MS: Managing Your Medications

The MS medication challenge

People with MS may be on a variety of medications for multiple sclerosis therapy, including medications to slow disease progression, drugs to manage symptoms, and medications to treat acute attacks. But many people with MS may be missing out on the benefits because they don't take their medications as directed. This problem affects up to half of all patients taking disease-modifying drugs for MS. Why?

There's no simple answer. The reasons are complex and different for each person. But some common reasons include:

Forgetting when and how to take the medication: This is a problem for many people taking long-term medications, but for people with MS, cognitive impairment and memory issues may make it even more difficult to keep track of their medications.

Physical issues: People with MS may have coordination problems, fatigue, vision problems, tremors, and spasticity (involuntary muscle spasms). These physical symptoms may make it difficult for them to open medication containers or give themselves injections (disease-modifying medications for MS are given by injection).

Expectations and concerns about the medication: It's hard to stick with a medication when it doesn't work as well as you'd hoped it would. While hope is important, it's also important to have a realistic expectation of how well the medication will work so that you know what to expect. Fears or concerns about a medication can be another barrier to using it as directed. These can range from anxiety about self-injection to fears of side effects or concerns that the medication won't work. People may also experience feelings of denial about having MS and view taking medication as a sign that they are sick.

Are you experiencing any of these medication challenges? If so, learn more about how to manage them in the next topics of this health feature.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Managing-Your-Medications

The MS symptom catch-22

Medication Management

Some of the physical disabilities and symptoms caused by MS, such as coordination problems, fatigue, spasticity (involuntary muscle spasms), tremors, or vision problems, can get in the way when it comes to taking your medication as directed. It becomes a catch-22: you need the medication to deal with the symptoms, but the symptoms keep you from taking the medication. So what can you do?

The first step is to identify which symptoms are making it harder for you to take your medication. Then, you can create your own plan to make it easier by choosing the suggestions that match your symptoms.

If you have vision problems: You may have trouble reading your prescription bottle and seeing which medications you are taking. Here are a few things that may help:

Use a magnifying glass to read the label and view the medication.
Have someone (such as your pharmacist, a friend, or a caregiver) attach coloured, large-print tags to each drug container so that you can see them. If they do this, make sure someone double-checks their work.
Ask if your pharmacist can print your labels in larger type or Braille. If not, ask them to refer you to a pharmacy that can.
Have regular eye check-ups and keep your prescription for glasses up to date.

If you have coordination problems, spasticity, or tremors: It may be harder for you to open medication bottles (especially child-proof ones!) and give yourself injections. To get around these problems:

Ask your pharmacist to dispense your medication in non-childproof bottles. These should be easier to open. If you use non-childproof bottles, be sure to keep the medication well out of the reach of children. You can also use devices that are specially designed to help you get the bottle open – ask your pharmacist or occupational therapist where you can find one.
If you are giving yourself medications by injection, check to see if the medication is available as a prefilled syringe. With a prefilled syringe, you do not need to mix and measure the medication before injecting it. This can make it easier to administer, especially if you have coordination or spasticity problems.
Another option is to ask a friend, loved one, or caregiver to give you the medication, or find a nurse who is available for home visits.

If you suffer from fatigue: You may miss doses because you are asleep, or may feel too tired to give yourself the medication. There are some things that you can do to help:

Schedule medication taking (especially injections) for the times of day when you are most awake. Set an alarm at the scheduled dosing time to make sure you are awake, or ask a friend or loved one to remind you to take your medication.
Talk to your doctor or pharmacist to see whether one or more of your medications could be making your fatigue worse.
If you are taking several medications or using medications several times per day, ask your doctor or pharmacist if your medication schedule can be simplified. Often it is possible to reduce the number of doses per day by switching to combination medications or drugs that are given less frequently.

Keeping track of your medications

Medication Management

Approximately 43% to 65% of people with MS have cognitive problems (troubles with thinking, memory, reasoning, or concentration) that interfere with their daily lives. And about half of MS sufferers have these difficulties in a less severe form.

Cognitive problems can lead to trouble when it comes to medication. People may forget how the medication should be used or what it's for, they may forget a dose, or they may take double doses because they not remember that they've already taken the medication. What can you do if cognitive problems are interfering with your medication taking?

Ask your pharmacist for help. They will work with you and your doctor to "tune up" your medications. They will suggest getting rid of unnecessary medications, switch medications that are not working well (or change the dose), and add medications that you may need but are not receiving. They will also check for side effects and drug interactions, and help you simplify your medication routine to make it easier to remember. They may also suggest other steps to help you keep track of your medications, such as memory aids. As well, they will review the medications with you so to make sure you're clear on what it's for, how and when to use it, and what to expect. After the review, they can provide you with a medication list showing your current medications and doses.

Try a memory aid. Memory aids such as alarms, calendars, and dosettes (plastic medication containers with slots for each day so that you can see whether you've taken a dose) can all help you keep your medications straight. Ask your pharmacist which system might work best for you. You can either fill the dosette yourself or have someone (preferably a pharmacist or caregiver) fill it for you. Medications can also be blister-packed in a pharmacy to work like dosettes.

Carry a medication list. Ask your pharmacist or doctor for a medication list (a list of all of your current medications and their doses, along with any medication allergies you may have). Keep a copy at home and carry one with you. This will allow all health professionals involved in your care to see which medications you're on at a glance.

MS treatment: expectations and reality

Medication Management

Could your expectations and concerns about a medication stop you from getting the most out of multiple sclerosis treatment? Yes - if your expectations are not realistic or your concerns are not properly addressed.

Set realistic expectations. If you do not have a realistic expectation of how the medication will help you, you may be disappointed (and possibly stop a medication that is giving you some benefit) when it does not work as well as you hoped. Talk to your doctor or pharmacist about what to expect from the medication. Find out when it will start working, what it will do to help you, and how much of an improvement you can expect.

Address your concerns. Concerns about the medication, such as fear of side effects and anxiety over having a needle, can stop you from using a potentially helpful medication. It's important to address these concerns so that you have all the information. This way you can make an informed decision of whether to start the medication, and you will also be prepared to deal with any side effects or other problems that may come your way while you are taking the medication.

Talk to your doctor and pharmacist about which side effects the drug can cause, how likely they are to happen, and what to do if you experience them. If you have other specific concerns, such as the cost of the medication or a fear of injections, tell your doctor. Financial assistance is available. Injection training can help you overcome your fear and inject yourself with confidence, and injection forms such as prefilled syringes can help make it easier for you to use injectable medications.

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