Transcript Are You Medicine SmartTM? A New Framework for Addressing

Are You Medicine Smart ?
A New Framework for Addressing Issues
Related to Promoting Safe and
Appropriate Medicine Use
TM
Wm. Ray Bullman
Executive Vice President
National Council on Patient
Information and Education (NCPIE)
5th Annual Unused Drug Return Conference
November 10-11, 2008
Portland, ME
ABOUT NCPIE
• Nonprofit Organization -- 501 (c)(3)
• Formed October 1982
• 100+ member organizations - diverse collection of
sometimes “strange bedfellows” that coalesce around
NCPIE mission.
• Mission: Stimulate / improve communication of
information on safe and appropriate medicine use to
consumers and healthcare providers.
NCPIE CORE VALUES
• To represent a wide spectrum of organizations serving the
public health through educational and advocacy programs.
– To empower consumers to be more informed
about and active in decisions affecting their use
of medicines.
• To be a catalyst for the development of new, useful, and
scientifically accurate information about medicine use that is
disseminated in multiple formats to a wide range of audiences.
ABOUT NCPIE
• Healthcare professional organizations
• Businesses (pharmaceutical cos.; trade
associations; drug information publishers)
• Government agencies / non-government
standard-setting organizations
• Consumer and Patient Groups
ABOUT NCPIE
– Produces/ disseminates educational messages &
materials to promote improved consumer –
provider dialogue about medicines
Some Recent Activities:
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“Talk About Prescriptions” Month (Each October)
“Be MedWise” about OTCs
“Medicines in My Home” partnership with FDA
Not Worth the Risk – Even If It’s Legal
MUST for Seniors Program
Enhancing Prescription Medicine Adherence: A
National Action Plan
MUST for Seniors™
Enhancing Prescription Medicine Adherence:
A National Action Plan
• Medication errors and patients who skip their
medications could cost the U.S. $177 billion
in medical bills and lost productivity,
according to a new report by the nonprofit
National Council on Patient Information
and Education.
• See www.talkaboutrx.org
Americans Taking Rx Medicines
in Greater Numbers
• More than 1/2 of insured Americans taking Rx
medicines regularly for chronic health problems.
• Most widely used: Medicines to lower high blood
pressure & cholesterol;
• In ’07, 51% of children and adults were taking
one or more Rx drugs for a chronic condition, up
from 50% the previous four years and 47% in ‘01.
• Most are taken daily, although some are needed
less often.
Americans Taking Rx Medicines
in Greater Numbers
• Medication use for chronic problems was seen
in all demographic groups:
*Almost two-thirds of women 20 and older.
*One in four children and teenagers.
* 52% of adult men.
*Three out of four people 65 or older.
• Among seniors, 28% of women & nearly 22% of
men take five or more medicines regularly.
(Source: Medco Health Solutions; prescription records from 2001 to 2007 of a
representative sample of 2.5 million customers, from newborns to the elderly)
Can You Spare a Pain Pill? Significant Proportion
Reports Rx Medication Sharing
• Nearly 25% reported loaning their Rx medications to
someone else, and 27 percent reported borrowing Rx
medications.
• Medications most frequently shared (loaned or
borrowed) were allergy drugs (25%), followed by pain
medications (22%); and antibiotics (21%).
• 7% said they shared mood-altering drugs like Paxil,
Zoloft, Ritalin and Valium.
• A little more than 6% said they shared the Rx anti-acne
drug Accutane and about 5% shared birth control pills.
Can You Spare a Pain Pill? Significant Proportion
Reports Rx Medication Sharing
• Whites (23%) and Hispanics (26%) were more apt to
share Rx pain medicines than were African Americans
(14%). Women were more apt than men to share
antibiotics (24% vs. 12%).
• People seemed most willing to share Rx medicine when
the medication came from a family member, they had a
prescription for a particular medication but ran out of it
or did not have it with them, or they had an emergency.
(Source: American Journal of Public Health; Beyond Abuse and Exposure: Framing the
Impact of Prescription- Medication Sharing; Richard C. Goldsworthy, PhD, Academic
Edge, Inc., Bloomington, IN. (June 2008; One-on-one interviews with 700 Americans)
Depending on Patients’ Recall
May Be Dangerous to their Health
• Nearly 50% of pts. taking antihypertensive drugs in 3
community health centers were unable to accurately name
a single one of their medications listed in their medical
chart. The number climbed to 65% for patients with low
health literacy.
• Study looked @ 119 pts, average age 55; from CHCs in
Grand Rapids, MI.
