November 2012


Dag-nabbit! 

Walter Brennan was a familiar character in many of the western movies and television shows, including “The Real McCoys”, we watched growing up as a kids in my parent’s home. I always remember when he was angry or just really emphatic he used the word dag-nabbit often in these shows.

I was recently reminded that Walter Brennan played the role of Murph, a pharmacist, in the 1947 movie “Driftwood”. I don’t remember if he used the word “dag-nabbit” in Driftwood or not. But I can imagine him as a pharmacist using it when frustrated with patients who don’t take their medication as prescribed.

Physicians and pharmacists dedicate their lives to helping patients manage their various disease states with the help of prescription drugs. Whether it is hypertension, diabetes, COPD, Parkinson’s or any other chronic disease a patient may have… if patients don’t take their medication as prescribed their disease will progress and they may find themselves in the emergency room at the local hospital.

$300 billion dollar a year problem: 

And dag-nabbit, we’ve got a medication adherence problem in the U.S. that increased healthcare costs by over $300 billion last year! Failure to take medications correctly decreases the quality of life for these individuals and it’s estimated that failure to take prescription medications as prescribed results in over 125,000 deaths each year.  So why don’t people take their medications as prescribed?

barriers to medication adherence

There are a number of reasons people don’t take their medications correctly. Communication barriers, socio-economical barriers and motivational barriers all contribute to the medication non-adherence problem.

Forgetfulness, poor understanding of disease or illness, concerns about medication costs are all contributing factors to the non-compliance issue. So how do we work towards solving the medication adherence problem?

Solving the medication adherence problem: 

Healthcare professionals need to step up efforts to engage and educate patients to the importance of taking medication correctly. Physicians, nurses and pharmacists should increase efforts to enhance patient’s understanding of their disease and how they will benefit from taking their prescription medications appropriately. Pharmacist medication therapy management MTM has also been shown to increase adherence resulting in improved patient outcomes and reduce healthcare costs.

There are a number of organizations like Script Your Future that provide information and tools to improve medication compliance. Those who care for the elderly can also assist patients with reminders to take their medications as prescribed.

Technology can help with medication reminders and tools that improve medication adherence. Text messaging and reminders via phone are available to give personal medication reminders. There are many ‘pill reminder’ devices and systems available that have audible alarms or visual cues to remind patients it’s time to take their medication.

The LCD Compliance Card is the most accepted and used compliance device in the world. More than 10 million units have been distributed globally in several health care fields including both physician and veterinary practices.

The functions of the Compliance Card are all pre-programmed. There are no user settings. Users start the device at the desired time of day by depressing one button. There are variations of the Compliance Card that adapt to multiple regimens including daily, twice a day, or once a week.

So dag-nabbit – there really shouldn’t be any excuses not to take your medicines as prescribed!

I was immediately intrigued when I read @PhilBaumann ‘s thought provoking post titled ‘140 Health Care Uses for Twitter‘.

Twitter evolution via @mashable
(nursing caps added)

I’ve observed many of the 140 uses Phil mentions over the last couple of years while following and tweeting on Twitter.  But some of the ideas he came up with were totally new to me, if not ‘off the wall’ in some respects. Phil comments: “there’s potency in the ability to burst out 140 characters, including a shortened URL”… and he’s right!
Twitter is potent medicine!
He also cautioned about several additional issues health care tweeters face including patient privacy, legal and HIPAA concerns.

But if we focus on what Phil suggests, to “be imaginative, determined and innovative” in our approach to using Twitter (and other social media) as a powerful adjunct ‘healthcare tool’, we’ll find even more possibilities and ways to improve patient lives.

As a pharmacist the gears in my head started turning right away after reading #29 – Prescription management, including pharmacy refill reminders.  I thought I would expand on a few uses for Twitter that pharmacists might employ in their practice in the future.

Phil already mentioned the first one on my list, #29a prescription refill reminders. I would add #29b “your prescription is ready” reminders and #29c “we’re waiting for your doctor to authorize a refill” reminders. There may be others that fall into similar, logistical type categories as these.

Here’s a few more I thought of that expand on and utilize the pharmacists professional expertise:

#29d:  Patient Medication Education-

This is an area any pharmacist on Twitter can leverage, after all, pharmacists are medication experts.  Most of my tweets on any given day will have some component of patient education, although some more than others. One patient education plan could be to target specific disease states or patient populations to help them understand their disease and how to manage it properly. Another plan could be to educate patients on drugs and drug interactions as well.

#29e:  Medication compliance and adherence-

Lack of adherence to prescription medication therapy cost the U.S. $317.4 billion in 2011 and we can expect that figure to continue to rise until we find solutions to the problems surrounding the issues of compliance. Pharmacists who find a way to improve medication reminder programs for their patients will not only save healthcare dollars but improve patient lives. Twitter and/or texting could be leveraged to improve patient compliance.

