drug recalls - patient guide - scriptsave wellrx - blog image

by Jenny Bingham, PharmD, BCACP
SinfoníaRx

Have you ever experienced the unsettling feeling when you hear a drug recall announcement for a prescription that you take every day? The United States Food & Drug Administration (FDA) recalled over seven different products in December 2018 due to impurities, mislabeling, or performance defects. The FDA works closely with drug manufacturers to recall and remove any defective medications from the consumer market.  They also have laws that require organizations to contact patients subject to the recall.

If you do find yourself not knowing what next steps to take after a drug recall, here are some useful tips to guide you throughout the process.

Step 1: Resources for Recalled Medications

The FDA publicly shares a current listing of all recalled products on their website. If you receive a phone call, email, mailer, or any type of communication from your dispensing pharmacy and/or organization that administers your medication to you, you can use this website to learn more information about the recall and the reason for it.

Patients can also contact their dispensing pharmacy to confirm whether their medication was subject to the recall. Most pharmacies keep a digital log of the lot number, expiration date, and NDC. They can compare it to the FDA’s drug recall tracking information (as shown below), along with product photos on their website.

NDC Manufacturer Product
Description
Lot/Batch Expiration
Date

The FDA classifies drug recalls based on their severity. Class I Recalls pose a risk for serious health problems and death. Class II Recalls pose a risk of temporary or reversible health problems. Class III Recalls are not likely to cause an adverse health problem, but it violated FDA laws. Only your provider can determine what is the best course of action to take in response to the recall.

Step 2: Contact Your Provider

Whether your provider is an ambulatory care pharmacist, nurse practitioner, or a medical doctor, it is imperative that you contact them once you learn about your drug’s recall. Do not abruptly stop therapy without consulting your provider. Some medications pose severe risks if you suddenly stop taking them.

Your provider can work with you to develop a plan. Your pharmacy might be able to refill the medication from a different manufacturer that is not related to the recall. If they are not able to substitute with a different manufacturer, your provider will work with you to determine what is an appropriate alternative therapeutic regimen.

Step 3: Disposing of Your Medication

If your medication is recalled and your provider advises you to discontinue therapy and stop taking it, it is important to properly dispose of your medicine. The Drug Enforcement Agency (DEA) announces National Prescription Drug Take-Back events on their website. The FDA also has a website that shares useful tips on how to safely dispose of medicine.

 

Resources:

https://www.fda.gov/Drugs/DrugSafety/DrugRecalls/default.htm

https://www.deadiversion.usdoj.gov/drug_disposal/takeback/index.html

https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm#1


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Do ARBs cause cancer - scriptsave wellrx - blog image

by Mitchell Welton, PharmD Candidate 2019
University of Arizona

As with all cause and effect scenarios it is always best to cover the basics. Before we ask if ARBs cause cancer let’s discuss what an ARB actually is. An ARB is a family of medications taken by mouth to lower blood pressure. The acronym stands for angiotensin II receptor blocker (ARB) and its name implies its function. This medication blocks angiotensin II from binding to its respective receptor. When angiotensin II binds to its receptor it causes the blood vessel to contract which increases the blood pressure.1 A patient taking an ARB would have less binding of the receptor and thus no contraction of the blood vessels causing lower blood pressure. Aside from its intended purpose, do ARBs also cause cancer?

Evaluation of Cancer Risk

In 2016 an analysis was done to evaluate the incidence of cancer in patients treated with ARBs for high blood pressure. The review concluded that ARBs had no effect in the incidence of cancer which was consistent with the findings of a similar study conducted in 2011.2 In other words, to say that ARBs as a drug class cause cancer would not be correct. However, in June of 2018 Valsartan, a commonly prescribed ARB, was recalled by the manufacturer citing an impurity found in the medication. The impurity, N-Nitrosodimethylamine (NDMA), is a probable cancer-causing agent.

