I have long concluded that pharmacist are underated. They have a vast wealth of information to share. I really believe until physicians , pharmacist and the patient have a better system of collaboration, the risks and concerns of polypharmacy will be ongoing, to the harm of the latter.
Recently my church held a health fair. One of the goals was to educate our community about their medications. We were able to do this with the help of "Walgreen's Brown Bag Program" . It is a wonderful tool to help the problem of polypharmacy. The education and information the participants received from the Walgreen pharmacist was invaluable. Each of the six pharmacist had 30 minute individual appointments scheduled where they sat at tables privately and discussed the partipants px's & otc's. Each person brought all their meds. The event was very successful evident by the feedback. Each pharmacist volunteered 6 hours of their time on a Saturday. I am a nurse and learned many things about my otc's that I didn't know.
Many communities are taking advantage of the knowledge their local pharmacies are more than willing to volunteer and share. I highly recommend this resource. There is a Walgreen or drugstore on every corner.
http://www.ismp.org/Newsletters/consumer/alerts/BrownBag.asp
http://www.ohiopatientsafety.org/meds/Brown%20Bag/PlanningBrownBagEvent.doc
Thursday, March 19, 2009
Saturday, March 14, 2009
I'm not old!
Beside the elderly, is there any age group that can be considered to be at risk when it comes to polypharmacy?
The teenager and the youth population may be at risk for polypharmacy. People in this group turn to be under peer group influence. They may be in danger when it comes to the use of drugs. The information they get might not be from a reliable source. And many are under the impression that the more of a drug they take the faster it will work.
Also, polypharmacy is also seen in psychiatric patients. Many studies have been done on this...just google polypharmacy and most of the stuff that pops up is about psychiatric patients taking too many medications at once. Obviously, psychiatric prescription has nothing to do with how old you are!
The teenager and the youth population may be at risk for polypharmacy. People in this group turn to be under peer group influence. They may be in danger when it comes to the use of drugs. The information they get might not be from a reliable source. And many are under the impression that the more of a drug they take the faster it will work.
Also, polypharmacy is also seen in psychiatric patients. Many studies have been done on this...just google polypharmacy and most of the stuff that pops up is about psychiatric patients taking too many medications at once. Obviously, psychiatric prescription has nothing to do with how old you are!
Its a Matter of Circumstance
What are some of the circumstances that always end up in polypharmacy? Is there any way that the public can be educated on how to avoid it? If yes, where do we start?
Disease and sickness always deplete people from healthy lives. With different drugs on the market, people turn to use any drug that is said to cure the disease they may have, especially people with chronic illnesses who are always in pain. They use those drugs in any way, forgetting about drug-drug interactions and its side effects. Community and neighborhood meetings must be organized by the health department to educate the public about dangers of polypharmacy.
Disease and sickness always deplete people from healthy lives. With different drugs on the market, people turn to use any drug that is said to cure the disease they may have, especially people with chronic illnesses who are always in pain. They use those drugs in any way, forgetting about drug-drug interactions and its side effects. Community and neighborhood meetings must be organized by the health department to educate the public about dangers of polypharmacy.
Saturday, March 7, 2009
Should YOU care?
Polypharmacy doesn’t concern just nurses or just consumers but both. Nurses need to care about the problems that result from polypharmacy so that they can better care for their patients. By knowing what drugs or supplements can interact with each other, nurses can prevent problems before they happen. Many healthcare facilities use electronic resources to help them detect drug interactions that could occur. With medications changing constantly, it is important to be up to date on all possible drug interactions.
Consumers can take a proactive role in their medications as well. Do you take any over the counter medications, or do you perhaps take any herbal supplements? Many people do. I know I do. If you do, you might not realize that these things that you’re putting into your body might not mix so well. According to an article from oxfordjournals.org, dietary supplementation is growing in the United States, and the problem with this is that there is not much research to determine how these supplements could interact with different medications. Also, many people that go to the pharmacy to get things such as cold medicine grab multiple medications, and a lot of the time they have the same exact active drugs in them. This can cause over medication. A simple way to help with this issue is to look at the back of the box. The pharmacist can also be a VERY important tool to determine what medications might interact with what. As a consumer or a nurse is there anything that you can think of that you could do to help with the issue of polypharmacy?
if you want to check out the article you can at: http://ecam.oxfordjournals.org/cgi/content/full/nem150
Why Polypharmacy is a hot topic
Polypharmacy has become a hot topic because it is widespread in the population, especially in the elderly. The elderly population might be taking more drugs than what they need. This has lead to dangerous effects such as severe drug interactions, rising healthcare costs, and a decrease in patient compliance. While one of the main concerns for the field of geriatrics is to reduce polypharmacy, prescribing multiple medications for patients who have chronic disorders, is also very common and accepted among healthcare providers for treatment. For instance, cardiologists often use multiple medications to control hypertension. This controversy is what makes polypharmacy a hot topic since it needs to be controlled but it is also needed for treatment.
