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People with chronic illness often struggle to manage several prescribed drugs at a time and trying to figure out which drug is which, or when to take what.
Do you have your prescriptions filled through a mail-order pharmacy? You are not alone.
Too often, mental health patients have problems accessing or paying for their prescription drugs under Medicaid. The results — longer hospital stays and more emergency room visits — are hard on patients and costly for the entire health care system, a new study finds.
Cost-cutting measures are creeping into the medicine cabinet. We split pills in half or take the drugs every other day to stretch our doses. We stop filling the prescriptions for our most expensive drugs. We buy prescriptions from online pharmacies with questionable credentials. As patients pay more for their prescription drugs ' whether it's through higher insurance co-pays or shouldering the full costs ' many people decide to opt out of taking the drugs altogether. But there are safer ways to cut costs than skimping on ' or skipping 'the medicines you need.
If prizes were given for ingenious marketing, drug companies would win top honors. Like most businesses, they want to expand markets'that means getting you to buy more drugs whether you need them or not. Their appetite for finding new ways of doing that is insatiable.
'I had a wonderful gentleman patient who had resistant blood pressure,' recalls Vicki Koenig, M.D., a retired family doctor in Exmore, VA. 'When he came for a blood pressure check on the latest new med and it was great, I was ecstatic. Then he said, 'But I notice my urine's a little dark.' His was one of the first cases of fatal liver complications from this medication.' Medication side effects are common'but when should you speak up?
For more than 30 years, pediatricians have treated children who have croup with inhaled epinephrine to relieve their symptoms quickly. Now, a new review confirms the value of this approach.
A new study shows that diabetes patients who do a better job of taking their medication have slightly lower health care costs.
Overdose of the common household drug acetaminophen leads to more than 78,000 emergency department visits a year, and the majority of the overdoses are intentional, according to a new CDC study.
When misused, acetaminophen — marketed as Tylenol — can lead to acute liver failure and worse, often due to accidental overdose by an uninformed consumer. A new small study looks at what’s missing in consumer education and how to overcome those gaps.
Medication mishaps are a widely recognized problem in health care and a new study finds that ambulatory care settings, not ERs, deal with them most.
Clinicians have tried a variety of ways to encourage people to take prescribed medicines, but a new research review says it is still unclear whether many of these interventions have been effective.
You are sick with something-or-other and your doctor writes you a prescription for a medication. She briefly tells you what it's for and how to take it. You go to the pharmacy, pick up the medication, go home and follow the instructions, right? I mean, how hard could it be? Pretty hard, it appears. Between 20 percent to 80 percent of us ' differing by disease and drug ' don't seem to be able to do it.
David Harlow highlights recent research that finds that people stopped taking their cancer medications due to high costs and a burden from taking a number of prescription drugs broadening the picture of poor medication adherence.
If I were to choose a Medigap policy to supplement my basic Medicare coverage, I would still have to buy a separate plan for prescription drugs, since Medigap sellers can't include drug benefits in those policies.
Over the long term, treatment with cholesterol-lowering statins reduces the rate of mortality and cardiovascular events such as heart attack. Still, it is unclear whether these drugs take effect rapidly when the risk of these dire events is highest.
Medication non-compliance is a pervasive problem resulting from a complex set of factors. Now, using publicly identifiable information, the credit-rating company FICO has developed a Medication Adherence Score that may help health plans identify those most at risk, and Geisinger Health Systems and CVS Caremark are conducting a study to assess whether enhanced doctor-pharmacist communication can help.
Reading those lengthy package inserts about the medicines you're taking is a bit like eating peas. You know they are good for you, but your gut says 'yuck.' So odds are you don't bother with all that teensy-tiny fine print, but just take the medicine and hope for the best.
All the best efforts to practice science-based medicine are for naught when the optimal treatment is unavailable. And that's increasingly the case ' even for life-threatening illnesses. Shortages of prescription drugs, including cancer drugs, seem more frequent and more significant than at any time in the past.