Since then the United States Food and Drug Administration (FDA) launched an investigation into the affected Valsartan products. That investigation found a second impurity known as N-Nitrosodiethylamine (NDEA) also a probable human carcinogen. Further investigation and testing on other ARBs revealed that some irbesartan and losartan products contained NDEA as well. All affected products have been recalled. Not all ARBs are affected by this recall, however a list of all affected products can be found on the FDA website. It is also important to note that the drugs candesartan, eprosartan, olmesartan, and telmisartan belong to the ARB drug class and have not been identified as containing either of the previously mentioned impurities.3

The Impact of Impurities

The effect that these impurities have on cancer rates is difficult to assign a number to. Professionals at the FDA estimate that there would be one additional case of cancer out of 8,000 people taking valsartan contaminated by NDMA.3 This estimate assumes the patient was taking the highest daily valsartan dose of 320 mg over a period of 4 years. Prescribed dosages of valsartan range from 40 mg to 320 mg daily and lower strength tablets would contain less NDMA respectively than a higher strength tablet.3 This estimate also assumes that every tablet taken over the four-year period contained NDMA. Not all batches affected by the recall actually contained the impurities and over a four year period of refilling the prescription it is unlikely that a patient was exposed to the amount of NDMA calculated in the 1 in 8,000 risk.

With that being said, even if the risk of getting cancer is smaller than 1 in 8,000 it doesn’t take into account the emotional toll this recall can have on a patient that has taken a potentially affected blood pressure medication. NDEA was discovered after NDMA and the FDA does not yet have a risk estimate for the later impurity but will update the information as soon as it becomes available.3

What Should You Do?

If you or someone you know is taking an ARB for the treatment of high blood pressure, check the FDA website regularly. A list of affected medication with their lot and expiration dates can be found for all valsartan, irbesartan, and losartan included in the recall. Again, not all ARBs are affected, and if you are unsure how to match the lot and expiration dates on the medication you picked up from the pharmacy, call and talk to your pharmacist. If you are taking a medication affected in the recall, your pharmacist may be able to recommend or provide you with an unaffected medication by a different manufacturer. The FDA recommends you take your current medication as prescribed until you can get a replacement from your pharmacist or doctor.3

 

References

  1. Ogbru, O. (n.d.). Angiotensin II Receptor Blockers (ARBs) Drug Facts, Side Effects and Dosing. Retrieved from https://www.medicinenet.com/angiotensin_ii_receptor_blockers/article.htm
  2. Zhao, Y., Li, P., Zhang, J., Wang, L. and Yi, Z. (2018). Angiotensin II Receptor Blockers and Cancer Risk. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863811/
  3. Center for Drug Evaluation and Research. (n.d.). Drug Safety and Availability – Questions and Answers: Impurities found in certain generic angiotensin II receptor blocker (ARB) products. Retrieved from https://www.fda.gov/Drugs/DrugSafety/ucm626122.htm

 


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medical marijuana mmj - scriptsave wellrx - rx discounts -blog image

by Mitchell Welton, PharmD Candidate 2019
University of Arizona

The use of marijuana draws a wide range of strong opinions out of people. Its advocates will tout all of its potential benefits of medical marijuana, while its opponents try to draw from the negative stigma that surrounds it. As in all hotly contested topics, the truth usually falls somewhere in between the opposing viewpoints. While the use of marijuana still remains illegal at the federal level, there are many states that have approved its medical use for qualifying individuals to treat certain conditions, and even fewer states have approved its recreational use.

California was the first state to legalize marijuana for medical use in 1996 and since then many states have followed suit. About a dozen states have legalized marijuana for medical use. The difference between medical and recreational use warrants its own discussion and the disagreement can be seen at a legislative level with more leniency being extended to medical over recreational. This author would generalize medical marijuana in this article as containing a higher concentration of CBD over THC, for all intents and purposes, in order to discuss medical marijuana compared to FDA approved cannabinoids.

Medical Marijuana (MMJ) Uses

The two chemicals of interest found in marijuana are tetrahydrocannabinol (THC) and cannabidiol (CBD) although the plant itself may contain up to 400 different chemicals. A recreational smoker would be looking for a higher concentration of THC which is the psychoactive component delivering the “high” that users seek. 1 CBD is the cannabinoid that doesn’t produce the “high” and has recently been approved by the FDA as an oral solution, called Epidiolex, to treat seizures. There are currently only three FDA approved, cannabinoid medications on the market. 2

