patient focused care - scriptsave wellrx - blog image

by Robert “Jed” Swackhammer, Ohio State University

The Patient Dilemma

A patient recently had a primary care follow-up appointment with her physician. She was concerned about waking up during the middle of the night sweaty, shaky, and dizzy. The patient’s physician decided to decrease, her insulin dosage of Lantus, a long-acting insulin.

A few weeks later, the patient received a phone call from her community pharmacist regarding a refill gap on her insulin. The patient stated that her doctor decreased her dosage of Lantus due to low blood sugars in the middle of night. The pharmacist then asked, what insulin where you injecting in the evening? The patient responded, “My Humalog,” a rapid acting insulin.

The patient had been mistakenly taking her Humalog before bed without eating, but her doctor assumed she was using the Lantus, as prescribed. It was at this time the pharmacist counseled the patient on the differences between her insulins and the appropriate time to inject them. After concluding the phone call, the pharmacist advised the patient to follow-up with her physician if her blood sugars remained uncontrolled within a week. A month later, the patient called her community pharmacist to report her symptoms resolved and her blood sugars were controlled!

Working With All Healthcare Providers

Currently, many healthcare professionals are having problems balancing the numerous responsibilities present in their day-to-day jobs. Consequently, this impacts patient care. A difficult and complicated question to ask is what should patients look for in a healthcare professional? The solution is to observe their willingness to work with all your healthcare providers. Consequently, it is important that your healthcare professional is an excellent communicator and prioritizes your needs.

Patient-focused Care

Recent studies by BioMed Central Health Services Research identified 25 different patient-centered care models. The main takeaway from the study was patient-care models consisted of communication, partnership, and health promotion to meet the needs of patients.[1] Similarly, the Nursing Clinics of North America states that in order to improve quality of care in the United States, there needs to be continued focus on 6 dimensions: safe, effective, patient-centered, timely, efficient, and equitable.[2]

It’s vital that healthcare professionals (i.e. physician, nurse practitioner, physician assistant, pharmacist, psychiatrist, psychologist, dentist, cardiologist, endocrinologist, oncologist, and many others) work with one another so that you, as a patient, receive optimal care. With this collaboration, your healthcare team will be able to appropriately share information, deliver compassionate and empowering care, and consider the sensitivity of you as an individual while addressing your needs.[3]

With the aging Baby Boomer population, all healthcare professionals should appropriately equip themselves to focus on taking care of each patient individually instead of just isolated conditions. In dealing with the rise in our elderly population, the American College of Clinical Pharmacy states that “multiple articles have been published in support of clinical pharmacists’ involvement in patient-centered medical homes (PCMH) to help complete team‐based care, enhance patient access, transitions of care, and improve the quality and safety of patient-care”.[4] All professions have a unique position on this team, including pharmacists, because we all bring a different perspective and lens with which to view and treat our patients.

It is vital that all healthcare professionals work together to help deliver optimal patient care. As a patient, you can ensure that this by observing current and future healthcare professional’s ability to communicate with one another. Remember, communication is vital, so that you can be treated as a patient and your needs are addressed.

References:

[1] Bmchealthservres.biomedcentral.com. (2018). [online] Available at: https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/1472-6963-14-271 [Accessed 27 Aug. 2018].

[2] Owens L, Koch R. Understanding Quality Patient Care and the Role of the Practicing Nurse. Science Direct. http://dx.doi.org/10.1016/j.cnur.2014.10.003. Published 2018. Accessed August 27, 2018.

[3] Bmchealthservres.biomedcentral.com. (2018). [online] Available at: https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/1472-6963-14-271 [Accessed 27 Aug. 2018].

[4] Onlinelibrary-wiley-com.proxy.lib.ohio-state.edu. (2018). Shibboleth Authentication Request. [online] Available at: https://onlinelibrary-wiley-com.proxy.lib.ohio-state.edu/doi/abs/10.1002/phar.1357 [Accessed 27 Aug. 2018].


For the best Rx price on
prescription medications,
visit www.WellRx.com.
Compare prices at more than
62,000 pharmacies nationwide.

0 views

lab tests - scriptsave wellrx - blog image

by Samantha McKinnon, PharmD Candidate 2019
University of Arizona College of Pharmacy

Diabetes, Cancer, HIV, seizures, pregnancy, organ transplant… chances are high that you or someone you know have experienced or are currently suffering from one of these conditions. But what do they all have in common? They’re all diagnosed or screened for with lab tests. Diagnostic lab test results influence approximately 60 to 70 percent of medical decisions. Without lab tests, we wouldn’t know what to do!1

What Are Lab Tests?

A lab test is searching for something specific in your body, and can use your blood, saliva, urine, feces, breath, or organ tissue (tissue biopsy). These tests can help you and your physician determine the presence, absence, or extent of disease or monitor the effectiveness of a treatment2. They are performed by having blood drawn, spitting into a cup, having your cheek swabbed, urinating into a cup, or breathing into a special device. Some examples of lab tests you may already be familiar with are a DNA test to determine if a man is the father of a child, a urine drug test for employment, an HIV screen to test if someone does or does not have HIV, a finger-prick blood sugar test, or an alcohol breath test (breathalyzer).

Why Should I Get a Lab Test?

If you’re experiencing any unusual symptoms, a lab test may help guide you toward a diagnosis. For example, if you’ve been feeling tired and fatigued lately a lab test may determine if your thyroid is underperforming, if you have anemia, if you have an electrolyte imbalance, or if you’re developing a chronic disease such as diabetes. Sometimes, lab tests are repeated to confirm a diagnosis. If you know you’re a carrier for a disease or have a close relative with a disease you should be screened regularly3.

Catching a condition or disease early gives you more treatment options, more opportunity for lifestyle modifications, and saves you time and money4. Screenings help establish a baseline that is unique to you, and some screenings (such as breast or colon cancer) become mandatory with age. A lab test can determine how well certain organs are working, and monitor their function – most especially the kidneys, liver, heart, thyroid, and pancreas, this is especially handy as you age.

Anyone needing an organ transplant or anyone wanting to donate an organ or blood will have blood typing and compatibility testing done. Certain medications, called narrow therapeutic index drugs, as well as antibiotics, are monitored to make sure those levels don’t get too high or too low and verify treatment is working. Lab tests also can be used to substantiate specific events; such as an exposure to heavy metals, or the administration of a rape kit.

What Lab Tests are Important?

Critical or required lab tests vary by individual and their current health levels. An 80-year-old man with diabetes and a foot infection is going to need different tests than a healthy 28-year-old pregnant woman. Some lab tests are precise and reliable, while others provide general clues to possible health problems. For a generally healthy individual, some common tests that are done at your routine checkup that establish your baseline are things like:

  • Complete Blood Count (CBC) which differentiates types of blood cells
  • Comprehensive Metabolic Panel (CMP) that determines your cholesterol, hormone levels, electrolytes, and enzymes;
  • Hemoglobin A1C (HbA1C or A1C) which measures how much sugar is attached to your hemoglobin (the stuff in your blood that carries oxygen) and determines your risk of developing diabetes.

