Are You Medicine SmartTM A New Framework for Addressing Issues Related to Promoting Safe and Appropr

1
Are You Medicine SmartTM? A New Framework for
Addressing Issues Related to Promoting Safe
andAppropriate Medicine Use

• 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

2
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.

3
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.

4
ABOUT NCPIE

• Healthcare professional organizations
• Businesses (pharmaceutical cos. trade
  associations drug information publishers)
• Government agencies / non-government
  standard-setting organizations
• Consumer and Patient Groups

5
ABOUT NCPIE

• Produces/ disseminates educational messages
  materials to promote improved consumer
  provider dialogue about medicines
• Some Recent Activities
• Talk About Prescriptions Month (Each October)
• Be MedWise about OTCs
• Medicines in My Home partnership with FDA
• Not Worth the Risk Even If Its Legal
• MUST for Seniors Program
• Enhancing Prescription Medicine Adherence A
  National Action Plan

6
MUST for Seniors
7

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

8
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.

9
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)

10
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.

11
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)

12
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 _at_ 119 pts, average age 55 from CHCs
  in Grand Rapids, MI.

13
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).

14
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.
• (SourceChung MK, Bartfield JM. Knowledge of
  prescription medications among elderly emergency
  department patients. Ann Emerg Med. June
  200239605-608. 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.)

15
Are You Medicine SmartTM? Considering a A New
Framework

• Consider
• 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

16
Are You Medicine SmartTM? Considering a Total
Person Framework

• 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.

17
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

18
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)?

19
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?)

20
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
• 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.

21
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 _at_ 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.

22
Thats 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.

23
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)

24
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 ResponseRx
  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.

25
Medicine List Life Saver Being Medicine
Smart
26
Being Medicine Smart
For your free Medicine List Visit
www.talkaboutrx.org
27
Being Medicine Smart
Etc. Etc. Yada YadaYada BlahBlahBlahBlah Bei
ng 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
28
Heres 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.

29
Heres 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/

30
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.

31
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 teens use of the Internet,
  especially for any unapproved online purchases.

32
When Your Medicine is In the NewsBeing
Medicine Smart

• 1. Dont 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 e-mail.

33
When Your Medicine is In the NewsBeing
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)

34
When Your Medicine is In the NewsBeing
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 non-drug 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 weve decided and see how I am doing?

35
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
• [phone] ext. 314
• bullman_at_ncpie.info email
• www.talkaboutrx.org
• www.mustforseniors.org
• www.bemedwise.org