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Journaling to most people sounds like a chore.
They may have tried and failed in the past because they did not have a system. I will describe how it can be done quickly and easily.
This can be a powerful habit that leads to you better understand your medication. In this case your goal would be to improve your health and save money on medication in the process.
People who reach their set goals in life most often do so because of habits they have formed. This is no different, journaling around the time you are taking your medication each day, not only ensures you reflect on how you feel, it also makes sure you take your medication, which is one of the biggest issues in healthcare today.
Why is journaling needed?
According to a study from the Journal of the American Medical Association, Americans pay more for their medications than any other country. On average, Americans spend $858 per person on medications each year versus $400 in other develop nations.
There are many reasons for the excess spending and I won’t get into those in this post. The point I am trying to make is that if you are spending that much money, you should be getting a positive response…right?
What do I mean by bulleted journaling exactly?
It means you briefly document several things about your medications. Keep your journal near the place where you keep your medications or where you actually take them.
The best way to keep your journaling brief is to use a short form bulleted fashion to ensure you get the thoughts and feelings out without too much verbiage to sift through. This is very important because you want to be able to quickly go back and find details over time and this method will allow you to do just that.
You can organize these things by denoting each topic with a different bullet icon. The icons can be anything you want them to be. In the list below the example uses shapes of circle, square, triangle and diamond. The topics for each shape are:
How is med making me feel in the past day?
- How did you feel before you took your medication for the day?
- You need to note the good and the bad feelings
- Document any blood pressure, book sugar readings.
- Any home testing that you are doing you should document the numbers you got under the circles bullet.
- How did you feel after you took your last dose of the medication, so the day before or the dose before.
- The idea here is you have the journal in the place where you keep the medication and jot down these notes right before or right after taking the medication. Clearly you won’t be able to have a change in how you feel immediately after taking most medications. That is why you should reflect on how you felt after taking the last dose.
- Examples could be: felt tired or had headache
- Examples for after last dose could be: stomach felt funny or had a lot of energy
Did you take the med and when did you take it?
- What time did you actually take the med?
- Did you forget previous doses that day or the day before?
- Adherence to your medication is probably the single most important determinant to that drug actually helping you. When drugs are brought to market the pharmaceutical companies make sure the doses are taken as they should be. If you don’t take it as prescribed then you likely will not get the same effect. Being able to pull this out of a journal quickly is invaluable information for a doctor. The majority of patients overstate how compliant they are when simply going from memory.
- Did you forget previous doses that day or the day before?
What did you do before you took the med?
- Did you take the med with food?
- Did you drink alcohol before taking the med?
- Did you smoke prior to taking the med?
- Did you do strenuous exercise prior to taking the med?
- Anything that was significantly different than what you normally do should be documented.
What is your perception about if the medication is working?
- Do you think the med is working?
- Do you think the med still needs more time to work?
- Do you think the med used to work for you and now is not?
Once you start journaling you will need to put a key in your journal to remind you what to document for each bullet type. After a week or so you will remember what each one means.
Prior to visiting your doctor you can quickly go through the shapes and jot down the overall summary for each shape. This will allow you to tell your doctor quickly how you feel short term, if you have been taking it correctly, what you take the med with and if you still feel if it is working or not.
I recommend some journals at the end of this article that I feel are great resources. Journaling does not have to be in a journal it can be on paper as long as you keep dates noted, or it can be done on your phone or on various apps.
The Reasons to keep a bullet journal of your medications
How do you know the medications are working if you don’t journal? Do you really know if you’re getting a good value out of your $858 dollars or more annually? Everyone thinks that they will remember how they felt before they started taking a medication but in 30, 60 or 90 days it can be tough to recall, much less notice a pattern.
If you don’t keep a journal on your medications you likely have no idea if they are really working. Or worse yet if that expensive medication is the reason you are having some other adverse effect.
The ultimate pharmacy disappointment is to take a medication that gives you a side effect that you end up having to take another medication to treat. If the medication is not working then you can talk to your doctor about discontinuation and that can save you big bucks.