If you have an infection, a culture and sensitivity test will be ordered so your physician knows what the offending bacteria is and the appropriate antibiotic to treat it. Participating in your own health care is paramount to your well-being, so ask your doctor what tests are right for you.

Important Questions to Ask Your Doctor Before Having a Lab Test5

  • What will this test measure? A patient on the “blood-thinner” warfarin would want to check their INR, a patient with diabetes would measure their A1C. Knowing what you’re measuring will ensure you get only the necessary tests.
  • Why is this test necessary? Someone that has seizures may need their medication levels monitored to ensure the levels are safe and appropriate. A person with an unsteady gait may need a test to rule in or rule out Huntington’s Disease. If it’s necessary, your doctor will be able to explain the test and why.
  • Are there risks or side effects to this test? Most lab tests are benign, but some do come with some risks or negative side effects. A biopsy patient may want to have someone else to drive them to and from their appointment. Ask your physician so you can prepare accordingly.
  • How do I prepare for this test? Some tests require fasting, others require drinking a special preparation beforehand, while some require no preparation at all. Every test is different, but it’s important to follow the directions so you don’t have to repeat the test.
  • What results should I expect from this test? Results can be confusing. Sometimes you want a positive, sometimes you want a negative, other tests you may want a high number or a low number. Understanding what a normal value is will help you to interpret your result.
  • How often will I need to do this test? As mentioned earlier, some tests will be repeated to ensure the diagnosis is correct. Some screenings are done annually to monitor any changes.  Some tests are daily or weekly. Other tests are only done once, so be sure to ask how often a test is needed.

If you don’t understand something, be sure to ask your doctor to explain it to you. Some additional factors that may influence your lab test results are:

  • age
  • sex
  • race
  • weight
  • diet
  • alcohol or tobacco use
  • caffeine intake
  • stress level, and,
  • hydration status

Always request a copy of your results, and retain it for your personal medical record. After all, it is your health!

References

  1. Ngo, Andy, et al. “Frequency That Laboratory Tests Influence Medical Decisions.” The Journal of Applied Laboratory Medicine, The Journal of Applied Laboratory Medicine, 1 Jan. 2017, jalm.aaccjnls.org/content/1/4/410.
  2. Kennedy, A G. “Evaluating Diagnostic Tests.” Journal of Evaluation in Clinical Practice., U.S. National Library of Medicine, Aug. 2016, ncbi.nlm.nih.gov/pubmed/27091221.
  3. Elmore, Joann G. “Screening for Breast Cancer.” JAMA Internal Medicine, American Medical Association, 9 Mar. 2005, jamanetwork.com/journals/jama/fullarticle/200479.
  4. Yong, PL. Saunders, R. and Olsen, L. (2018) Missed Prevention Opportunities from The Healthcare Imperative: Lowering Costs and Improving Outcomes Roundtable. Available at https://www.ncbi.nlm.nih.gov/books/NBK53914
  5. Talking with your doctor. No author. Available at https://www.nia.nih.gov/health/doctor-patient-communication

 


For the best Rx price on
prescription medications,
visit www.WellRx.com.
Compare prices at more than
62,000 pharmacies nationwide.

0 views

bleeding risk - scriptsave wellrx blog image

by Randall Flores, PharmD Candidate 2019
University of Arizona

Bleeding can manifest itself in a variety of different ways which, at times, may not be easy to recognize. Some bleeds are also more serious than others and may require emergency medical attention. Bleeding frequency may also vary depending on a variety of factors such as underlying bleeding disorders or the use of certain medications.5

Potential Signs of Different Types of Bleeding

Gastrointestinal Bleeds5 
  • Bloody or black, tar-like stool
  • Weakness
  • Paleness
  • Swollen or firm abdomen
  • Vomiting or coughing blood
  • Abdominal or stomach pain
Urinary Tract Bleeds5  
  • Bright red or brown-colored urine
  • Pink urination
  • Frequent urination
  • Pain while urinating
  • Lower-back pain
Nosebleeds5  
  • Prolonged headache
  • Confusion, lethargy, and/or slurred speech
  • Discomfort to bright light
  • Double vision
  • Enlarged pupils or different size pupils
  • Dizziness and/or stumbling
  • Stiff neck or back
  • Seizures
  • Irritability
  • Loss of appetite
  • Sudden or forceful vomiting not due to upset stomach
Throat Bleeds5  
  • Choking
  • Vomiting or coughing up blood
  • Swelling or discoloration in the neck
  • Change in tone of voice
Eye Bleeds5  
  • Swelling or pain within or around the eye
  • Reddening of the white part of the eye
  • Double or blurred vision
  • Change in vision

Monitoring Lab Results While Taking Anticoagulants

Anticoagulation therapy is vital to the prevention and treatment of thromboembolic diseases; however, close monitoring is very important to treat and prevent harmful adverse effects. Lab monitoring is an important part of anticoagulation therapy to determine if it is necessary to counterbalance the anticoagulant effect of the drug4. Each drug has its own recommendations on lab monitoring depending on how it works in the body and possible adverse effects.

Coumadin (warfarin) remains the most prescribed oral anticoagulant medication worldwide despite the higher risk for bleeding compared to alternative anticoagulants1. The use of warfarin entails frequent blood tests and patient education about food and drug interactions4. The laboratory test that are most frequently monitored are prothrombin time (PT) and international normalized ratio (INR). PT is a test used to measure the number of seconds it takes for a clot to form3. INR on the other hand, is a more standardized PT measure so that it may serve as a reference value on how to adjust the dose depending on the result3. Higher INRs represent thinner blood, while lower INRs represent thicker blood.  [ Read more on our blog post, Losing the War With Warfarin? ]

New oral anticoagulants (NOACs) now formally known as direct oral anticoagulants (DOACs) have a few advantages over the use of warfarin. DOACs include dabigatran (Pradaxa), rivaroxaban (Xarelto), and apixaban (Eliquis). One of the biggest advantages over warfarin is that DOACs typically do not require dose adjustments and routine monitoring4. There are however some recommendations of monitoring certain parameters in patients with specific circumstances and comorbidities. Kidney function is an important parameter to monitor because all DOACs are eliminated by the kidney and impairment is a risk factor for bleeding1.

Antidote Medications to Reverse the Effects of Anticoagulants?

There are several reversal agent options for warfarin, despite its challenging management. The reversal agents used for warfarin include phytonadione (vitamin K), fresh frozen plasma (FFP), and prothrombin complex concentrate (PCC)2. The availability of these agents makes warfarin a viable option for patients who are at increased risk of bleeding and enables it to still be recommended by guidelines2.

DOACs are becoming more popular due to safety and efficacy over other anticoagulants, however only one of these agents has an FDA-approved reversal agent. Praxbind (idarucizumab) received accelerated FDA approval due to its promising results in clinical trials as a reversal agent to dabigatran (Pradaxa)2.

Currently, there is one agent called andexanet alfa that in phase III clinical trials as a reversal agent to the remaining DOAC agents2. As the use of DOAC agents become more popular, the need for effective antidotes is demanded.

Whether a someone is on anticoagulant therapy or not, it is important for people to have a general understanding about bleeding risks and how to identify different types of bleeds. Patients on anticoagulant therapy should also have a general idea about the monitoring that their therapy entails, potential risks, and management of those risks. The more patients know, the lower their chance of hospitalization from bleeding.

