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.”
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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.”
Continue reading Another opportunity for pharmacist$

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.

Lexi-CALC now available for Android

I received an email today from Lexi-Comp announcing the availability of Lexi-CALC for the Android OS. The email reads in part:

“…you might not be aware of the newest addition for Android® smartphones: Lexi-CALC™!

Lexi-CALC includes 65 medical calculators designed to assist you in addressing dosing, drug conversions, infusion rates, pharmacokinetics and more.

Purchase any Lexi-Comp® handheld product for your Android smartphone today and get 25% off! Take advantage of this special discount offer in celebration of the Lexi-CALC release!”

The 25% discount is nothing to shake a stick at as purchasing Lexi-Comp drug information databases can add up quickly. Lexi-CALC does not appear to be a stand alone application, but shows up as one of the databases in several of their packages.

Rxplore: a new way to explore medication side effects visually

Journal of Biomedical Informatics

Patients on multiple medications are at increased risk for adverse drug events. While physicians can reduce this risk by regularly reviewing the side-effect profiles of their patients’ medications, this process can be time-consuming. We created a decision support system designed to expedite reviewing potential adverse reactions through information visualization. The system includes a database containing 16,340 unique drug and side-effect pairs, representing 250 common medications. A numeric score is assigned to each pair reflecting the strength of association between drug and effect. Based on these scores, the system generates graphical adverse reaction maps for any user-selected combination of drugs. A study comparing speed and accuracy of retrieving side-effect data using this tool versus UpToDate demonstrated a 60% reduction in time to complete a query (61 s vs. 155 s, p < 0.0001) with no decrease in accuracy. These findings suggest that information visualization can significantly expedite review of potential adverse drug events. – J Biomed Inform. 2010 Apr;43(2):326-3

The visual support tool mentioned in the abstract above is called Rxplore and was developed by Jon D. Duke, M.D., a medical informatics fellow at the Regenstrief Institute and the Indiana University School of Medicine.
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Sad, but all too common experiences with healthcare

I read Warner Crocker’s musings at GottaBeMobile as well as his Tweets via the @LPH/tablet-pc-enthusiasts list on Twitter. Warner also has a second blog called Life On the Wicked Stage: Act 2, which I do not read with any regularity. I was, however, driven toward his personal blog secondary to a Twitter post. The post, titled Rush and My Mom: Two Different Care Experiences, talks a little about his experiences with his mothers medical care. She is apparently very ill with lung cancer. I sympathize with Warner as my mother-in-law, Mary Lou, succumbed to lung cancer in December of 2008. I also understand much of what he is talking about as my wife and I experienced similar problems during Mary Lou’s chemotherapy, pain management and surgeries.
Continue reading Sad, but all too common experiences with healthcare