People with chronic illnesses are more likely to take long-term medications according to doctors’ instructions if the packaging includes a reminder system, according to a new review of evidence
Over-the-counter and prescription drugs are sold with instructions either on the package itself or in accompanying materials. Alas, research has shown that many people find this medication information confusing and thus do not take their medications correctly ' or at all. Can interventions like drug fact panels, reminder packaging and "integrated" health systems help solve the problem?
Patients who take certain popular types of blood pressure medication once a day are able to achieve somewhat better control of their hypertension if they take their daily dose at bedtime, according to a new systematic review.
The perception from many consumers (based on my personal experience) seems to be that products are inferior if they contain non-drug ingredients. By this measure, drug products are problematic...
Patients with depression who fail to see improvement after taking an antidepressant often have their initial medication switched or combined with a second drug. The perception of potential side effects has influenced clinician decisions about which strategy to take. New research now suggests one strategy may not be any more likely to be harmful than the other.
Last week I went to the family pharmacy I use in New York City to pick up a new anti-arrhythmic drug that might slow down or even stop the atrial fibrillation I had experienced for the previous two weeks. The pharmacist came from behind his privacy wall to speak with me before dispensing the drug.
Caffeine improves the effectiveness of over-the-counter pain relieving drugs, but only by a small margin, according to a new evidence review in The Cochrane Library.
Patients with schizophrenia and other mental illnesses are commonly prescribed high dose combinations of antipsychotic drugs earlier than recommended by some guidelines, finds a new study in the March issue of General Hospital Psychiatry.
One of the most interesting aspects of working as a community-based pharmacist is the insight you gain into the actual effectiveness of the different health interventions.
People with multiple chronic medical conditions are helped by medical interventions that target personal risk factors and/or their ability to perform daily activities. Interventions aimed at general case management or enhancing teamwork among a patient’s care providers are not as effective, finds a new review in The Cochrane Library.
Our unwillingness to take our medicine as directed is often mistakenly viewed by clinicians and researchers as a sign that we are not engaged in our care. Baloney. Many of us would be perfectly happy to do so were it not for those pesky side effects.
A new Cochrane Library evidence review reveals that little is known about the best ways to avoid inappropriate prescribing of medications for seniors or how to maximize health benefits while minimizing prescriptions.
Doctors often prescribe drugs for people with mild high blood pressure with the hope of preventing cardiovascular disease (CVD). However, a new review from The Cochrane Library has found that this treatment does not reduce death rates, heart attacks or strokes.
What does it take for us and our families to find good care and make the most of it? And what can be done to help those who lack the skills, resources or capacities, or who are already ill, compensate for their inability to do so? This collection of essays identifies some of the key challenges posed to most of us by health care as it is currently delivered in many settings.
Young people ages 15 to 24 are abusing prescription painkillers more than any other age group or any other youth in history. Availability of these drugs from their parents’ medicine cabinets may be to blame, according to new research in the Journal of Adolescent Health.
Negative perceptions about generic drugs are more widespread among ethnic minorities than among whites, finds a new study in Ethnicity & Disease.
In a recent post entitled “The Joys of Health Insurance Bureaucracy” I described how it took me (a physician) over three months to get one common prescription filled through my new health insurance plan. Of note, I have still been unable to enroll in the prescription refill mail order service that saves my insurer money and (ostensibly) enhances my convenience.
You and your doctor need accurate information from each other. Open communication with your doctor is one of the most important factors in getting and staying healthy.
Got a new prescription? Here are some tips for managing your new medication.
A new review in The Cochrane Library finds that education and social support for staff and caregivers can reduce the use of antipsychotic drugs in nursing home patients with dementia.
Better health is more likely when we agree on a plan of action with our doctor and follow it.
