Do your patients share or borrow meds?

Did you know that up to 20% to 25% of patients, of all ages, admit to borrowing or sharing prescription medication?

Ellis and Mullan (2009) discussed medication sharing in recent study of data from Australia and the United States. They found the drugs most likely to be shared were opioid analgesics and other pain medications, NSAIDs, allergy medications, antibiotics, anticoagulants, and cardiovascular medications. Most preferred to borrow meds that had been prescribed to them previously.

The authors gathered from the literature that the conditions under which a patient shared or borrowed meds include:
• keeping leftover meds deliberately for next time
• wanting to help a friend
• sharing with a family member.
• asking for the same prescription so they could share with someone else
• borrower had run out of prescription medicine in the short term
Sharing meds was more likely when there were more people in the house, or the patient was single (not in a relationship).

The authors identified a number of problems borrowing and sharing meds could cause, including:
• Complications of incorrect use.
• Development of antibiotic resistance, due to people not following the full course of antibiotics.
• Poisoning of patient due to inappropriate dose.
• Damage to fetus during early pregnancy.
• Delays in seeking professional medical help which could lead to misdiagnosis or diagnosis of a disease at a later stage, leading to poorer outcomes.

Adults use their problem-solving skills to deal with issues in front of them. Patients have told me they think we don’t want them to share meds because we want to make more money. With limited information, it is logical to think saving leftover antibiotics for that next infection makes sense, or saving leftover pain killers for the next episode of pain is a good idea. We cannot expect patients to know what we don’t tell them. Unless we give them the whole picture, with all the rationales and risks, how can they make informed decisions?

The authors’ advice:
• Be proactive. Tell your patients not to share or borrow prescription medicines, and why this could be a problem.
• When a patient’s prescriptions are changed, tell the patient how to safely dispose of old medicine.
• Upon discharge from a hospital carefully reconcile meds. Tell the
patient how to discard medications that are no longer required. Tell the patient that prescriptions are for his or her use only, not to share them, and why.

Anticipatory guidance is an important part of patient education. It is a good idea to clearly tell all your patients not to share or borrow meds, how to safely dispose of meds, and why.

Source: Ellis, J., & Mullan, J. (2009). Prescription medication borrowing and sharing–risk factors and management. Aust Fam Physician, 38 (10), 816-819.