Depending on Patients’ Recall
May Be Dangerous to their Health
• Although study focused on low-income patients, other
patients likely have similar trouble recalling the names and
dosages of all their medications, particularly those who take
a lot of different drugs and the elderly, who may have
cognitive limitations.
• Lead author, Stephen Persell, MD: “The Northwestern
study indicates a need for future research to address how
patients’ inability to name their medications -- particularly
those with limited health literacy -- impacts hypertension
control and drug safety.”
(Source: Journal of General Internal Medicine, Nov. 2007).
Many Older ER Dept. Pts. Lack Full
Knowledge of their Rx Medicines
• Patients averaged 5.9 Rx medications on presentation to the ED.
• Patients correctly identified 78.4% of these medications.
• Thirty-three (42.8%) pts were able to correctly identify all of their Rx
medications.
• Patients correctly identified 65.5% of dosages; 32.5% named all
dosages correctly, 91.4% of dosing intervals. 57% of patients named
all intervals correctly, and 83% of indications; 63% of patients named
all indications correctly.
• Conclusion: Elderly patients presenting to the ED have only a fair
knowledge of their Rx meds.
(Source:Chung MK, Bartfield JM. Knowledge of prescription medications among elderly emergency department patients. Ann Emerg Med. June
2002;39:605-608.] Patients older than 65 years who presented to the ED of an urban teaching hospital were interviewed about their Rx meds and the
indications for their use. Meds/dosages verified through the patients' pharmacies. (Data on 88 patients were collected over a period of 2 months.)
Are You Medicine Smart ?
Considering a A New Framework
TM
Consider:
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Medication error prevention
Adverse drug events
Avoidable Drug Interactions
Preventable side effects
Drug safety as daily news (Vioxx and beyond...)
Useful consumer medicine information
Medication Guides
Health Illiteracy
Cultural competency
Prescription medicine abuse
OTC Medicine Abuse
Proper unused medicine disposal
Are You Medicine Smart ?
Considering a Total Person Framework
TM
Are You “Medicine Smart” poses a simple
question with profound implications for
good health.
Arriving at a “Yes” response to this
question means taking into account action
steps that relate to yourself and all the
members of your family as well.
Are You Medicine Smart?
Considering a Full Response Framework
Being "Medicine Smart" means getting all the
information necessary to use your medicine
correctly.
-- That means asking questions, and
-- Sharing important information about past
medicine use to better ensure that you get the
most benefit from your treatment.
If you're not sure what questions to ask about
your medicine - see
10 Important Questions to Help
You Be “Medicine Smart™”
1. What is the name of the medicine and what is it for? Is
this the brand name or the generic name?
2. Is a generic version of this medicine available?
3. How and when do I take it - and for how long?
4. What foods, drinks, other medicines, dietary
supplements, or activities should I avoid while taking this
medicine?
5. When should I expect the medicine to begin to work, and
how will I know if it is working? Are there any tests
required with this medicine (for example, to check liver or
kidney function)?
10 Important Questions to Help
You Be “Medicine Smart™”
6. Are there any side effects, what are they, and what do I do if
they occur?
7. Will this medicine work safely with the other prescription and
nonprescription medicines I am taking? Will it work safely with
any dietary / herbal supplements I am taking?
8. Do I need to get a refill? When?
9. How should I store this medicine?
10. Is there any written information available about the medicine?
(Is it available in large print or a language other than English?)
Do Tell ....
Being “Medicine Smart™”
• And remember, when medicines are prescribed, tell
your health professionals:
• All of your medical conditions and the names of doctors
providing treatment
• The names of all medicines and other products you are
taking, including:
– Prescription and nonprescription medicines
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Dietary supplements / herbal remedies, vitamins or minerals
Laxatives
Pain relievers
Sleeping aids
• Any problems you are having with your medicines;
• The medicines to which you are allergic;
• If you are, or might be pregnant.
Sharing – About Your Medicines
Being “Medicine Smart™”
Being "Medicine Smart™" also means:
• Knowing several key facts about the medicines you are
currently taking - and being able to share that
information with the members of your healthcare team @
each visit.
• Keeping track of the names of the medicine(s) you are
taking, how much you take, when and how you take
it, why you take it, and when you started taking it (for
how long), for example.
That’s a Lot to Remember...
Being “Medicine Smart™”
• There is help available to make it easy to keep
track of personal medicine information.
• NCPIE provides access to nearly a dozen
sources where you print out a medicine list
for yourself and other members of your family.
• Some can even be filled in, updated, and printed
from the computer - making your medicine list
just a click away whenever it's needed.
