RESEARCH INFORMATION ON INDEPENDENT LIVING

Permission granted to reproduce. Please cite source.

Volume 2, Issue 2

Medical Prescriptions

Lack of coverage for medications can have grave health consequences for people with chronic conditions and diseases. It also limits their ability to live independently, stated Disability, Medicare, and Prescription Drugs (2001) by the National Economic Council.

            Prescription medicine provides critical health care for people with disabilities. It also helps them live independently and return to work.

            For example, New medications treating schizophrenia that emerged in the 1980s have allowed more consumers to take part in the community. It is estimated that between 19% to 45% of people with severe psychiatric disabilities living in the community take drugs that reduce psychosis and treat other forms of mental illness.

            Medications also carry risks. Taking more than one prescription drug from different physicians or mixing a prescription with over-the-counter drugs are two possible risk  situations.

            Consumers need to ask questions about their medications. “What are the side effects?” is one typical question. It may help to write down questions before seeing the doctor.

            All medications have some side effects. Ask your doctor to describe them before taking a drug. It is also important to tell your doctor of ANY side effects or problems that you are having while taking the medication. If the side effects bother you too much, ask to change the medication or consider adjusting the dose. 

            A doctor may prescribe a medication to reduce side affects, but these medications have their own side effects (for instance, blurred vision and sedation). Even under the best of circumstances, medications do not work for everyone.

            Doctors should describe the normal effects of a drug and what changes to expect in your body. They also should tell how long it will take for the medication to begin working. If you think it would be helpful, get family members or significant others involved in your drug treatment choices.

            Remember, you are not required to take any medication unless you and your doctor think it will help.

            It’s a good idea to know your medication history. Keep records of medicine taken, how well it worked, and any side effects. Realize that doctors are busy and may have conflicting interests, especially if they work for managed care companies that may require them to prescribe certain medications.

            Because of managed care's growth, Ellen Grabois of Baylor College of Medicine and Mary Ellen Young of the University of Florida at Gainesville asked 16 people with disabilities in managed care plans about their satisfaction with their health treatment. One of their problems was not getting approval for the most effective medications needed for chronic disease symptoms. Managed care organizations should be more flexible when providing for individuals with disabilities, the researchers concluded.

            Physicians also are not experts on everything. Take notes during the appointment. Bring a friend or advocate, too, if they make you feel more comfortable.

            Older people have a decreased ability to process medications and tend to have more side effects than those who are younger. Why? With aging comes a loss of water and muscle and increase in fat. These changes affect medication absorption. Aging also slows down kidney and liver functions.

            Medications, too, have stronger effects on aging people. This creates possible over-medication. It is estimated that 25% of older people’s admissions to hospitals results from incorrect use of prescription drugs. Reactions can resemble conditions such as dementia, Alzheimer’s, or senility.

            ― Cindy Higgins, The Research and Training Center on Independent Living, The University of Kansas. This project funded by National Institute on Disability Rehabilitation Research grant  #H133A980048.

            Information for this review came from the interactive Research Information on Independent Living (RIIL) database at www.GetRiil.org, which contains research summaries related to independent living with disabilities. A special effort has been made to include information that independent leaders in the field said they wanted, namely topics regarding accessible, affordable housing, effective advocacy for rural areas, effective transition from schools and nursing homes, accessible, affordable transportation, reaching underserved populations, policies that impede independent living, rural health care services, and Medicaid/Medicare regulations for durable equipment.

            RIIL is a joint effort of the Research and Training Center on Independent Living at the University of Kansas and the Independent Living Research Utilization (ILRU) Program of TIRR.