References:

1 Conway, S. E., Hwang, A. Y., Ponte, C. D., & Gums, J. G. (2016). Laboratory and Clinical Monitoring of Direct Acting Oral Anticoagulants: What Clinicians Need to Know. Pharmacotherapy, 37(2), 236-248. doi:https://doi.org/10.1002/phar.1884

2 Griffiths, C., Vestal, M., Livengood, S. and Hicks, S. (2017). Reversal agents for oral anticoagulants. [online] The Nurse Practitioner. Available at: https://journals.lww.com/tnpj/fulltext/2017/11000/Reversal_agents_for_oral_anticoagulants.2.aspx [Accessed 21 Sep. 2018].

3 Hull , R., Garcia, D., Vazquez, S. (2018). Warfarin (Coumadin) Beyond the Basics. UpToDate. Retrieved from https://www.uptodate.com/contents/warfarin-coumadin-beyond-the-basics

4 Ramos-Esquivel, A. (2015). Monitoring anticoagulant therapy with new oral agents. World Journal of Methodology5(4), 212–215. http://doi.org/10.5662/wjm.v5.i4.212

5 The Basics of Bleeding Disorders. (2018). National Hemophilia Foundation. Retrieved September 19, 2018, from https://stepsforliving.hemophilia.org/basics-of-bleeding-disorders/identifying-types-of-bleeds


If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

0 views

Pharmacy Gag Clause - pharmacist perspective - ScriptSave WellRx blog image

by Mitchell Welton, PharmD Candidate 2019
University of Arizona

After the much anticipated release of the 2016 Gallup poll, which had Americans assign a rating of honesty and ethical standards in professions, Pharmacists found themselves in a top-three ranking for the 14th straight year.1 In last year’s poll however, it seems the general public’s opinion of pharmacists had shifted slightly. With increased news coverage and scrutiny over rising drug prices, it seemed harder for patients to be able to separate the practices of big pharmaceutical companies with the copay price that the pharmacists were asking for at the drug counter.

Pharmacy Gag Clauses

Although the community pharmacist was unable to control the inflating cost from the manufacturers, there was a more insidious practice taking place that kept their hands tied and mouths shut, even though patients might have been paying more for their prescription medications than they needed to. This was due to pharmacy gag clauses, written into the contracts between the pharmacy and pharmacy benefit managers (PBM). These clauses prevented a pharmacist from telling the patient at the point of sale if the cash price was lower than their insurance copay. To violate such a gag order would mean risking the pharmacy’s network contracts with its PBMs and facing other sanctions.2

An example of this practice will help explain why the opinion of pharmacy ethics and honesty were not found in the top-three ranking in last year’s poll: A patient’s spouse went to pick up her generic medication, telmisartan, from their local pharmacy. He paid $285 for a 90-day supply. Before the 90-day period he and his wife decided to go on a trip and would run out of her previous fill before returning home. He went to go purchase another 90-day refill out of pocket and found out the cash price was $40. While a spokesperson for the PBM involved in this event confirmed that the $285 copay was correct he was unable explain why that dollar amount was so much higher than the cash price of the medication.3 Overpayments like this, known as “clawbacks”, have unfortunately not been isolated events, and the occurrence was recently quantified by the University of Southern California’s Schaeffer Center for Health Policy and Economics.

[ Read more about PBM Pharmacy Clawback’s ]

The study which was completed in March of this year looked at available pharmacy claim data from 2013. The study analyzed over nine million claims in which they found close to a quarter of them to involve overpayment. The average amount patients overpaid was $7.69 and overpayments on a brand name medication were significantly higher although not as frequent. 4

States Take the Lead

Between 2016 and August 2018 at least 26 states have enacted laws prohibiting “gag clauses” in pharmacy contracts. The most recent action came from the White House on October 10, 2018, when President Donald Trump signed into law the “Know the Lowest Price Act” and the “Patient’s Right to Know Drug Prices Act” which banned gag clauses immediately upon signature. This has represented a major victory for pharmacists who have had to remain silent while they watched the patients they care about struggle to pay for their medications. 2

How Pharmacists Feel About Gag Clauses

Pharmacists and law makers alike are disturbed that such practices have been allowed to exist. Senator Susan Collins, Republican of Maine, said, “I can’t tell you how frustrated these pharmacists were that they were unable to give that information to their customers, who they knew were struggling to pay a high co-pay.” Senator Martin M. Looney, Democrat of Connecticut said, “This is information that consumers should have, but that they were denied under the somewhat arbitrary and capricious contracts that pharmacists were required to abide by.” 5 Pharmacist Robert Iacobucci Jr., who owns White Cross Pharmacy in North Providence, Rhode Island expressed his frustration,” There’s no other profession in the world where you can’t tell your customer how to best utilize their money.”  When you see a 98-2 vote from the senate in such a divisive political climate to eliminate these gag clauses, it is telling that change was long overdue.

For more than a decade pharmacists have consistently been thought of as the pinnacle of honesty and ethical behavior when evaluating professions. The recent ban on these gag clauses will allow pharmacists to maintain that respected title and get back to what they do best; Improving the health and outcomes of their patients.

 

References

  1. Gallup, Inc, and Jim Norman. “Americans Rate Healthcare Providers High on Honesty, Ethics.” com, 19 Dec. 2016, news.gallup.com/poll/200057/americans-rate-healthcare-providers-high-honesty-ethics.aspx.
  2. Snyder, Lynn S, and John S Linehan. “New Federal Laws Banning ‘Gag Clauses’ in the Pharmacy.” The National Law Review, 30 Oct. 2018, natlawreview.com/article/new-federal-laws-banning-gag-clauses-pharmacy.
  3. Thompson, Megan. “Why a Patient Paid a $285 Copay for a $40 Drug.” PBS, Public Broadcasting Service, 19 Aug. 2018, pbs.org/newshour/health/why-a-patient-paid-a-285-copay-for-a-40-drug.
  4. Van Nuys, Karen, et al. Overpaying for Prescription Drugs: The Copay Clawback Phenomenon. USC Schaeffer, Mar. 2018, http://healthpolicy.usc.edu/wp-content/uploads/2018/03/2018.03_Overpaying20for20Prescription20Drugs_White20Paper_v.1-2.pdf.
  5. Pear, Robert. “Why Your Pharmacist Can’t Tell You That $20 Prescription Could Cost Only $8.” The New York Times, The New York Times, 24 Feb. 2018, nytimes.com/2018/02/24/us/politics/pharmacy-benefit-managers-gag-clauses.html.
  6. Povich, Elaine S., and Tribune News Service. “The ‘Gag Clause’.” The Lewiston Tribune, 1 July 2018, lmtribune.com/business/the-gag-clause/article_8c269796-7d54-5116-86ca-f3e59da23fae.html.
  7. Cauchi, Richard. “Ncsl.org – Legislative News, Studies and Analysis.” Prohibiting PBM “Gag Clauses” That Restrict Pharmacists from Disclosing Price Options: Recent State Legislation 2016-2018, 22 Aug. 2018, pm, ncsl.org/.
  8. Gallup, Inc, and Megan Brenan. “Nurses Keep Healthy Lead as Most Honest, Ethical Profession.” com, 26 Dec. 2017, news.gallup.com/poll/224639/nurses-keep-healthy-lead-honest-ethical-profession.aspx.

Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.

If you’re struggling to afford your prescription medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

what to tell the dentist about medicine you take - scriptsave wellrx - blog image

by Heather Lee, PharmD Candidate
University of Arizona

A Guide to Medication Warnings

When you visit the dentist, you expect to answer typical questions regarding your oral health, such as how often you are brushing your teeth or the infamous question of whether or not you floss. It may surprise you when your dentist asks what medications you take at home. Why would it matter if the dentists knows what you’re taking? Many medications, which includes prescriptions, over-the-counter, and even herbal medications, can affect your oral health and it is important for the dentist to know what you take so they can determine the best course of action for your oral health.

Blood Thinners

Many patients are currently on blood thinners or antiplatelet therapy to prevent the risk of blood clots. Common examples of blood thinners include warfarin (Coumadin), dabigatran (Pradaxa), apixaban (Eliquis), rivaroxaban (Xarelto), and edoxaban (Savaysa). Common examples of antiplatelet medications include clopidogrel (Plavix), ticlopidine (Ticlid), prasugrel (Effient), ticagrelor (Brilinta), and/or aspirin. Taking these medications is important to prevent blood clots, but they can also increase the risk of bleeding, especially during a dental procedure. The risk increases if you are taking multiple medications to prevent clots.  It is important for the dentist to know if you are taking these medicines so they can take extra precautions to prevent bleeding, such as stopping the medication temporarily or controlling the bleeding through local measures. They can control the bleeding through various methods, such as mechanical pressure, agents that stop the bleeding, or suturing. The dentist can make a more informed decision with what they want to do with the medication when they have a better knowledge of the type of medication you’re taking, your bleeding risk, and what procedure you’re going in for.1

Dry Mouth

Having a dry mouth can be caused by a variety of different factors, such as a medication’s side effect, having a certain medical condition, or personal habits (mouth breathing and alcohol/tobacco use).

Saliva plays an important role in maintaining your oral health through multiple ways by:

  • Reducing the population of bacteria in the mouth
  • Neutralizing acid caused by bacteria, which damages your teeth
  • Repairing tooth enamel that may have been damaged by acid
  • Washing food particles away2

A lack of saliva can cause dry, cracked lips, bad breath, infections in your mouth, and cavities. Medications that can cause this include medications used to control allergies, asthma, blood pressure, pain, and depression.

Your dentist can help by:

  • Recommending a special gel or rinse to keep your mouth moist
  • Prescribing or applying a fluoride containing toothpaste or mouthwash to prevent cavities3

Other ways to relieve this symptom can include:

  • Chewing sugar-free gum or sucking on sugar-free hard candies to increase the flow of saliva
  • Sucking on ice chips
  • Drinking water with meals to help with chewing and swallowing food
  • Using alcohol-free mouthwash
  • Avoiding carbonated drinks, caffeine, tobacco, and alcohol
  • Using a lanolin-based lip balm to soothe dry lips3

Enlarged Gum Tissue

There are some medications that may increase your risk of getting enlarged gum tissue, which is also known as “gingival overgrowth”. This is usually associated with antiseizure medications (phenytoin), immunosuppressive drugs (cyclosporine), and calcium channel blockers (including nifedipine, verapamil, diltiazem, and amlodipine). If your dentist is aware you are taking these medications, they may encourage you to do professional cleaning more often throughout the year and educate you on how to improve your brushing technique.4

Jaw Pain

There have been some reports of individuals who had difficulty healing or jaw pain after going through invasive dental procedures or even a tooth extraction. This can be due to bone death caused by a lack of blood supply (osteonecrosis). The common factor in these individuals were that they were taking a medication from the bisphosphonate class. Bisphosphonates are usually used to prevent bone weakening or destruction and are commonly prescribed to treat osteoporosis. Examples include risedronate (Actonel), zoledronate (Zometa), alendronate (Fosamax), and ibandronate (Boniva).

Over 90% of cases were in patients receiving an IV form of the drug. The risk is thought to be less than 1% of patients receiving an IV form, but they were at least ten times more likely to be affected than those who took the oral form. If you are on this medication, your dentist can discuss ways to minimize the risk of needing invasive procedures, such as tooth extractions and surgery. They may consider more conservative treatments, such as a root canal procedure. They can provide preventative advice regarding whether you need professional cleaning more often, how to observe any changes in your mouth, and how to be more careful with taking care of your teeth and gums.5

The following may increase your risk of developing jaw pain:

  • Older age (greater than 65 years)
  • Treatment with chronic corticosteroids
  • Long-term use of bisphosphonates
  • Gum infection that damages the gum and can destroy the jawbone (periodontitis)6

Signs to watch out for:

  • Gum wounds that heal very slowly or do not heal for six weeks or more after a procedure
  • Exposed bone
  • ”Roughness” on gum tissue
  • Pain if the open wound becomes infected
    • Pus or swelling
    • Numbness, especially in the lower jaw, if the infection lasts long enough5

Current treatment options include:

  • Antiseptic rinses to help prevent the growth of bacteria
  • Antibiotics
  • Cleaning/removal of dead bone from the affected area
  • Possible referral to a specialist or a surgeon for further evaluation5

Updating Your Dentist Regarding Medications

These are just a few of the reasons of why it is important to inform your dentist regarding what medications, over-the-counters, and herbal supplements you take. Your dentist can take extra precaution when you come in and educate you as to the best way to maintain your oral health when they are aware of what medications may be affecting it. The next time you go in, bring an updated medication list so your dentist is on the same page as to what you are taking at home.

References:

  1. Anticoagulant and Antiplatelet Medications and Dental Procedures. https://www.ada.org/en/member-center/oral-health-topics/anticoagulant-antiplatelet-medications-and-dental-. Accessed October 31, 2018.
  2. Department of Health & Human Services. Teeth and drug use. Better Health Channel. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/teeth-and-drug-use. Published June 30, 2014. Accessed November 1, 2018.
  3. Managing dry mouth. The Journal of the American Dental Association , Volume 146 , Issue 2 , A40
  4. Staff SBI. Gingival Enlargement. The American Academy of Oral Medicine. http://www.aaom.com/index.php?option=com_content&view=article&id=132:gingival-enlargement&catid=22:patient-condition-information&Itemid=120. Accessed November 2, 2018.
  5. Staff SBI. Bisphosphonate Therapy. The American Academy of Oral Medicine. http://www.aaom.com/index.php?option=com_content&view=article&id=78:bisphosphonate-. Accessed November 2, 2018.
  6. Dental management of patients receiving oral bisphosphonate therapy. The Journal of the American Dental Association. 2006;137(8):1144-1150. doi:10.14219/jada.archive.2006.0355.

Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.

