The Case for Writing Things Down

So my tip for the day, though nothing profound, is to keep a list of your medications including the following:

• Names (trademark and generic),
• Dosages,
• Dates taken and dates of any dosage changes,
• List of any side effects for each drug, dates, and whether it resolved,
• Effects, both positive and neutral, on disease activity.
  

            A recent study in the March issue of Arthritis Care & Research reports that while patients with rheumatoid arthritis tend to report current medication use with a high level of accuracy when compared to the medical record, patient self-reporting of past medication has a much weaker agreement level.  They found that patients had poor recollection of the use of individual DMARDS such as methotrexate.
 
            While the researchers did not hypothesize about why people may not be able to recall their medications, I have my own theories.  Maybe it’s because drug names are difficult to remember.  Maybe it’s because people often don’t really understand their medication regime or can’t remember the dosages without looking at the bottle.  When I switched from Celebrex to Mobic last year, I knew the dosages were vastly different, but it took me months to remember what it was.  All I could remember was to take one pill per day.  And maybe when people try many different medications over a long period of years, like I have, things just run together and they forget the particulars, like the dates and any side effects.  This can be a hassle, both when filling out patient histories for a new doctor or for justifying a Tier III medication.  By Tier III, I mean those drugs on many insurance formularies that require documentation of the failure of other drugs before insurance will approve the current drug.  
 
For example, when I began taking Humira a year and a half ago, my rheumatologist had to send the names and dates of at least three other failed medications, both NSAIDs and DMARDS.  Naming the drugs was easy for me, but I couldn’t remember the exact dates and saying, “well sometime around my sophomore year of college and last year” doesn’t cut it.  I’ve also moved quite a bit and have had 4 rheumatologists over the last 10 years, but I haven’t always remembered to request my medical records from each doctor.  It’s something I always mean to do, like finally making that medication list… but I never seem to get around to it.  It's one of those tedious resolutions that always seems to be broken early.