Saturday morning coffee [December 7 2013]

“There is never a better measure of what a person is than what he does when he’s absolutely free to choose.” – William M. Bulger

So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

LIFE: “President Franklin Roosevelt declared December 7, 1941 — when Japan launched more than 350 fighters, bombers, and torpedo planes against the U.S. naval base at Pearl Harbor in Hawaii — a “date which will live in infamy.” In fact, that Sunday morning is so seared into America’s memory that the tumult of the critical weeks and months afterward, as the U.S. responded to the attack, is often overlooked. Here, on the anniversary of Pearl Harbor, LIFE.com presents photos — most of which never ran in LIFE magazine — from Hawaii and the mainland, chronicling a nation’s resolute reply to an unprecedented act of war.” – Some amazing photos here. Roosevelt’s speech can be found here. I had an opportunity to visit the Pearl Harbor Memorial a few years ago. It was an amazing experience. One that is difficult to explain, but easily understood once you’ve experience it.

MUG_SMC
Continue reading Saturday morning coffee [December 7 2013]

Saturday morning coffee [September 6 2013]: The Butler, Surface, Med Adherence, Note 3

“Hardships often prepare ordinary people for an extraordinary destiny.” ~ C.S.Lewis

So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

I have officially run out of coffee mugs from which to pull for my SMC posts. The coffee mug below was a Christmas present from my youngest daughter, Mikaela, and will be used as my official SMC mug for the time being.

MUG_SMC
Continue reading Saturday morning coffee [September 6 2013]: The Butler, Surface, Med Adherence, Note 3

Saturday morning coffee [August 17 2013]: Elysium, Pharmacogenomics, Gonorrhea, Limo Joust

So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The coffee mug below comes straight from Canada. My family and I spent a little time in Victoria, British Columbia this summer. What a beautiful place. It’s a great little town, and we were blessed with awesome weather. It was sunny and in the 70’s-80’s the entire time we were there. We spent some time milling around the town, rented a car and drove around the beach areas, and took a short trek to Butchart Gardens. I’m not a gardens-type of guy, but Butchart Gardens is really neat. We took a boat tour of the area and stayed for the fireworks show that took place late one night. Great memories. I would do it again.

MUG_Canada

Just a quick side note: this is the last coffee mug in my collection. Not sure what I plan to do for my next SMC. Any suggestions?
Continue reading Saturday morning coffee [August 17 2013]: Elysium, Pharmacogenomics, Gonorrhea, Limo Joust

Smart prescription bottle to be used in clinical trial for med compliance

adheretech

Medical Xpress:

“Weill Cornell Medical College in New York City, a Cornell University college, has been awarded a $100,000 grant from the New York City Economic Development Corp. and Mayor Michael Bloomberg’s administration for a clinical study to test the effectiveness of the smart pill bottle on drug adherence in HIV-positive patients. It was one of 10 partnerships to win an inaugural PILOT Health Tech NYC grant.

The smart bottle is made by AdhereTech, a startup firm that licensed the technology from UAH (University of Alabama in Huntsville), which holds an equity position in the company.

For 12 weeks, the New York trial is scheduled to follow 70 HIV patients with medication compliance difficulties who are being treated at Weill Cornell. Each patient will receive adherence counseling, but only half will also use the smart pill bottles.”

I first mentioned the AdhereTech bottle back in March of this year. Then I mentioned it again during a presentation that I gave in May at the HIMSS Southern California Chapter 5th Annual Clinical Informatics Summit: Adventures in Clinical Informatics. It’s an interesting piece of technology. I’m curious to see what the outcome of the study shows.

Medication adherence, it should begin and end with a pharmacist

There’s no question that medication adherence is a problem. How big a problem? Well, according to an article in The American Journal of Medicine, 28% of new prescriptions never get filled, and among patients who do fill their prescriptions, adherence rates are less than 50%. The problem with these numbers is that they represent not only grief for the patient, but for the entire healthcare system.

According to Dave Walker, a pharmacist that blogs at pharmacy 2.0 and ½, “although the causes and proposed solutions to the medication adherence/compliance problem vary widely and are often debated, it seems one thing can be agreed upon by all… it is a very costly healthcare problem in the U.S. today. The cost of non-adherence was estimated to be $290 billion annually by the New England Healthcare Institute NEHI in 2009. It’s now estimated by some to be in the neighborhood of $330 billion or more annually.” That’s a lot of money.
Continue reading Medication adherence, it should begin and end with a pharmacist

Saturday morning coffee [June 15 2013]: The Purge, Nanopatch, NSA, Adherence, Smartphones, CPOE

So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The coffee mug below is from the Netherlands. Just in case you’ve forgotten, I stopped in Amsterdam back in November 2011 on my way to Germany for work. Amsterdam is the largest city in the Netherlands and serves as the regions capital. It’s also a dirty city with a weird vibe to it. Didn’t care for it. I would return to Germany in a heartbeat, but wouldn’t choose to spend any personal time in Amsterdam. I can’t really say much about the rest of the Netherlands.