If you’re struggling to afford your prescription medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

0 views

avoiding hospital readmissions - scriptsave wellrx - blog image

by Eli Kengerlinski, PharmD Candidate 2019
University of Florida, College of Pharmacy

Congestive Heart Failure (CHF), occurs when your heart muscle doesn’t work as well as it should to pump blood. Some conditions, like narrowed arteries in your heart (coronary artery disease) or high blood pressure, gradually leave your heart too weak or stiff to pump efficiently. Most patients struggling with CHF usually present to the hospital with shortness of breath, the most frequent symptom in patients with deteriorating CHF.1 It is crucial to be able to identify if your CHF is worsening. Early management of CHF can prevent hospitalization and equip you with the proper knowledge to identify trigger factors, improve the signs and symptoms of heart failure, and help you live longer.

Presenting CHF Symptoms

Usually CHF patients present to the hospital with worsening symptoms of:

  • Shortness of breath and/or difficulty breathing while lying down
  • Weight gain (over 2 kg), usually due to leg or ankle swelling caused by fluid retention.

However, there are major medical conditions reported in literature that can occur simultaneously in a patient with CHF, such as Chronic Obstructive Pulmonary Disease (COPD) and Coronary Heart Disease (CHD).1 Therefore, patients hospitalized with worsening CHF can be admitted for more than one reason such as pneumonia (respiratory infection due to COPD worsening), pulmonary edema (fluid built up in lungs due to CHF), or CHD event (heart attack or stroke).

Hospital Readmissions

Patients readmitted following COPD exacerbation have 10-20% readmission rate within 30 days post hospital discharge, especially during May to November compared to January indicating seasonal admissions.4 Accordingly, it is crucial to use your inhalers, as prescribed with proper technique throughout the year, and inform your doctor if your symptoms are getting worse during seasonal changes. Also, management of other conditions like CHF, high blood pressure and cholesterol, can help reduce COPD readmission rates, as one condition can worsen another if not properly managed.

How to Tell if  Your Condition is Worsening

Congestive Heart Failure Chronic Obstructive Pulmonary Disease
Shortness of breath when active or at rest Shortness of breath, especially when active or during exercise
Shortness of breath when lying down or at night Chronic cough (dry or productive) with clear white, yellow, or greenish mucus
Wheezing & coughing Wheezing
Rapid or irregular heartbeat Chest congestion, tightness, discomfort
Swelling in your ankles & feet Unintended weight loss
Frequent urination especially at night Increased usage of short acting inhalers
Weight gain of 2-3 lbs/day or 5 lbs/week Frequent respiratory infections
Feeling fatigued or weak Feeling fatigued or weak

Preventing Emergency Room Visits and Hospitalizations

While you may not be able to prevent every return trip to the emergency room or hospital, there are some steps you can take to help minimize the possibility:

  • Patient Centered care: Effective communication and rapport between healthcare professionals and patients are crucial in preventing hospitalizations. Patients can have precipitating factors due to their other health conditions therefore reporting on signs and symptoms of worsening conditions are important as it would enable the health care provider to practice preventive medicine and construct appropriate treatment strategy after an effective patient assessment.
  • Medication Adherence: Being adherent to your medication therapy will prevent disease progression, hospitalizations, as well as additional health care costs.2 There are multiple tools and resources to help patients overcome barriers such as access to medicine, forgetfulness, improper administration technique, perceived side effects, cost, as well as understanding of their disease state and how to appropriately manage their condition. If you have any issues with adherence, make sure to inform your provider as effective communication will provide you optimal treatment.
  • Vaccines: COPD admissions are seasonal as studies show strong association with the flu season, however every patient is unique and can have worsened symptoms during seasonal changes, therefore it is highly recommended to get your flu and pneumonia vaccines to decrease chances of readmission.
  • Diet & Lifestyle Modifications:
    • CHF: Limit your salt and fluid intake, as increase in salt intake can pull water into your body and cause you to swell up. Therefore, it is crucial to weigh yourself every morning to ensure you do not gain more than 2-3 pounds in a day or 5 pounds in a week. If your medication or limited salt intake is not helping you control your fluids, seek your provider immediately as this is a sign for deteriorating CHF.
    • COPD: Current smokers should seek smoking cessation as it is the most effective in minimizing symptoms and risk for respiratory infections. Furthermore, COPD patients should avoid dust as well as indoor and outdoor air pollutants. Make sure to follow up with primary care provider within 7 days after discharge for lab tests and assessment to ensure
    • CHD: Controlling your blood pressure as well as your cholesterol will reduce the risk for heart attacks as well as stroke. For patients at a higher risk for heart attacks should have NTG sublingual tablets at hand and report to their provider if they start to experience chest pains more than usual as this can indicate a risk for another heart attack. Obesity is also associated with worsened cholesterol and high blood pressure therefore managing your weight as well as your disease states can put you at a lower risk for heart attacks and stroke.

If you’re having trouble managing your disease states, talk to your doctor for a referral to a dietician and/or lifestyle coach who can aid in minimizing your risk for readmissions.

 

References:

  1. Shafazand, Masoud et al. “Patients with Worsening Chronic Heart Failure Who Present to a Hospital Emergency Department Require Hospital Care.” BMC Research Notes5 (2012): 132. PMC. Web. 12 Oct. 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3315737/
  2. Jimmy, Beena, and Jimmy Jose. “Patient Medication Adherence: Measures in Daily Practice.” Oman Medical Journal3 (2011): 155–159. PMC. Web. 12 Oct. 2018.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191684/
  3. Ziaeian, Boback, and Gregg C. Fonarow. “The Prevention of Hospital Readmissions in Heart Failure.” Progress in cardiovascular diseases4 (2016): 379–385. PMC. Web. 12 Oct. 2018.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783289/
  4. Simmering JE, Polgreen LA, Comellas AP, Cavanaugh JE, Polgreen PM. Identifying patients with COPD at high risk of readmission. Chronic Obstr Pulm Dis. 2016; 3(4): 729-738. doi: http://doi.org/10.15326/jcopdf.3.4.2016.0136

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

0 views

keep an eye on diabetes - scriptsave wellrx - blog image

by Pawel F. Kojs
University of Arizona College of Pharmacy

Living with diabetes is not an easy task, however, you are not alone. Roughly 415 million people across the world are affected with this disease. If you have diabetes, you should consider several things, such as lifestyle, medication adherence, and check-ups with your healthcare provider. These are important to make sure that your diabetes is controlled and doesn’t lead to a deterioration in your overall health. Keeping blood sugars controlled can prevent serious problems like diabetic cardiomyopathy, stroke, and atherosclerosis4. An ounce of prevention is worth a pound a cure.

Tests to Keep Your Diabetes in Check

According to Kaiser Permanente, there are several exams that a person living with Diabetes should consider1:

Weight and blood pressure: checked at every doctor’s visit.1

A1C (Glycosylated hemoglobin): This is a test that is meant to be done every three months. Blood test that shows your average blood sugar for the past two to three months. This is done by measuring the amount of glucose attached to your blood cells1.

The A1c target is usually less than 7% for people with diabetes. However, your provider will decide the ideal A1c target for you3.

Urine check: This annual test is done to look for small proteins which show signs of early kidney damage1.

Lipid blood test: This test performed once every two years checks the level of your triglycerides, total ( “good” and “bad” cholesterol)1.

