Preventing Reactions That Impede Compliance

• Discuss the patient's drug therapy with him. As he receives drugs, name them, explain their intended effect, and describe possible adverse reactions to watch for and report.
• Tell the patient that you'll ask questions to help identify (or reduce the risk of) harmful food or drug interactions (such as those caused by alcohol and caffeine) that may interfere with compliance.
• Ask the patient about all drugs—prescription, nonprescription, and herbal remedies—he's currently taking and those he has taken in the past. If possible, ask to see samples. Have him name each drug and tell you why, when, and how often he takes it. Remember, the patient may have drugs prescribed by more than one physician. Ask whether he's taking any drugs originally prescribed for another person (a common occurrence).
• If your facility has a specially designed computer program, use it to help prevent possible drug interactions. Enter all the data you've collected on drug dosage, frequency, and administration route into a master file of drugs commonly used by elderly patients, such as anticoagulants (warfarin), benzodiazepines (diazepam), beta-adrenergic blockers (propranolol), calcium channel blockers (verapamil), digitalis glycosides (digoxin), and diuretics (furosemide). From this information the computer compiles a list of the patient's drugs, possible adverse reactions, potential interactions, and suggested interventions. Then review the findings with the patient. If he knows what to expect, he'll be more likely to comply with treatment. (If you don't have access to such technology, you can compile a similar list using a reputable drug reference.)
• Alternatively, encourage the patient to purchase drugs from only one pharmacy, preferably one that maintains a drug profile for each customer. Advise him to consult the pharmacist, who can anticipate drug interactions before they occur.
• Inform the patient about specific food-drug interactions. Based on the information in your drug history, provide a list of food items to avoid.