MUG_Netherlands
Continue reading Saturday morning coffee [June 15 2013]: The Purge, Nanopatch, NSA, Adherence, Smartphones, CPOE

Inhaled Corticosteroid Adherence and Emergency Department Utilization Among Medicaid-enrolled Children with Asthma [article]

J Asthma. 2013 Jun 5. [Epub ahead of print], Rust G, Zhang S, Reynolds J.

Abstract
Objectives: Asthma is the most prevalent chronic disease among children enrolled in Medicaid. This study measured real-world adherence and outcomes after an initial prescription for inhaled corticosteroid therapy in a multi-state Medicaid population.

Methods: We conducted a retrospective study among Medicaid-enrolled children aged 5-12 with asthma in 14 southern states using 2007 Medicaid Analytic Extract (MAX) file claims data to assess adherence and outcomes over the three months following an initial prescription drug claim for inhaled corticosteroids (ICS-Rx). Adherence was measured by the long-term controller to total asthma drug claims ratio.

Results: Only one-third of children (33.4%) with an initial ICS-Rx achieved a controller to total drug ratio greater than 0.5 over the next 90-days. Children for whom long-term control drugs represented less than half of their total asthma drug claims had a 21% higher risk of emergency department visit (AOR 1.21 [95% CI 1.14, 1.27]), and a 70% higher risk of hospital admission (AOR 1.70 [95% CI 1.45, 1.98]) than those with a controller to total asthma drug ratio greater than 0.5.

Conclusion: Real-world adherence to long-term controller medications is quite low in this racially-diverse, low-income segment of the population, despite Medicaid coverage of medications. Adherence to long-term controller therapy had a measurable impact on real-world outcomes. Medicaid programs are a potential surveillance system for both medication adherence and emergency department utilization.

Posted online on June 5, 2013. (doi:10.3109/02770903.2013.799687)

Two things to consider:
Continue reading Inhaled Corticosteroid Adherence and Emergency Department Utilization Among Medicaid-enrolled Children with Asthma [article]

Saturday morning coffee [June 7 2013]: Fast & Furious 6, Peach Cobbler, PRISM, Pharmacy, MedPod

So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The headline for SMC is a bit different today in case you haven’t noticed. I’ve taken the advice of a Twitter colleague, Charles Webster, MD (@EHRworkflow). Charles has recommended a couple of times now that I make my headline more descriptive. I like the idea so I’m giving it a shot. Feedback welcome.

My trip to Minneapolis, MN for the ASHP Summer Meeting has me waxing nostalgic. The coffee cup below was my trophy for winning the first ever ASHP Midyear Meeting Twitter contest. I’m not even sure what year it was, but I believe it was 2009; don’t hold me to that recollection though. At that time ASHP  was unable to use any of the official Twitter logos due to some time of licensing issues. So instead they generated a Wordle from my website and placed it on the mug you see below. My Twitter handle (@JFahrni) and web address (JerryFahrni.com) are displayed on the back near the handle.

ASHP Twitter contest mug
Continue reading Saturday morning coffee [June 7 2013]: Fast & Furious 6, Peach Cobbler, PRISM, Pharmacy, MedPod

Saturday morning coffee [June 1 2013]

So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

Is it really June 1st already? Wow, time is flying by this year.

The coffee cup below is a simple, cheesy mug used by some place here in the Denver airport to serve coffee. I’m passing through on my way to the ASHP Summer Meeting in Minneapolis, MN. I get in later this afternoon. The festivities will start for me tonight and go through Tuesday. I plan on spending some time attending sessions as a real pharmacist. I have to admit, I’m a little excited by the idea. I’ve been unable to attend an educational session at a conference in approximately two years. I’m looking forward to having my brain cleansed by some good old fashioned pharmacy information.

MUG_DEN
Continue reading Saturday morning coffee [June 1 2013]

Saturday morning coffee [May 25 2013]

So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The coffee cup below is several years old. It’s a plastic Starbucks cup that I picked up somewhere in either Fresno or Visalia, California during my time as an IT Pharmacist at Kaweah Delat Medical Center in Visalia. The commute from my front door to Kaweah is just under an hour. There’s a Starbucks around the corner from my house and I used to swing by there on the way to work several mornings each week. Seemed like a shame to throw away all those cups, so I bought this dude. This weekend it’s sitting on the desk of a hotel room in San Mateo, California as I wait for my crew to stir so we can make our way to my daughter’s volleyball tournament.

MUG_StarbucksPlastic

Continue reading Saturday morning coffee [May 25 2013]