The following tests are recommended to be checked every 2 years if you have Type 2 Diabetes with no symptoms, or had Type 1 Diabetes for more than 5 years1

Eye Exam: Diabetes can affect your vision. Exams checks for any nerve damage of the eye. If you have nerve damage of the eye then it is recommended to see the doctor yearly1.

According to the American Diabetes Association (ADA) guidelines, pregnant women with preexisting type 1 or type 2 diabetes, the exam should be done in the first trimester. Patients should then be monitored at every trimester and for 1 year after giving birth2.

Foot Exam: Diabetes can affect your feet. This test performed at least annually is to examine the feet. Tests are done more often if you have any positive findings1. This checks for any numbness, sores, infections, and calluses1,3.

Vaccines: According to the ADA, vaccines are recommended for diabetic patients. The flu vaccine is recommended for all people greater than 6 months of age. A 3-dose series of Hepatitis B vaccine should be given to people ages 19-59. People over the age of 60 should be considered for a 3 dose Hepatitis B vaccine. A PPSV23 Vaccine is recommended for people between the ages of 2-64 years of age and after age 65, the PPSV23 vaccine is necessary even if you had a vaccine in the past2.

Diabetes management does not end in the doctor’s office. It all starts with the goals that you have set out for yourself. Whether it’s controlling your blood pressure or reducing your weight, this requires small and achievable goals. Set a goal too big and you will become overwhelmed. Talk over your goals with your healthcare provider. Putting in a consistent effort to maintain or achieve your diabetic goals will produce worthy results.

 

References:


If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

0 views

food allergies and medicine -scriptsave wellrx blog image

by Samantha McKinnon, PharmD Candidate 2019
University of Arizona College of Pharmacy

Nearly 20% of Americans have self reported an allergy to a medication and roughly 4% of the nation suffers from some form of food allergy.1 While it would seem obvious to avoid something if you’re allergic to it, you’d first have to know you’re allergic. When it comes to medications this can be challenging.

There are different grades to an allergic reaction. It could be as mild as some pesky itching or a cough; a more serious fever, rash or painful blisters; or very serious blood irregularities, difficulty breathing or death.2,3 Allergic reactions can occur within many different classes of medications such as antibiotics, antidepressants, anesthetics, narcotics, nonsteroidal anti-inflammatory drugs (NSAIDs), among others.1

Excipients – Crucial for Drug Delivery

When you take medication, there is more than just an active drug inside the tablet, capsule, spray or syrup; these additional “inert” products are called excipients4. Excipients play a variety of roles in medications. They are used to stabilize the active drug, bind the active drug(s), increase the solubility, enhance or delay absorption (such as enteric coated tablets), and provide flavor or sweetness.4 Some excipients come from foods that people have an allergy to. The most common food allergies in the United States are milk, egg, peanut, soy, fish, and gluten.5 The Food Allergen Labeling and Consumer Protection Act (FALCPA) was enacted to inform patients if a major allergen was in their food, even in trace amounts. This carries over to medications, however, this information comes and stays with the original bottle, it will not be transferred to the prescription label. These food and drug allergies are why the pharmacy will ask for your allergy information when creating your profile and before dispensing any medications. Different manufacturers use different excipients in their preparations, so you may be allergic to one brand and okay to take a different brand. If you would like to know if an allergen is in your prescription, ask your pharmacist.

Milk: Milk allergy, sometimes called lactose intolerance causes discomfort in the digestive tract whenever dairy products are consumed. There are other enzymes in milk that people may be allergic to such as casein. Lactose is used as a stabilizer in some asthma inhalers and as a filler (excipient) in some tablets. Other milk products can be found in TUMS smoothies, as well as some vaccines, so be sure to ask your doctor or pharmacist to avoid an allergic reaction.5,6

Egg: Those with an egg allergy should be cautious of vaccines that use egg as a stabilizer and certain hospital drugs for intravenous use as some patients have had an anaphylactic reaction. The CDC has said that the Flu vaccine is safe, even in people with an egg allergy but there are egg-free versions of the vaccine available. IV Benadryl and the sedative propofol are two medications that contain egg. Again, make sure any health care professional that considers you a patient knows your allergy history as it is important for your safety.5,6

Peanut: Peanut is a well-recognized allergy alert and as such is not found in many medications. The package inserts for progesterone capsules and valproic acid capsules have peanut as an ingredient. Dimercaprol lists peanut oil and there is peanut oil in some asthma inhalers and the topical medication fluocinolone.6  There are alternatives to any of these medications for anyone with a peanut allergy that would also need one of these medicines.

Soy: Soy can be listed as soy or as one of its derivatives – lecithin. Again, it can be found in some inhalers and propofol5. Some over the counter products I’ve discovered that have soy are Advil liquid-gels, TUMS smoothies, and black cohosh (an herb sometimes used to treat perimenopause and menopause symptoms). Be sure to read the ingredient list when choosing an over the counter medication or ask your pharmacist if you are unsure if an allergen is in a product.

Fish: Fish products can be found in some (not all) multi-vitamins and supplements, which highlights the importance of reading labels. A reversal agent for the anti-coagulant heparin called protamine contains some derived fish products. NPH insulin also contains some fish oil, so diabetic patients with a fish allergy needing a short acting insulin could choose a different insulin.3,5 There are case reports of patients with a fish allergy trying fish oil and not experiencing a reaction, if you would like to try the fish oil test then ask your doctor.

Dyes: One final excipient that causes a reaction in some patients is medical dye. Most specifically FD&C Blue 1, Blue 2, Red 4, and FD&C Yellow 5. These colors can be used in many different medications, your doctor or pharmacist would need to check to ensure these dyes aren’t in any of your medications7.

This is not a complete list of possible allergens or medications that may contain allergens. If you have ever experienced a reaction to a food, medicine, or dye be sure to inform your primary care doctor, pharmacist, and any specialists that you see. Document your reaction so that you can remember what happened if a health professional asks you about your allergy. Questions about possible allergens can be answered by your prescriber, pharmacist, poison control center, or manufacturer of your medication so never hesitate to call and ask. Any patient that has ever experienced an anaphylactic reaction should wear a bracelet advertising the allergy.

 

References

  1. Macy E, Ho NJ. Multiple drug intolerance syndrome: Prevalence, clinical characteristics, and management. Ann Allergy Asthma Immunol2012; 108:88–93
  2. Stevenson, DD. Sanchez-Borges M. Szczeklik, A. Classification of allergic and pseudoallergic reactions to drugs that inhibit cyclooxygenase enzymes. Ann Allergy Asthma Immunology 2001; 87:177
  3. Demoly P, Adkinson NR, Brockow K, et al. International Consensus on Drug Allergy. Allergy 69:420-437, 2014
  4. Lesney, Mark S. More than just the sugar in the pillToday’s Chemist at Work. 10(1): 30–6, 2001
  5. Kelso JM, Davis C. Food Allergy Management. Immunology and Allergy Clinics of North America 2018; 38:53-64
  6. Kelso JM. Potential food allergens in medications. Journal of Allergy and Clinical Immunology. Jun 2013; 133(6):1509-18
  7. Swerlick RA, Campbell CF. Medication dyes as a source of drug allergy. Journal of Drugs in Dermatology. Jan 2013; 12(1):99-102

If you’re struggling to afford your prescription medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

0 views

blockchain technology and healthcare - scriptsave wellrx blog image

by Sterling Harpst, 2019 PharmD Candidate

There are many news stories about the digital currency Bitcoin, and some have heard of the technology behind it: blockchain. However, most people are probably unaware of the impact this technology could have on our society, especially within the field of healthcare. Demand for blockchain, is exploding, so let’s look at its potential applications to consider from a patient perspective.