Part of participating in your treatment is remembering to take your medication as prescribed. This task can get difficult if you aren’t feeling well or are juggling multiple prescriptions
As patients pay more for their prescription drugs, many people decide to cut their pills in half or opt out of taking the drugs altogether. But there are safer ways to cut costs than skimping on — or skipping — the medicines you need.
An increasing number of people die from unintentional home injury, in large part due to accidental drug overdose, according to a new study in the American Journal of Preventive Medicine.
This week in health behavior news: Effects of deployment on those left behind | Commuting style linked to weight gain | Drugs for fibromyalgia may do more harm than good | Accidental poisonings leading cause of deaths at home
In addition to dispensing, packaging or compounding medication, pharmacists can help improve patient outcomes in middle-income countries by offering targeted education, according to a new review in The Cochrane Library.
Let’s face it. Despite all the rhetoric about health care transparency, most health care providers really don’t want patients to know the price of their products and services.
Improving people’s knowledge and skills about their medications may be best achieved with multimedia patient education materials, finds a new systematic review in The Cochrane Library.
Giving prescribers access to education and advice or imposing restrictions on use can curb overuse or inappropriate use of antibiotics in hospitals, according to a new Cochrane systematic review.
In America, the conventional wisdom is that we don't ration health care. But we do, and there's no better example than patients rationing themselves when it comes to the medicines they take.
Most teens have unsupervised access to their prescription drugs at home, including drugs with potential for abuse, finds a new study in the Journal of Adolescent Health
Nicotine replacement therapy and other licensed drugs can help people quit smoking, according to a new systematic review published in The Cochrane Library
Black and Hispanic children with asthma are less likely than White children to use long-term asthma control medications, finds a new study in Health Services Research
Have you noticed all the articles in the health care press lately touting health information technologies’ ability to increase patient medication adherence? Smart phone-based apps, Smart pill bottles and Patient Portals are all about trying to get patients to do something (take a medication) which some physician somewhere has deemed to be the right thing for the patient to do. Some would call this process of generating adherence patient engagement.
A person with type 2 diabetes spends on average more than $85,000 treating the disease and its complications over their lifetime, according to a recent study in American Journal of Preventive Medicine
I'm always juggling more than one role, making second-to-second trade-offs depending on which is the most demanding at the moment. Becoming ill demands that we shift responsibilities around.
Sumanah was a 26-year-old event planner in New York City when she was suddenly diagnosed with congestive heart failure. After learning that some pharmacies can be upwards of 16 times more expensive than others, Sumanah was able to price shop for the right pharmacy and save a lot on her prescription costs. You can too...
Only half of patients take the drugs as prescribed for them by their physicians. So what happens to the other half? And why does this costly problem continue despite efforts to improve patients’ adherence to prescription medications? There are many potential solutions, but not all of them are likely to become available...
What people pay for medicine can vary widely. And a recent study found that 20% of Americans take five or more prescription medications. These 'Be a Prepared Patient' resources can help people pay for and manage their medications.
Prescription drugs can be expensive. Here’s how to get help paying for them and finding lower cost options.
Teens with a variety of chronic illnesses report facing similar barriers to taking their medications, according to a new review in the Journal of Adolescent Health
Male adolescents who participate in organized sports are more likely to be prescribed opioid medications and misuse them than male teens that don’t play sports, finds a new study in the Journal of Adolescent Health
People with chronic pain and emotional distress are more likely to be given ongoing prescriptions for opioid drugs, which may not help, finds a new review in General Hospital Psychiatry
For people with diabetes and high blood pressure, keeping blood pressure levels lower than the standard recommended offered no benefits, finds a review in The Cochrane Library
People who identified their medication by shape, size or color instead of name had poorer adherence and an increased risk of hospitalization, finds a recent study in the Journal of Health Communication: International Perspectives
A new study in the Journal of Adolescent Health
finds that pharmacy staff frequently give teens misleading or incorrect information about emergency contraception that may prevent them from getting the medication.
