Making wise choices about medicines
Do you know what to consider when making medicines choices and talking with your doctor? Read how to weigh up the pros and cons of taking a medicine and how to work with your health professional to make the right decisions for you.
Is this medicine right for me?
To get the best out of your medicines, it helps to understand them and to think about whether they are right for you. Making wise choices about medicines will help you do this by:
- showing you how to weigh up the pros and cons of taking a medicine
- giving you the skills to work with your health professional to make the right decisions for you.
Some people want to be more involved in making decisions about their medicines than others. Some want to be very involved, do their own research and carefully weigh the benefits and risks of different treatments with their health professionals. Others prefer their health professionals to make the decisions for them. Either way, it is important to speak up if you don't understand something or if you have concerns about your medicines.
Good communication is a two-way street, and you have a crucial role to play.
You know your own health concerns, values and priorities better than anyone else. So feel confident to ask questions and discuss your wishes and concerns with your health professional.
Everyone is different. Some people prefer to let their health professional make all the decisions about their medicines. Others want to know absolutely everything there is to know about every medicine they're taking. The important thing is that you make the decision and make it quite clear to your doctors, your nurses, your pharmacists, exactly how much information you would like to have. It's extremely important that people know what medicines they are taking, what they're for, and any possible side effects they might have or any interactions with other medicines they might be taking. Only with that information can they decide if that's the appropriate medicine for them.
Weighing up your options
Questions to ask your health professional about medicines.
There are times when it is very clear you need a particular medicine or medication, and the benefits greatly outweigh the risk of side effects.
To understand the benefits and risks of taking a particular medicine you can start by asking your health professional the following questions:
- What are the likely benefits of taking this medicine?
- What risks, such as medication side effects, should I be aware of?
- What would happen if I didn't take this medicine?
- What are my other treatment options?
- Which option has the best balance of benefits to harms for me?
Other points to consider are:
- How do I take the medicine and for how long?
- How much is it going to cost?
If your health professional has recommended a particular medicine, the best place to start will be to ask them why. Ask what benefits you can expect from taking the medicine. Discuss how important these benefits are to you.
Also try to find out how effective the medicine is, and for whom. A harder question to answer is how likely you are to get these benefits. No medicine is effective in everybody, so it is worthwhile discussing with your doctor how you will both decide if the medicine is working.
It's very common for people to not understand their medications. Don't be afraid to ask questions. I very often suggest people write a list of questions that they have that they would like answered, and a lot of people say, 'Oh, doctors are too busy'. I always say you can't take the goods back; it's not like Franklins.
So you go with your list and you can present it to the doctor; it makes it a lot easier for him or her too to know that you're interested, you're informed in some way and you want certain questions answered. So I think it makes it a lot easier for everybody to get the answers that you want.
Very often we will go into the doctor, they say, 'how are you?', you say, 'fine thank you', you go out and you say, 'I wish I had asked him this', or 'I wish I had asked him that'. So I think a list is always very important: a list of medications that you are on already; a list of your symptoms, because you probably may forget some of them.
The most important thing is just don't be afraid to speak up with somebody. There is your pharmacist; there is your doctor. Your doctor should be your first port of call, but sometimes they are difficult to get hold of or they're not there, then go to the pharmacist.
All medicines can have side effects, but not everybody will experience them. You should find out about:
- common side effects — which you are more likely to experience, but are usually less serious
- serious side effects — which are often less likely, but may have a greater impact if they do occur.
Side effects always need to be weighed up against the likely benefits. You should also be aware of the possibility of interactions between different medicines.
Some illnesses, such as colds or flu, get better without you needing to take any medicine. However, other conditions will get worse and may cause irreversible damage if you don't take medicine to treat them. Talk to your doctor so that you understand what will happen to your health if you don't take the medicine.
There may be other treatment options to consider. If you want to compare more than one medicine, you need to consider the benefits and risks of each.
There may also be other approaches, such as, physiotherapy, counselling, surgery, vitamins or other supplements that may help improve your condition.
Lifestyle changes may also be another treatment option. Bear in mind that often you don't have to choose between the two — lifestyle changes can often be a good idea as well as taking medicines (see box).
Some people can lower their blood pressure enough with regular physical activity and a healthy diet that they don't need to start medication, or can at least delay it for a while. Losing weight or being physically active can also prevent or delay the onset of diabetes and reduce pain in osteoarthritis.
Medicines can come in many forms such as tablets, powders, liquids, patches, injections, inhalations and suppositories. Some can be taken once a day, some must be taken four times a day. Some are a one-off treatment, others are a month's course, and some need to be taken on an ongoing basis.
Whatever the type of medicine, it is important that you take it only as directed. Taking it incorrectly could mean you end up with too little or too much of the medicine in your body, meaning you don't get the full benefit, or you are at greater risk of side effects and other risks, respectively.
Make sure your health professional provides clear written instructions on how you need to take your medicine. If you are concerned that you will find it difficult to take the medicine as prescribed, discuss this with your health professional.
Most prescription medicines in Australia are subsidised by the Government under the Pharmaceutical Benefits Scheme (PBS). For medicines listed on the PBS the patient pays a reduced amount (co-payment), and the federal government pays the remainder of the total cost.
The Safety Net entitles people to free or cheaper medicines if they spend more than a certain amount on PBS (prescription) medicines in a calendar year. If you were paying the general rate, your payments will be reduced to the concessional rate once you reach the Safety Net threshold. If you were paying the concessional rate, PBS medicines will be free for the rest of the year.
These thresholds apply to family units and are the same regardless of whether the unit consists of one person, a couple, or a family with dependent children.
The size of patient co-payments for PBS-subsidised medicines, and the Safety Net thresholds, can change, but you can find the current values on the PBS website under What are the current patient fees and charges?
If a medicine is not on the PBS for your condition, you will have to pay the full price for it. This will usually be between $10 and $100 per prescription, but in some cases it can cost hundreds of dollars.
If the cost of the medicine is a problem for you, ask your health professional if there are more affordable options. For tips on how to keep your medicine costs down, see Keeping a lid on medicine costs.
1. Take your time
In many cases you won't have to make a decision immediately, so ask your health professional whether you have time to think things over. If you are not sure what to do, tell your health professional this and arrange to come back in a few days when you've done some research and had time to think about it.
2. Take notes
Sometimes it is helpful to take notes when you are talking to your health professional. The Questions to ask your doctor tool can help you make a list of questions, and includes space to write your notes.
3. Weigh up your options
Once you have information about the benefits and risks of your treatment options, think about how they compare and which is best for you. If you are finding this difficult, the Personal decision guide for medicines (below) may help.
Remember that to use the same process if you are deciding whether to take a medicine at all — think about the benefits and risks of taking the medicine versus not taking it.
Personal decision guide for medicines
If you are trying to decide between treatments, filling in the Personal decision guide for medicines may help you compare your different options.
It has space to list the pros and cons of each option, and you can give each factor a rating according to how important it is to you. Remember if you are deciding whether to take a medicine at all, you can think about it the same way — weigh up the benefits and risks of taking the medicine versus those of not taking it.
Remember to always talk over your medicines decisions with your health professional.