Physicians say that the reasons they practice polypharmacy are to control the positive symptoms of other drugs or they use more drugs because the previous treatment did not work. Previous studies also make polypharmacy a hot topic because such studies help answer questions about polypharmacy, but they also bring up more questions. For instance, one study shows that there is a positive correlation between high levels of polypharmacy and hospitalization. Although it is not clear whether the rising in hospitalized patients causes the rise in polypharmacy or vice versa, polypharmacy should be a reason to prevent hospitalizations in the elderly population.
Another issue which makes polypharmacy a hot topic is whether patients actually improve with multiple drugs. The answer at this time is that scientist don’t really know yet. Some scientist say that the use of herbal medicines, which usually have a low to no efficacy, contribute to the negative effect of polypharmacy. Polypharmacy is particularly a hot topic in the area of chronic pain. Geriatricians are faced with the question of whether giving elderly patients will improve the patient or make him/her worse, since there is much evidence that pain is untreated in elderly patients.
Physicians say that the reasons they practice polypharmacy are to control the positive symptoms of other drugs or they use more drugs because the previous treatment did not work. Previous studies also make polypharmacy a hot topic because such studies help answer questions about polypharmacy, but they also bring up more questions. For instance, one study shows that there is a positive correlation between high levels of polypharmacy and hospitalization. Although it is not clear whether the rising in hospitalized patients causes the rise in polypharmacy or vice versa, polypharmacy should be a reason to prevent hospitalizations in the elderly population.
Another issue which makes polypharmacy a hot topic is whether patients actually improve with multiple drugs. The answer at this time is that scientist don’t really know yet. Some scientist say that the use of herbal medicines, which usually have a low to no efficacy, contribute to the negative effect of polypharmacy. Polypharmacy is particularly a hot topic in the area of chronic pain. Geriatricians are faced with the question of whether giving elderly patients will improve the patient or make him/her worse, since there is much evidence that pain is untreated in elderly patients.
Wednesday, March 4, 2009
What's the big deal?
The biggest argument is that prescription drugs are pushed on consumers. I read this great study by the New England Journal of Medicine, which I found while looking for the 1959 issue, that addressed this promotion of prescription drugs to consumers. Do keep in mind that this study was done in 2002, so the statistics have most likely changed. The study found that spending on drugs had increased greatly and is "now the fastest growing component of the healthcare budget". The data was collected from IMS Health and Competetive Media Reporting. Spending on direct-to-consumer advertising is concentrated on only a few prescription drugs. According to the Table, in 2000, the 20 prescription drugs for which spending on direct-to-consumer advertising was greatest accounted for about 60 percent of the total industry spending on such advertising. 60%! That is a lot!
According to the study, many physicians and consumers are worried about these statistics. According to physicians, direct-to-consumer advertising has made their job harder because they have to answer patients questions and make sure the patient understands what they have seen on the television. This definitely seems plausible; I am sure that someone sees a commercial for a new drug for their condition and immediately want to get a prescription for it. To add to this article, I would say that the internet has also aided in this problem. So many people now-a-days go to WebMD, or google symptoms and go into the emergency room with printed papers. The nurses and doctors are then given the responsibility to help the patient get the correct answers and information.
Consumers are also concerned that direct-to-consumer advertising leads to unnecessary prescribing by the physician. Apparently there have been previous allegations of physicians participating in this. I acctually heard on the news recently that it is the most common reason for innappropriate prescribing. But they also addressed that the reason is that physicians are pressured by patients. This again leads back to the percieved problems of consumers asking too many questions and not being properly informed.
According to the study, many physicians and consumers are worried about these statistics. According to physicians, direct-to-consumer advertising has made their job harder because they have to answer patients questions and make sure the patient understands what they have seen on the television. This definitely seems plausible; I am sure that someone sees a commercial for a new drug for their condition and immediately want to get a prescription for it. To add to this article, I would say that the internet has also aided in this problem. So many people now-a-days go to WebMD, or google symptoms and go into the emergency room with printed papers. The nurses and doctors are then given the responsibility to help the patient get the correct answers and information.
Consumers are also concerned that direct-to-consumer advertising leads to unnecessary prescribing by the physician. Apparently there have been previous allegations of physicians participating in this. I acctually heard on the news recently that it is the most common reason for innappropriate prescribing. But they also addressed that the reason is that physicians are pressured by patients. This again leads back to the percieved problems of consumers asking too many questions and not being properly informed.
the doc is in
It's obvious that physicians know that polypharmacy has its "goods" and "bads", its their business to diagnose and treat. You can see that doctors believe that the advantages outreach the dangers because they still put this synergism to use. Of course the experts of the trade are in the know about the dangers of such treatment but they prefer to take precautionary measures rather than dispose of polypharmacy. A major danger of polypharmacy is that fact that many people do not disclose over the counter meds they are on. One good point offered up in by an expert in an article i read at http://www.straightfromthedoc.com/ titled the dangers of taking too many pills, would be to advise people to keep an updated list of the meds they are on with them at all times and bring that list to every doctor you see. Also people need to have some knowledge about their medicines whether that be from a medical expert or on their own. Doctor's are going to keep using polypharmacy because it is an effective practice so maybe its time people (experts and patients) started taking measures to lessen the dangers. What measures do you make?
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