Keep & Share an Updated Medicine List
Being “Medicine Smart™”
• Personal Medication Record - Arizona
Center for Evaluation and Research in
Therapeutics (CERT)
• How to Create a Pill Card - Agency for
Healthcare Research and Quality
(AHRQ)
Keep & Share an Updated Medicine List
Being “Medicine Smart™”
• My Medicine List™ - American Society of Health System
Pharmacists -- can be filled out electronically and saved to your
computer for printing out as needed.
• Personal Medication Card - Rx Response
Rx Response partners: American Hospital Association; American
Red Cross; Biotechnology Industry Organization; Generic
Pharmaceutical Association; Healthcare Distribution Management
Association; National Association of Chain Drug Stores; National
Community Pharmacists Association; Pharmaceutical Research and
Manufacturers of America
• Personal Medication Record - AARP; developed by the SOS Rx
Coalition. Available in PDF and Word formats.
Medicine List = Life Saver
Being “Medicine Smart™”
Being “Medicine Smart”
For your free Medicine List Visit www.talkaboutrx.org
Being “Medicine Smart”
Etc. Etc.
Yada— Yada—Yada
Blah—Blah—Blah—Blah
Being MEDICINE SMART!
One of the above plays a major role in helping consumers
treat disease, control chronic illnesses, and avoid deadly
medication errors. The others are just so many words.
Find out how to be “MEDICINE SMART™”
Go to www.talkaboutrx.org
Here’s what makes YOU
“Medicine Smart™”
Here are 10 important things you can do to make you “Medicine
Smart:”
1. Make a list of your medicines; share it at every medical visit.
2. Ask questions whenever a medicine is prescribed for you.
3. Share important information about your medicine use including
any medicine allergies or problems taking medicines.
4. Recognize that all medicines have risks as well as benefits and
talk about this with your doctor or pharmacist.
5. Know how to talk to / what to say to your kids about medicine
abuse.
Here’s what makes YOU
“Medicine Smart™”
6. Get the full value of your medicines by following
instructions carefully and report any problems if
they occur.
7. Read carefully all of the written information that
comes with your prescription medicine.
8. Carefully read and follow the information on the
Drug Facts Label on OTC medicines.
9. Store your medicine safely and away from children.
10. Properly dispose of any unused medicine. Not sure
how? See www.smarxtdisposal.net/
Talk to Your Kids about
Rx Medicine Abuse
Here are some ways you can help:
• Speak to your teen about prescription medicines – do
not presume that illegal drugs are the only threat.
• Encourage your teen to ask you or a doctor
about the negative side effects of a prescribed
medicine, how to watch for them, and what to do
if a negative effect is suspected.
• Alert your family physician that you are concerned and
ask him or her to speak to your teen about the
importance of proper use of prescription medicines.
Talk to Your Kids about
Rx Medicine Abuse
• Avoid stockpiling prescription medicines and
keep them in a safe place.
• Promptly and properly dispose of any unused
Rx medicines.
• Provide a safe and open environment for your
teen to talk about abuse issues.
• Monitor your teen’s use of the Internet, especially for any
unapproved online purchases.
When Your Medicine is “In the News”
Being “Medicine Smart”
1. Don’t panic. Usually a safety debate about a popular drug relates to
reports of rare effects.
2. Contact your doctor or pharmacist - personally, by phone, or email.
When Your Medicine is “In the News”
Being “Medicine Smart”
3. Have a list of things to ask your doctor or pharmacist.
4. Tell your doctor or pharmacist exactly how you take your
medicines.
– Be sure to say if you are not following directions,
– taking more than you should,
– forgetting dosages etc.
5. Ask the following questions.
– Do you think the benefits of my taking this medicine outweigh the
risks?
– What risks might I face in taking this medicine?
(Source: CA. Pharmacy Board / UCSF Center for Consumer Self Care; this slide and next)
When Your Medicine is “In the News”
Being “Medicine Smart”
•Are there alternative medicines to the one I am taking?
•Are there alternatives to some of my medicines, such as lifestyle
changes?
•Should I try these? What do I need to do to be successful with nondrug alternatives?
• If I have to continue to take this medicine, what side effects should
I look out for, and when should I call you about them?
•In summary, would you review the best course of action for me?
•Can we set up an appointment in 1-3 months to review what we’ve
decided and see how I am doing?
Contact Information
Ray Bullman
Executive Vice President
National Council on Patient
Information and Education (NCPIE)
4915 Saint Elmo Ave., Suite 505
Bethesda, MD 20814-6082
(301) 656-8565 ext. 314
[email protected] – email
www.talkaboutrx.org
www.mustforseniors.org
www.bemedwise.org