Studies have looked at the typical length of an office visit with your doctor in the room and determined it is around seven minutes in length. Is seven minutes enough time to recall all the things that might be good to review with your doctor about the medications you take and the effects or lack thereof they are having for you? If you don’t go into a visit with your doctor prepared to talk about your health then the visit will not have maximum value.
Doctors are busy people. They are paid today by the number of patients they can see. You might be one of thirty or more patients they will see in a day. You can’t expect them to remember every detail of your previous interactions.
Even though your information is in an electronic medical record you see them looking at on a laptop during the visit, it is not always easy to pull out all the details. Especially within seven minutes. That is where you can help your doctor out, by having the synopsis of the key things you need to discuss will keep you healthy and save you money in the long run.
You need to be able to tell your doctor if you are taking your medication correctly. What does that mean? Well the typical patient is non adherent, which means they don’t take their medication as often as they are supposed to.
An example is you should take your fluoxetine 20mg once per day. You actually forgot to take the medication three times this week and two times last week. So, in the last two weeks instead of taking 14 doses, you actually only took 9. You tell your doctor that you are still feeling depressed but if you don’t tell them about the missing doses your doctor increases your dose to 40mg per day.
Your doctor can’t serve you if they don’t have all the information!
Now you put yourself in a position to have more adverse effects with the higher dose. In reality if you would have taken the 20mg as prescribed it could have been effective for you and put you at less risk of adverse effects. If you don’t journal when you took your meds then you lose insight into this important fact.
By the way, don’t feel bad many patients struggle with adherence. Many forget to take doses, it is okay! Don’t be afraid to tell your doctor and pharmacist, they will not be mad or scold you. However, they do need to know so they can advise your properly on next steps.
Being forgetful is one thing, but if you are skipping doses because the medication is causing side effects that is another. If you are journaling and realize that you are continuing to feel bad after taking the medication and that is causing you to not take it frequently, then don’t wait. Contact your doctor and talk to them about what you should do. Waiting until the next appointment that might be months away is not the best option. Journaling allows you to know when communication with your doctor and pharmacist is needed
If you have read my book Prescription for Maximum Savings then you know I recommend making medication changes one at a time. The only way to make sure the changes you make are effective is to journal about this day by day. You need to ask your doctor when you should get full effect from your medication. Once that timeframe nears you need to go back and review your bulleted journal entries and look for patterns. Those will be the key points to discuss so you don’t waste money on changes that don’t work for you.
Everyone needs to keep a personal medication list. You can see my medication list I created that has the most important pieces of information you will need to share with your healthcare team.
How does journaling tie in with a medication list? The medication list needs to be kept up to date and if you are journaling and keeping this medication list in the journal then when you prepare to see your prescriber it will be easy for you to update. Now you will have a complete medication list that is updated with key points you have noted during your time since last visit in your journal. This is the best way to help your doctor and pharmacist have the most current information about you, thus saving precious time during an office visit.
Your doctors list must match yours!
Your doctor will have a list of medications that they think you take based on their electronic medical record. However, a high percentage of the time this list is not current nor completely accurate. You are the one living your healthcare journey and only you have the truly updated Medication list.
Your doctor may not have insight into the other doctors you see and the medications those other doctors have prescribed. You always need to make a copy of your medication list to any doctors appointment. You will want to make a copy of it for your doctor prior to the visit. Then you can take in your journal with you if you need to show them what you have been documenting over and above any brief notes you put on your medication list.
The list has to have all medications
Your medication list will be all encompassing, including prescription medications, over the counter drugs and any dietary supplements or herbal products you use. You will be amazed at how this can improve the understanding of the true picture of your health for your doctor. Ultimately, you will be in charge of your healthcare and how much you spend on it.
The Bullet Journal
Bullet Journal is a great journal resource. While not intended specifically for medication journaling the Bullet Journal takes journaling to the next level for all areas of your life. This book has now reached New York Times Bestseller status.
See the video below where a patient describes the value of journaling on his medications. For more actionable advice on how to save the most on medications, check back to my blog for the latest updates.