In part four of our series, we look at a few ways to estimate the cost of your care ahead of time so you can make the best choice for you and your loved ones. Our 'Be a Prepared Patient' resources offer trusted websites and tips to get started...
We know that the U.S. has the most expensive health care in the world. But beyond noting that dubious achievement, we seldom ask why...
Lately, the public's faith in the safety of prescription and over-the-counter drugs has been making me uneasy. Why do so many of us continue to purchase pills that are not effective in causing weight loss, swallow syrups that promise to cure diabetes, and fiddle with our medication-taking regimens?...
Ever get confused over the names of medicines? I do. There's Zantac. And Xanax. Zanaflex; Zaleplon. Every drug has (at least) two names – this is a recipe for disaster...
A couple weeks ago, the Medicare Rights Center, a well-known New York-based advocacy group, released a report card showing that seniors on Medicare are struggling to pay for their health care. This finding brings up an important question: Why aren't seniors using the variety of state and federal programs that have been set up to help people in this situation?
The $800 bottle of meds in my bathroom cabinet is a powerfully expensive reminder of my (former) family physician's lapse in attention – and my own lapse in catching her error. She'd somehow accidentally doubled both the dosage and the number of times per day to take these meds. How is this even possible? Somebody is not paying attention...
Seniors are starting to realize that fewer doctors and hospitals may be available to them if they select a Medicare Advantage plan. Restricting these choices – in theory – is a way to control the price of health care. There's just one problem: Consumers still want to choose their doctors or stick with the ones they've got...
National conferences aimed at solving the problem of our wide-scale non-adherence to prescription medications feature expert reports about our misbehavior and bewail the huge number of us who fail to adhere to the ideal schedule. Then each conference gives plenty of airtime to more experts describing smart pill bottles, apps that nag at us, and how patient communities can provide important information about our drugs since our clinicians rarely do. Enough with blaming patients for our approach to taking our (many) medications...
There's a pesky cognitive bias that creates a honking big barrier to patients and families making the most of the health advice and services available to us. It's the tendency of experts to overestimate the knowledge of others. Given my current, frequent brushes with health care, I experience this all the time: "Just go to the lab and ask them," I'm told by my chemo nurse. I think: Huh? What lab? Where? Ask who? The effects of health stakeholders' overestimation of our knowledge are profound...
Since 2001, health care costs have become more burdensome for almost all Americans, at every income level and in every geographic area, finds a new study published in The Milbank Quarterly
I recently had breakfast with an aging cousin, Walter, who has become infirm in his senior years. I knew he had several doctors and took medicine. It wasn't until breakfast time, however, that I realized how many medicines Walter took – and I was bowled over...
"I walked in a person, and out a cancer patient," my dad said as we filed home. Crossing this threshold, we found ourselves on the other side of medicine – the side on the exam table or gurney, as opposed to the one standing over it. In time, it became clear we were running out of money...
Pharmacist-patient telephone consultations appear to reduce hospitalizations in patients who are least at risk, finds a new study in Health Services Research
As the health care system changes in the coming years, one particular trend that will negatively impact consumers' out-of-pocket costs is the use of co-insurance (instead of a co-pay) for expensive specialty medications. Approximately 57 million Americans rely on these drugs to maintain their health, and it is disheartening to learn that many people are suffering because their medications have become too expensive...
I don't know if it's growing older, or New England winters, or the meds I take, or watching Homeland and Downton Abbey in the same week – but my memory isn't as crisp as it used to be. My partner, Richard, has become part of my cerebral cortex...
One in every five older Americans takes medications that work against each other. And some interactions between prescription drugs and supplements can pose dangerous health risks. So what must we do to make sure that we benefit from the drugs we take?
"All patients are alike. This one complains about the same things that the last one did." "Every patient is unique. We can never find a way to make each one of them happy." This public health paradox is alive and well today, particularly when trying to improve outcomes attributable to patient engagement. The question is, what aspects of care need to be customized to individual needs and what can be delivered in a standardized fashion to all of us?
