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by Abigail Van Buren

DEAR ABBY: This is in response to "Lee in Walnut Creek, Calif.," whose husband was on 11 different medications and experienced either drug interactions and/or dosage problems that led to increasing disability.

My immediate reaction to that letter was WHERE WAS HIS PHARMACIST? Could it be that the family used several pharmacies and were never asked for a complete medication list? However, someone should have asked. Pharmacists are required by state and federal regulations to counsel patients on all new prescriptions. Being aware that a patient is taking multiple prescriptions should have sent red flags up in the mind of any pharmacist taking care of that man.

I have been a practicing pharmacist for 30 years. Any time a patient takes more than eight different medications a day, I start asking questions. Often I find that some of the medications are being used to treat side effects of other medications! Then the appropriate solution is to find an alternative medication with fewer side effects.

Poly-pharmacy (the use of multiple medications for one patient) can be very dangerous. Unfortunately, many pharmacists may be hard-pressed to find the time to counsel adequately. Also, some doctors view us as police and resent our intrusion into their field of expertise.

I know doctors who listen and doctors who don't. However, those who always listen are the patients or caregivers, because they are the most affected. So I educate the patient and send him or her back to the doctor with alternatives and the tools necessary to adequately communicate their concerns. It's the biggest part of my job, and the one I don't get paid for.

To answer Lee's question about what happens to patients who have no reliable caregiver to look out for them: They enter nursing homes, or -- if the statistics can be believed -- they die. It is estimated that more than 100,000 persons in the United States die every year because of poly-pharmacy.

How do we protect the people we care about? Ask questions! Ask the doctor, the nurse and the pharmacist. Make a list of all prescribed and over-the-counter medications the patient is taking. Know what each medicine is for and what it will do. When given a new prescription, ask what current medication it replaces.

Abby, health care will not change unless we force it to. As patients we should all expect the best from each member of the team who helps us stay well. I hope your readers will make good use of this information. -- MARTHA G. MOSHER, R.PH., SENECA CASTLE, N.Y.

DEAR MARTHA: You have written an important letter. I hope it will persuade patients and caregivers to discuss their medications -- and possible drug interactions -- with their physicians and pharmacists. One can never be too careful. If someone is having prescriptions filled at several pharmacies, serious consideration should be given to ending that practice.

Dear Abby is written by Pauline Phillips and daughter Jeanne Phillips.

Good advice for everyone -- teens to seniors -- is in "The Anger in All of Us and How to Deal With It." To order, send a business-size, self-addressed envelope, plus check or money order for $3.95 ($4.50 in Canada) to: Dear Abby, Anger Booklet, P.O. Box 447, Mount Morris, IL 61054-0447. (Postage is included.)

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