Yin Ling Wong, Emily Musing’s father
Yin Ling Wong, Emily Musing’s father, with his grandchildren Marisa and Max, had to keep track of 20 medications daily. (Photo: Courtesy of Emily Musing)

Keeping track of about 20 medications at any one time was distressing for Yin Ling Wong, who usually managed his multiple conditions well into his 80s, with confidence and a smile.

"My father was well-organized, independent and energetic," says Emily Musing, Executive Director, Pharmacy, Clinical Risk and Quality and Patient Safety Officer at UHN. "But he found himself in a situation where he had to take many drugs, see multiple specialists and it was confusing. He was not sure what each specialist knew, how best to ask questions and what phrases he should use."

Although Emily tried to accompany her dad to many of his appointments, she could not be with him at all times. So she devised a "tip sheet" with a few basic questions and phrases to help her dad get the correct, up-to-date information for safe use of each medication. She also wanted him to feel confident that he was asking questions that made sense to both himself and each clinician.

In a media conference on Wednesday at Toronto General Hospital, Canadian safety organizations unveiled a set of five questions which patients and families can use to begin the conversation with healthcare providers.  These questions were based on Emily's early suggestions to her dad.​

Emily Musing in front of sign
Emily Musing, Executive Director, Pharmacy, Clinical Risk and Quality and Patient Safety Officer at UHN, holds a bag of typical medications that would be used by an older patient with multiple disease conditions. The set of five questions unveiled at Wednesday’s news conference were inspired by the ones Emily developed to help her parents and in-laws navigate the healthcare system. (Photo: UHN)​

The five questions, which can be downloaded here, are:

  1. Have any medications been added, stopped or changed and why?
  2. What medications do I need to keep taking, and why?
  3. How do I take my medications and for how long?
  4. How will I know if my medication is working, and what side effects do I watch for?
  5. Do I need any tests and when do I book my next visit?

'An industry issue'

Ensuring accurate and comprehensive medication information can be challenging for both the patient and healthcare providers. A 2004 Canadian study of hospitals across Canada found that drug- and fluid-related events were the second most common types of procedures or events related to patient safety incidents.

"Healthcare as we currently practice it is not as safe as it could be or should be. We have to acknowledge that preventable harm is an industry issue," said Dr. Peter Pisters, President and CEO of UHN. "Questions like these bring our patients and their family members into the patient safety conversation in a very meaningful way."

Typically, the number of medications that a healthy person who is in their 80s takes every day can range from eight to 12 pills. That range increases to 15 to 20 medications daily for a person with multiple conditions, such as diabetes, high blood pressure, kidney disease and infections.

"Having a set of questions helped my dad start the conversation about his multiple medications. He used to be worried, but with this tool, he was ready to be a partner in his own care," said Emily.

Please click here for a media release from Wednesday's media conference.​

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