerance to a medication.

A medication allergy is something that can often cause significant harm, most serious being anaphylaxis (swelling of the airways) which can potentially be life-threatening and requires urgent medical treatment. Medication intolerance often describes a less serious side effect to a medication. For example, developing a stomach upset after taking a certain painkiller. If you are unsure, record the allergy or intolerance on your medication list and discuss this with your doctor.

About the Author:
This article is written by Vanessa Ong. Vanessa is a registered pharmacist with the Singapore Pharmacy Council. She spent several years in the inpatient setting in a local hospital. She enjoyed her time spent in the wards working with a dedicated healthcare team passionate about better patient outcomes. She strongly believes that evidence-based health information can be made simple so that the public can find joy in taking ownership of their health and live life to the fullest.

At Jaga-Me, we believe that healthcare should be a social good – it is a basic human need, and should be available to as many people as possible. We aim to deliver the highest quality care through innovation and a commitment to building meaningful relationships.

Save travelling and long wait times at the hospitals. Get specialised medical treatments:
– Urinary Catheterisation
– Complex Wound Care
– Nasogastric (NG) Feeding Tube
– IV Infusion Therapy

Jaga-Me: Your Trusted Medical Home Care Professional

Once you have sorted out your medication list, the next step of organizing your physical medications at home is essential. Here is a step-by-step guide to help get you going:

#1 Take it all out

Take all your medications out in one spot so you can see all the medications you have at home. This should include any topical creams and ointments, eye drops, inhalers – even supplements and vitamins. Have an empty container or bag to place medications that are to be discarded. You can follow this checklist to decide what should be discarded:

Expiry date
Start checking your medications beginning with expiry dates. Discard any item that is beyond the expiry date. Medications may not be safe or as effective after their expiry dates. You can normally find the expiry date on the medication packaging or on the label. Expiry dates are usually put on medications by the manufacturer that produces it or the pharmacist who supplies it. Some medications like eye drops are usually given an expiry date of 4 weeks after first opening the container. This is to ensure its safe use as our eyes are particularly sensitive to bacteria that might get into the eye drop. When in doubt about the expiry date of a particular item, it is safer to discard it.  Otherwise, always consult your doctor or pharmacist for advice.

Appearance
Even if your medications have yet to reach its expiry date, check its contents to observe for any changes in colour, smell or consistency. Medications that have changed in appearance may have been exposed to too much moisture or sunlight. Discard these medications even if they have not reached their expiry dates as the safety and effectiveness of these medications have been compromised.

Identity
If a medication is no longer in its original packaging or container and cannot be identified, discard it. Unused prescription medications such as leftover painkillers or leftover antibiotics should be discarded. Keeping unused prescription medications that are outdated can be risky as they should not be used for self-medication without a doctor’s advice and can be accidentally taken.

#2 Discard unwanted medications the right way

Medications cannot simply be disposed of by throwing them out or flushing them down the toilet due to potential harm to others and the environment. Once you have identified the medications that are to be discarded, check if there are any specific disposal instructions on the medications labeling or medication information leaflet. Generally anti-cancer medications, antibiotics and medications that can be misused (e.g. opioids) should not be disposed of at home but brought to the pharmacy for proper disposal. If there are no specific instructions on how to dispose of the medications, they can generally be packed in a sealed bag and disposed of together with other household waste, in the rubbish chute or bin. Check with a pharmacist whenever in doubt. Always remember to remove and destroy all identifying personal information on the medication label or container to protect your identity.

#3 Everything has a place

Medications should ideally be kept in a cool, dry place away from moisture and sunlight. However in Singapore with temperatures normally ranging around 30°C, it may be a challenge to find a good place to store your medications at home.

It is commonly misunderstood to store all our medications in the refrigerator believing that it can help to prolong the shelf-life in an island with high heat and humidity. However, unless specified, medications should not be stored in the refrigerator as the moist environment and cold temperatures can cause damage.

Medications should also not be kept in the bathroom cabinet due to the high humidity or above the stovetop due to high heat. They should also be kept away from the curious minds of children. If possible, store medications in the coolest area of the house for example, the storeroom where there are no windows or a kitchen or bedroom cupboard that is away from the window and heating appliances.

Consider categorizing your medications in a divided box or separate boxes instead of throwing them all in to one basket or container. Your family may have parents, young kids, teenagers and grandparents. Organising medications separately with labels helps to avoid confusion and mistakes.

#4 Preventing wastage

If you or your family members have multiple long-term medications, it is easy for medications to accumulate with time. Preventing medication wastage with proper planning and medication organization at home can help to save costs. Here are 3 helpful tips to prevent medication wastage:

1. When prescribed new medications, limit collection to no more than 2-4 weeks supply to prevent wastage in the event of adverse effects, or if the medication proves unsuitable or ineffective.
2. Medications that are taken on a “use when necessary” basis should be obtained in small quantities, with more purchased when required. This applies to common household medications such as paracetamol (for pain or fever).
3. For long-term medications, collect them in installments e.g. a 3-month supply each time or just enough until your next appointment. It is not advisable to collect large supplies at one go as medication changes may happen during each doctor’s appointment as your health condition changes.

Your medications may not spark joy but having a pile of messy and disorganized medications at home could cause confusion. It may even be dangerous and harmful for your health and the people around you. Tidying up your medications helps you manage your health better and helps create a safer environment at home.

About the Author:
This article is written by Vanessa Ong. Vanessa is a registered pharmacist with the Singapore Pharmacy Council. She spent several years in the inpatient setting in a local hospital. She enjoyed her time spent in the wards working with a dedicated healthcare team passionate about better patient outcomes. She strongly believes that evidence-based health information can be made simple so that the public can find joy in taking ownership of their health and live life to the fullest.

At Jaga-Me, we believe that healthcare should be a social good – it is a basic human need, and should be available to as many people as possible. We aim to deliver the highest quality care through innovation and a commitment to building meaningful relationships.

Save travelling and long wait times at the hospitals. Get specialised medical treatments:
– Urinary Catheterisation
– Complex Wound Care
– Nasogastric (NG) Feeding Tube
– IV Infusion Therapy

Jaga-Me: Your Trusted Medical Home Care Professional