What is Blockchain Technology?

The blockchain is a permanent and public database that shows all transactions that have ever taken place on it.

Think of it as a single spreadsheet that can be simultaneously accessed and edited by a network of computers all around the world. Each time a participant on the network enters a new transaction, the change is reflected on all spreadsheets in real time. What makes this unique is its decentralized nature. In contrast to traditional networks in which the spreadsheet is owned by a single company (i.e. a bank), the blockchain stores the original information in millions of locations at the same time, with no single owner. This ensures all information stored on the blockchain is public and verifiable. It also greatly increases the protection of data, preventing hackers from corrupting a central location that houses every file on the network.1

When a digital transaction or “block” is initiated, it can only be finalized on the spreadsheet if there is public consensus among other participants on the network. This consensus requires multiple decisions regarding whether the information being transferred from one party to another is accurate and decisions are then compared to one another. Once a threshold consensus has been reached, the data is time-stamped and permanently linked to the previous transaction, forming a chain of information that is impossible to alter.2 The blockchain “spreadsheet” can only be distributed to other participants in the network, rather than copied, which eliminates the possibility of altering data and allows for an unbiased and trustworthy source of transaction information. Therefore, this type of network eliminates the need for a middleman to perform these services.

Although this new type of system can be difficult to comprehend, it has the potential to change nearly every aspect of business. In the same way that e-mails can be sent without fully understanding the underlying technology, the blockchain can be used by anyone. This still begs the question for patients – how will it affect me?

How the Blockchain Will Impact Healthcare

Electronic Health Record (EHR)

One of the most significant problems with the healthcare system today is the lack of information sharing. As a patient, many individuals find it hard to understand why one doctor can access their entire medical history, while another has only incomplete notes regarding once yearly office visits. The middleman, in this instance, is the electronic health record company. These entities protect the information that is stored on their software to incentivize other businesses to adopt or pay for the ability to communicate with their program. This can leave patients with partial, mismatching records that hinder the doctor’s ability to provide the best care. Many companies, however, are now proposing the use of a blockchain to solve this problem.

As described earlier, the blockchain allows for a digital “spreadsheet” to be shared across computers with access to the same network. The spreadsheet in this instance, would represent the patient’s electronic health record (EHR). This blockchain network would be personally controlled by the patient, who could then grant access to doctors or other healthcare professionals as necessary. Patients would even have the ability to grant access to only certain parts of the health record, leaving out personal information that doesn’t pertain to the specialist they may be seeing. Once an appointment has concluded, the patient can then subsequently revoke privileges to see the information, if they so choose. Examples of companies pursuing this type of blockchain solution for EHR include Iryo, Patientory, Guardtime, Coral Health, Medicalchain, and more.3

Pharmacogenomics

In the new and growing fields of pharmacogenomics and genetic testing, current industry business models have prompted some to seek another use for the blockchain. 23andMe and AncestryDNA are a few of the most well-known genetic testing companies in the direct-to-consumer market today. By selling patients an opportunity to receive a genetic test through the mail, the need for prescriptions or consultation by a healthcare professional has become something of the past. What few patients know is, a significant portion of their revenue comes from selling the genetic information to pharmaceutical manufacturing companies for the purpose of conducting research. Pharma companies pay billions of dollars each year to obtain this information and use it to direct their future drug development efforts. Unfortunately, patients do not see any kickback revenue as a result.

This practice has prompted companies such as EncrypGen, Nebula Genomics and others to offer a unique answer to this problem. In their models, the “spreadsheet” would be the results of a genetic test. In the same way mentioned prior, patients could both allow and revoke access privileges for Pharma companies to this information. Instead of Pharma companies acting as doctors to use the test results to make clinical decisions, they would instead pay the patients directly for their data.3 This would incentivize patients to not only further research efforts but receive payment at the same time.

The Future of Blockchain in Healthcare

A new generation of healthcare technology companies have launched efforts to create an information structure that performs each of these functions and many more using the blockchain. From prevention of drug counterfeiting to managing data loss in natural disasters, startups are appearing across the country to fix problems that have plagued the healthcare system for decades. Many think this technology is coming to our businesses and personal lives very soon, while others believe it is far from being fully integrated. Either way, with the potential to revolutionize several different areas in healthcare and beyond, the blockchain is a technology worth paying attention to.

 

REFERENCES:

  1. Elliott C, Rosic A, Lind, et al. What is Blockchain Technology? A Step-by-Step Guide For Beginners. Blockgeeks. https://blockgeeks.com/guides/what-is-blockchain-technology/. Published June 22, 2018. Accessed June 25, 2018.
  2. Mearian L. What is blockchain? The most disruptive tech in decades. Computerworld. https://www.computerworld.com/article/3191077/security/what-is-blockchain-the-most-disruptive-tech-in-decades.html. Published May 31, 2018. Accessed June 25, 2018.
  3. Top 12 Companies Bringing Blockchain To Healthcare. The Medical Futurist. http://medicalfuturist.com/top-12-companies-bringing-blockchain-to-healthcare/. Published April 4, 2018. Accessed June 28, 2018.

Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

 

0 views

rising insulin costs - scriptsave wellrx blog image

by Eli Kengerlinski, 2019 PharmD Candidate
University of Florida College of Pharmacy

Over the years, insulin prices have increased in accordance with newly developed insulins that have come to market. Traditional insulins, short and intermediate acting, as compared to newer rapid and long acting insulins, are less expensive in market value.1 Biosimilar traditional insulins with expired patents (some since 2000) may be a better option for some patients, as their market price has significantly dropped over the years. However, many patients are still having trouble affording their monthly Lantus or Humalog due to their high copays.

Why is insulin important?

Insulin plays an important role in managing patients with Diabetes Mellitus (DM). Patients with Type 1 DM have limited ability to produce endogenous insulin due to their pancreas’s inability to properly function. Patients with Type 2 DM can also have increased dependence on insulin therapy use as their disease state progresses. It is crucial for certain diabetic patient populations to have insulin at hand as they cannot control their sugar levels with just oral medications (eg. Metformin) that have no effect on insulin production. Type 1 DM population, there’s a greater need for basal (intermediate or long acting) as well as mealtime (rapid or short acting) insulin.

What options do you have?

Lifestyle modifications towards a healthier diet and exercise can be the most important changes any diabetic can make, and help ensure proper management of your condition. Monitoring your daily sugar levels, managing your weight via carb counting or following the plate method2, as well as exercising 30 minutes a day, five times a week, are all great habits to ensure effective DM management.