Bewildered, panicked and disheartened, I watched my mother's eyes dart back and forth as she read the pharmacy's prescription cash price list, knowing she could not possibly afford her monthly medicines. We drove home, not saying a word, but I knew she was deeply distraught. When we arrived, she began cutting each tiny elliptical or rounded tablet into halves and quarters...
For years, my colleagues on the Prepared Patient site have preached the importance of being an advocate for your own care. And they've noted that at times it is necessary to push back against doctors' recommendations if a suggested treatment does not seem right. I just returned from a visit to the U.K., which drove home the importance of that advice...
Are we finally doing something about the high prices of prescription drugs? Maybe. At the end of May, the Washington-based National Coalition on Health Care launched "Sustainable Rx Pricing," a campaign to "spark a national dialogue" about the high cost of drugs. Will it work?
Never before have I seen such intense interest from the press about health insurance rates, normally considered a snoozer of a story. For the public, this may be a good thing. If the stories are done well, consumers might learn something about the mix of factors that go into determining the premiums they will pay. But in the last couple of weeks, some stories have been downright misleading...
You need a refill for a prescription that's about to run out. You've taken the medication for years without any problems and can't think of any reason why the prescription can't just be automatically continued. But the doctor won't order a refill unless you make an appointment and come in to be seen. Is this an unfair burden on the patient or due diligence by the doctor?...
I just got off the phone with a very upset patient who discovered that her pharmacy has been giving her the wrong medication for the past five months. Despite all our fancy technology and advances in health care, medication errors can and will occur. So what can you do, as a patient, to be sure that your prescriptions are correct?...
One thing seems to be sure in medicine: if we just wait long enough for excellent science to guide us ahead, things we trust as ironclad rules often change. Case in point...
Adolescents around the world are frequently using over-the-counter and prescription medications without a doctor’s order, a risky practice that can lead to overuse and abuse and is often continued into adulthood, reveals a new review in the Journal of Adolescent Health
As we head into health insurance enrollment season, which opens in November, consumers/patients will face yet another challenge in selecting the best health plan...
A friend of mine suddenly learned the importance of patient engagement a few weeks ago when a matter affecting his pocketbook grabbed his attention. For the last several years the mantra has been "buy generics" as a way to lower the cost of drugs for consumers but also for the nation. For a while insurers did that. Not anymore...
I have complicated feelings about prescribing for chronic pain. On one hand, I recognize that relieving headaches, backaches, arthritis and nerve pain has been a core responsibility of the medical profession for ages. On the other hand, deaths and emergency room visits from overdoses of prescription painkillers have skyrocketed. I believe that addiction is a disease. So why do I find my patient's lies so hard to forgive?...
Many cancer therapies now cost over $100,000 a year. Obviously, this expenditure is not sustainable for the majority of patients. At age 64, I am approaching Medicare coverage. Will I have the 20 percent co-pay to shoulder? As more people survive cancer and remain on ongoing medicines, the U.S. has to have a fair and open discussion about the cost of these medicines...
I am a pharmacy student and was recently sent home with a prescription to treat a very painful earache. I do not recall the name of the medication, but I do remember my reaction when I went to pick it up. I was shocked that the drug would cost me over two hundred dollars! I could not afford the medication, so I went home without it...
More than 44 percent of Americans regularly take a prescription drug. And according to the 2013 Consumer Reports Best Buy Drugs Prescription Drug Tracking Poll, 57 percent of people reported taking steps in the last year – some of them potentially dangerous – to curb high medication costs: not filling a prescription, skipping a scheduled dose, and taking an expired medication. Why? And what can be done to help?
In general, today's patients are taking more medications for a multitude of ailments. Even for the most astute patients, keeping track of doses and regimens can be a challenge. Add in changes in color and appearance of chronic medications and the task can often be overwhelming, especially for elderly patients with cognitive decline. We must look for alternative ways to assist our patients with managing their disease while at home. I believe technology is the answer...