The Canadian Pharmacist Association is looking for a way to track drug shortages. They would like to get drug manufactures and hospitals to participate in a national reporting system. It’s a great idea and one that I think could provide value.
Pharmacists impact on osteoporosis management (review article)
Pharmacists are pretty good at helping people with chronic medical conditions manage their medications, hence the term Medication Therapy Managment (MTM). You can find more information about MTM at the American Pharmacists Association (APhA) website.
Anyway, I came across an article this morning that gives the results of a literature review “to examine the impact of pharmacist interventions in improving osteoporosis management“. While I’m not a big fan of review articles in general because the information can be skewed, I found the conclusion to my liking. The articles concludes that “[d]ata support the potential role for pharmacists to help reduce gaps in osteoporosis management through improved identification of high-risk patients.” And then the article goes on to say that more research is needed. I personally think it’s time to move beyond the research stage and start integrating MTM into the care of all patients. It should be the standard.
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Bacteria everywhere run scared as vancomycin gets new life
medGadget: “Scientists from the Scripps Research Institute have successfully reengineered vancomycin. They have reported their findings in the Journal of the American Chemical Society. This research could be a solution in the treatment of patients infected with highly resistant bacteria. Vancomycin is often considered the antiobiotic of last resort, if other antibiotics have failed to do the job. But the emergence of vancomycin-resistant bacteria is becoming a major health problem. Vancomycin works by binding the D-alanyl-D-alanine terminal dipeptide of peptidoglycan precursors, used by bacteria for constructing their cell walls. By binding it, the bacteria can not use the peptidoglycan anymore and they die. But certain bacteria have altered their peptidoglycan by replacing an amide with an ester, resulting in vacomycin resistance.
The reengineered vancomycin can bind the altered peptidoglycan and kill the bacteria once again using the same mechanism as described above. But besides binding the altered peptidoglycan, this new antibiotic can bind the original peptidoglycan as well. It took Dale L. Boger and his team some serious chemical engineering to redesign vancomycin into this new antibiotic. In the article down below you can read the report how they managed to synthesize this altered antibiotic and exchange a single atom in the vancomycin to reinstate its antimicrobial activity.”
Vancomycin is an oldie, but a goodie. It continues to be useful despite its age. Several drugs have been developed over the years to replace it, but for one reason or another the newer agents tend to fall out of favor. With that said, vancomycin won’t last forever as bacteria are slowing finding ways to combat its mechanism of action. So instead of finding a new drug, someone decided to alter the old one. Go figure.
Something new from Medscape – Medscape REFERENCE
Received an email this morning touting the benefits of a “new product” from Medscape called Medscape Reference. Medscape Reference offers several databases including one for drugs and diseases. In addition there’s a drug interaction checker to boot. I took the interaction checker for a test drive by putting in amiodarone, warfarin and TMP/SMX. As predicted several serious interactions were found. So on the surface it works.
I’ve used Medscape for years. In fact, it was one of the first online reference sources that I signed up for when I became a pharmacist back in 1997. Unlike today, online information was hard to come by back then.
I like the way Medscape has always tailored their content by specialty, i.e. I have my set to Pharmacist so I get mostly information that applies to my profession.
I only spent a little time with Medscape Reference this morning, but it has a nice layout with a good amount of information. Enjoy.
Drug shortages, the self-fulfilling prophecy
It seems that every pharmacy I visit lately has an excess of certain medications bursting from their shelves. It’s a strange thing as discussions involving inventory tend to focus on reduction, not accumulation.
I’ve seen boxes of enoxaparin, midazolam and propofol stacked to the ceiling in pharmacies throughout various parts of the country. When I inquire about the reasons behind the large quantities I typically get one of the following responses: “it’s on backorder so we ordered as much as we could get” or “it was hard to get so we ordered extra”.
Drug shortages have become quite a problem over the past year. ASHP has dedicated significant time and resources to the issue. They’ve even gone as far as establishing a website where you can go for the most up to date information. In addition they’re calling for action to help support the Preserving Access to Life Saving Medications Act.
With that said I think part of the problem is pharmacies over ordering medications on backorder, thus contributing to the shortage. Think about it. Reminds me of the Eric Cartman novel marketing strategy, dubbed the "you-can’t-come" technique. Tell people they can’t have something and the go crazy trying to get it.
There are reasonable alternatives to many of the medications on the drug shortage list. It’s a real shame to see pharmacies not utilizing a better strategy.
Technology and pharmacist impact on medication adherence
mobihealthnews: “According to a recent study by Express Scripts, Americans might be wasting as much as $258 billion annually by not taking their prescribed medications. Missed doses can lead to emergency room visits and doctors’ visits, which could be prevented if medication adherence was improved. The Express Scripts study found that more than half of people who believe they take their medications properly are not, according to a report in USA Today.
A similar study conducted by NEHI found that poor medication adherence results in illnesses and ensuing treatments that cost some $290 billion in unnecessary spending each year, $100 billion of that in avoidable hospitalizations alone.
Two members of Congress recently introduced bills to allow Medicare reimbursement for more patients to sit down with therapists one-on-one and equip patients with pill boxes or text message services that help patients become more adherent, the USA Today report said.
The Toronto University College of Pharmacy conducted a study that found medication therapy saved about $93.78 per patient annually in a study of 23,798 people, USA Today reports.”
Read more …
Healthcare is beyond repair, and I can prove it
Before we begin let me get a few things out of the way. First, I am a healthcare professional. Yes, a pharmacist is a healthcare professional. Second, I’ve spent a large portion of my adult life working in the healthcare industry, both inpatient and out. This includes more than a decade working in a hospital as either a “staff” pharmacist or a “clinical” pharmacist. Third, the average person has no idea what goes on in a hospital or their physician’s office. A majority of people that are misdiagnosed, receive unnecessary labs, get the wrong drug, etc. will never know because they have no reason to think they’re getting anything but the best of care. And finally, I’ve been called a pessimist. I don’t see it that way, but I’m simply giving you all the data I have.
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Another opportunity for pharmacist$
Reuters: “During the current study, 21 percent of the 1506 participants said they had previously not taken medications because of money concerns. Another 5 percent said they were worried they might not be able to pay for drugs.
The researchers, who published their results in the journal Academic Emergency Medicine, considered both groups to be “at risk” of nonadherence with future prescriptions.
Looking at the responses to other questions on the survey, Rhodes and her team found that people were more likely to be at risk of nonadherence if they had money issues – for instance, they worried about money, didn’t have enough food, reported housing problems, and had inadequate health insurance. But they were also more likely to be at risk of nonadherence if they smoked, used illegal drugs, or experienced domestic violence, as either the victim or perpetrator.”
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UA College of Pharmacy professor promotes pharmacists in direct patient care
I received my normal ASHP NewsLink via email today and found this interesting little tid-bit: “Public Television Station Features Research on Value of Pharmacists - Watch pharmacist researcher Marie Chisholm-Burns on Arizona Public Television discussing ASHP Foundation-funded research about the value of pharmacists.”
Dr. Chisholm-Burns spends a little time on Arizona Public Media discussing some of the research she’s done using pharmacists in direct patient care. It’s really good stuff. The video can be found at the Arizona Public Media website. The AJHP article that Dr. Chisholm-Burns refers to in the video can be found here.
Micromedex drug information application for the iPhone
I received an email recently announcing the availability of a free Micromedex Drug Information application for the iPhone.
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