From January 2014 to July 2018, short and intermediate acting insulins have dropped in price equaling less than half of rapid and long acting insulins in the market today.1 Even if newer insulins offer better sugar control, their high prices make it difficult for patient access. For these specific patient populations, traditional insulins should be considered to ensure patient adherence to DM therapy and prevent patients using less of their insulin. If you’re having trouble paying for your insulin, then ask your provider if short and intermediate acting insulins would be right for you. Also contact your insurance company to see if you qualify for additional programs (eg. Medicare, Medicaid).

Furthermore, ask your provider if there are generic alternatives to your rapid or long acting insulin. For example, Admelog costs 12 to 15% less than Humalog while Basaglar costs about 15% less than Lantus on a per insulin unit basis.3 Therefore, it is important to ask for biosimilar generics that have the same active ingredient as they are usually cheaper.

Another affordable alternative to ensure access to insulin would be switching patients on high cost insulin pens to vials. Even though pens are more convenient and patient friendly, vials should be considered, especially if you’re having trouble affording your insulin. However, do ensure that you are instructed on how to properly inject your insulin.

If you’re still having trouble affording your insulin, ask your local pharmacist for a manufacturer savings card. If you need help with diabetic medications, visit www.wellrx.com for substantial prescription savings at pharmacies throughout the U.S. and Puerto Rico.

REFERENCES:

  1. Eisenberg Center at Oregon Health & Science University. Premixed Insulin Analogues: A Comparison With Other Treatments for Type 2 Diabetes. 2009 Mar 25. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007-. [Table], Price of Insulin. Available from: https://www.ncbi.nlm.nih.gov/books/NBK45287/table/clininsulin.tu1/
  2. Lara Hamilton. “How to Create Your Plate.” Diabetes Forecast, Nov. 2015, diabetesforecast.org/2015/adm/diabetes-plate-method/how-to-create-your-plate.html
  3. “Sanofi Launches Follow-On Insulin Lispro, Admelog.” The Center for Biosimilars Staff, 9 Apr. 2018, www.centerforbiosimilars.com/news/sanofi-launches-followon-insulin-lispro-admelog.

For the best Rx price on
prescription medications,
visit www.WellRx.com.
Compare prices at more than
62,000 pharmacies nationwide.

0 views

why children need to play - scriptsave wellrx blog image

by Pattiya Wattananimitgul

When you think of a child’s development, you might think of good education, nutritious food, and a caring family. Play is likely not on the top of your list if it’s on your list at all, but it should be. In this post, playing means active activities that would engage children’s bodies and minds in imaginative and creative ways and not passive activities, like sitting in front of the screen playing computer or video games. Some examples of healthy, active activities are pretend plays, hide-and-seek, and board games. In this day and age, fast-paced lifestyle, family structure changes, and increased focus on academics are contributing to less free time for children to play.1 Some parents might think playing is useless or a waste of time. However, scientific studies show that play is crucial in children’s development.2 Here are some reasons why children need to play:

Strengthen “cognitive, physical, and emotional well-being of children”

Play is crucial to the development of the brain because it lets children use their creativity and imagination. By playing, they are able to make decisions, solve problems, and think for themselves. It allows them to explore the world around them, overcome their fears, and develop skills to deal with future challenges.1  Play also helps release stress, which help fortify children’s emotional well-being and reduce the risk of developing behavioral health problems.2 All these combined also lead to better academic outcomes.

Improve teamwork and social skills

Play allows children to work in groups, share, negotiate, boost confidence, solve problems, and learn how to respond to people’s feelings.1 It helps them develop social interaction skills and get along better with others.

Reduce obesity

Research shows that there is a link between decline in active outdoor play and increase in childhood obesity.2 About 18.5% of children and adolescents in the United States are obese, which increased more than three times the percentage from the 1970s when plays was more common.3,4  Obesity leads to complications such as high blood pressure and diabetes. According to Alliance for Children, doctors are warning that children today may be the first generation in two centuries to have a shorter duration of life than their parents. Active play increase children’s physical activities and therefore decrease childhood obesity epidemic.2

Discover their interests

Play allows children to explore in many different areas and discover interests without giving them any unrealistic expectations or pressure to be outstanding in each area. This would ultimately lead them to find their own passions they would like to pursue in the future.1

Open up opportunities for parents to engage with their children

Play would help build stronger bond with your children and better relationship with them. This would also give you opportunities to learn how to communicate with your children more effectively and give them nurturing guidance.1

By letting your children play and letting them be kids, it would strongly benefit them in the long run and help them become happy, healthy, and successful adults. Lastly, your pharmacist is a great resource to any questions you might have or to learn more about your children’s health and well-being.

 

References

  1. Ginsburg, K. R. (2007). The Importance of Play in Promoting Healthy Child Development and Maintaining Strong Parent-Child Bonds. Pediatrics, 119(1), 182-191. doi:10.1542/peds.2006-2697
  2. Miller, E., & Almon, J. (2009). Crisis in the Kindergarten: Why Children Need to Play in School. College Park, MD: Alliance for Childhood.
  3. Childhood Obesity Facts. (2018, June 13). Retrieved August 10, 2018, from https://www.cdc.gov/obesity/data/childhood.html
  4. Prevalence of Overweight and Obesity Among Children and Adolescents: United States, 1963–1965 Through 2011–2012. (2014, September 19). Retrieved August 10, 2018, from https://www.cdc.gov/nchs/data/hestat/obesity_child_11_12/obesity_child_11_12.htm

Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.
If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

0 views

morning sickness - scriptsave wellrx blog image

By Pawel F. Kojs, PharmD Candidate Class of 2019,
University of Arizona College of Pharmacy

Morning sickness or nausea and vomiting in pregnancy (NVP) occurs in 70-80% of pregnant women.  In the United States, roughly 4 million women are affected each year.  This is more common in women that live in Western countries.1 A small percentage of women are affected each year with the more extreme form of morning sickness called hyperemesis gravidarum (HG).1

To help with this condition, there are many remedies to consider with your provider.

How can diet help with morning sickness?

With respect to diet, it is best to avoid large meals and eat smaller meals more often throughout the day.  Eating more protein and less fat is advised as well.2

Even though it’s difficult, eating foods that do not have a high flavor profile and ones that are low in fat helps reduce the time it takes for food to leave the stomach.  This in turn helps with reducing the amount of symptoms one would have with morning sickness.2

Which options can help me with morning Sickness?

There are different options to help treat morning sickness. Avoid smells, foods, tastes, and smells that trigger that nauseous feeling. Talk to your healthcare provider before taking any new prescription or over-the-counter (OTC) medications, and nutritional/herbal supplements.

Prescription Options

Disclaimer: Always consult with your provider before taking any medication during pregnancy.

OTC Options

These options for pregnancy related nausea and vomiting are commonly used. The types of medications are available at your neighborhood pharmacy, but it is recommended to monitor for drowsiness or sedation.

Disclaimer: Always consult with your provider before taking any medication during pregnancy.

Prenatal Supplements

It is advisable to talk to a doctor regarding getting a proper prenatal supplementation. You and your provider can discuss how much folic acid you should take. US Department of Health & Human Services Office of Women’s Health (DHHS) recommends taking at least 400 – 800 micrograms of folic acid daily, starting at least three months before conception.3 Prenatal supplements should be taken on an empty stomach. If you experience stomach upset, try taking it before bed with a light snack.

References:


If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

0 views