#29f:  Medication safety and drug interaction alerts and reminders- 

Twitter could be utilized by pharmacists to notify patients of medication safety issues and potential drug/drug or food/drug interactions that could be problematic. There are over 2 million cases of adverse drug interactions annually in the U.S. resulting in over 100,000 deaths. The cost of these adverse drug interactions is also in the billions. It’s even more difficult to measure the cost of human suffering and loss of life.

#29g:  Alerting patients about special pharmacy programs- 

Many pharmacies offer special clinical outreach programs and screenings including blood pressure checks, blood glucose screening, bone density testing and immunizations. These could be promoted via Twitter and other social media sites. Twitter could be used as a patient reporting tool for tracking health data.

#29h:  Drug recall notifications- 

Pharmacists and pharmacy technicians are often involved in drug product recalls, both prescription and over-the-counter medications. It’s important to pass this information on to patients and consumers alike.

#29i:  Pharmacist to Pharmacist interaction-

One of the greatest benefits I’ve discovered (and it took me awhile) on Twitter is the ability of pharmacists to connect with other pharmacists. Of course, many pharmacists on Twitter have ‘secret identities’ making it difficult to connect on a professional level, most of them hiding their identities because they use Twitter to vent or as a release from their daily tasks in the pharmacy. You know who you are! Over the past several years I’ve connected with a number of great Twitter pharmacists on a professional level and I look forward to meeting more of you ‘lurking’ out there.

#29j:  Twitter as an professional educational tool- 

Another benefit I’ve found on Twitter is the magnitude to which a pharmacist (or other medical professional) can learn. Professional education, much of it on par with any accredited continuing education or medical education programs can be found if you look in the right places.

#29k:  Building professional credibility- 

Using Twitter (and other social media) can do one of two things for pharmacists and healthcare professionals:  You can use it to build your credibility and establish yourself as an expert in your field OR you can use it to cripple your identity as a professional. Tweet responsibly.  Enough said.

#29l:  Using Twitter to build patient relationships- 

Probably one of the most important ways pharmacists (and other health care professionals) can utilize Twitter is in building relationships with patients and keeping those lines of communication always open. If you’re using social media properly it will have of some component or level of social interaction. And if you can interact with patients and let them get comfortable with who you are they’ll begin to respond by showing trust and confiding in you.

I’m sure if we put on our thinking caps and throw caution to the wind a bit, we could think of more ideas for pharmacists and other medical providers to improve health care by leveraging social media. More important is the charge to be a leader in utilizing this technology to improve health care and not lag behind other professions.

What do you think?

In the aftermath of an emergency situation or natural disaster like Hurricane Sandy we often look back and ask a serious question:

“What could we have done differently to be more prepared?” 

Reflecting on the events that unfolded in 2005 during Hurricane Katrina, we can get a idea of the magnitude of what can happen:

  • approximately 1.5 million people were evacuated.
  • emergency shelters were set up to triage 30,000 to 40,000 people.
  • a 700 bed emergency room was set up to address patient needs.

But in the midst of this effort another crisis was being battled which increased the degree of difficulty for healthcare providers in treating these patients:

Medical records were lost, destroyed or inaccessible for use to treat patients properly.

In the wake of the storm many of these patients could not remember what prescription medications they took.  Doctors could not confirm medications, immunizations, test results or a patient’s medical history.  One can only imagine the problems that arose trying to treat these patients when healthcare providers were lacking important patient personal health information.

Some would say the electronic medical record systems employed at hospitals and doctor’s offices now solve the problems we faced during Katrina.  But recently during Hurricane Sandy, we saw hospitals losing power and cell phone grids being crippled. How are the electronic medical records to be accessed then?  Likewise, records ‘in the cloud’ or ‘silos’ may not be usable.

Taking responsibility:

You, as a patient, need to take responsibility to ensure your personal health information is available in a medical emergency.  You need to maintain a record of this information to share with medical providers, whether it be a routine checkup with your physician or a medical emergency situation.

A simple solution: 

Emergi-Tube and QuickStart ePHR

A personal health record (PHR) can be used to keep track of your personal health information and protect you in an emergency.  A simple PHR would  include medical conditions, allergies, a list of prescription medications along and emergency contact information.

Products like Emergi-Tube and QuickStart ePHR work together, making it easy to keep a record of your health information. With the QuickStart ePHR you can enter your personal health information and print forms to share with your physician. You can edit, update and save information on your computer or USB memory device. As you enter the information into the PHR form it automatically saves your health information and allows you to print a wallet identification card to carry at all times.

Emergi-Tube is a lightweight, water resistant storage device to hold your printed health records and USB memory device.  Designed to be visible in the home, it’s ‘grab and go’ feature allow you to take your records with you if evacuated or just on the go. Additional tubes are ideal for in your car or suitcase when traveling.

For more information on Emergi-Tube and QuickStart personal health records visit www.HealthRecordResources.com or email your contact information to info@HealthRecordResources.com for assistance.

(pharmacist affiliate program available now!)

http://healthrecordresources.com/pharmacists_affiliate.php