The first of these medications was approved in 1985 by the FDA known as Marinol or dronabinol. A synthetic form of THC first approved for the treatment of chemotherapy induced nausea and vomiting. Its indication was expanded to include the treatment of weight loss and anorexia in people with AIDS. Other studies have found efficacy in achieving pain relief in patients with multiple sclerosis (MS) and treating other neuropathic pain. 3 Cesamet, or nabilone, is another synthetic cannabinoid that mimics THC also approved in 1985 for the treatment of chemotherapy induced nausea and vomiting with off label use to treat fibromyalgia shown in a 2011 systematic review of cannabinoids for chronic pain. 4 The third, Epidiolex, has already been mentioned which is the first FDA approved drug derived from marijuana. The previous two drugs where synthetic. Epidiolex is used in the treatment of two rare, but severe forms of epilepsy. 2

MMJ Safety Factors

There are multiple factors to consider when thinking of safety between the two types of marijuana. First that comes to mind is the administration. Let’s take dronabinol for example as it has been around the longest from an FDA approval standpoint and such has been examined in multiple studies. This is a liquid filled capsule taken by mouth. Like many oral medications it may take some time for it to be absorbed which means a delay in its effect. This is something to keep in mind as a quick onset of action would be preferred when treating nausea and vomiting. Once the capsule is taken by mouth and absorbed the next consideration is its excretion from the body.

Dronabinol has an elimination half life of 19 to 36 hours meaning there will be a therapeutic level of the medication in the blood for a significant period of time. Other considerations I would bring to attention of the reader is the environment in which the medication is produced. Part of the FDA requirement is the manufacturing standard the medication is subjected to. Conditions must be controlled in its production which would allow us to assume there would be little tainting or contamination. Lastly, this synthetic medication is a pure isomer of THC meaning the end user is not consuming the potential 400 other chemicals found in the marijuana plant which could account for less of a “high” from any other psychoactive cannabinoids. 5

Marijuana in contrast when smoked has a much more rapid onset of action however may be inappropriate for use in patients with asthma or COPD. Ingesting marijuana will have a slower onset and more unpredictable absorption. Once in the system the body would eliminate marijuana faster than dronabinol. Though its production is not regulated like the FDA approved medications, each state has its own laws limiting the cultivating of your own marijuana and licensing of larger cannabis farms. 5

No matter where you might stand on the issue, there is a place in healthcare for the use of marijuana. The question lies in the best way to regulate and manage it. It is important to always evaluate safety and efficacy with any treatment used. Patients should always be treated with evidence-based methods and in accordance to state and federal laws. For better or for worse marijuana, and its use, continues to garner support and opposition in larger numbers. This is a landscape that will continue to change as we look for developments in the application of its use.

 

References:

  1. What Is the Difference Between Medical and Recreational Marijuana? (2018, September 10). Retrieved from https://docmj.com/2017/06/05/difference-medical-recreational-marijuana/
  2. Office of the Commissioner. (n.d.). Press Announcements – FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. Retrieved from https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm611046.htm
  3. Dronabinol: Marinol. (n.d.). Retrieved November 19, 2018, from Micromedex.
  4. Nabilone: Cesamet. (n.d.). Retrieved November 19, 2018, from Micromedex.
  5. Morrow, A. (n.d.). Marinol or Marijuana: Which Is Better? Retrieved from https://www.verywellhealth.com/is-marinol-better-than-smoked-marijuana-1132483

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2019 drug formulary changes - scriptsave wellrx - blog image

In the world of prescription drug insurance, there are medications that are covered by a health plan and some medications that are not covered. The list of drugs that are covered is known as the Prescription Drug Formulary (or “Formulary” for short).

What is a Prescription Drug Formulary?

If you’ve ever visited a pharmacy with a prescription in one hand and your insurance card in the other, only to be told that your medication is not covered by your insurance … but if your doctor is willing to change the prescription to a similar drug used to treat the same condition … you have first-hand experience of a Prescription Drug Formulary.

The formulary is a list of approved medications for which an insurer has agreed to help cover the cost. However, there might be multiple manufacturers of numerous drugs designed to treat the same condition. This is an opportunity for the insurance company to trim costs by only agreeing to cover one drug for each health condition.

For pharmaceutical manufacturers, this can be a very big deal to be included or excluded from an insurer’s formulary list. Accordingly, each health plan generally reviews its coverage list on an annual basis. This helps ensure they continue to get the best possible price-points for the competing medications that are available to treat high-cost health conditions.

For patients, this can mean that, each year, they may discover the drug they had been taking is no longer covered. This may require them to switch to an alternative medication to continue receiving help paying for the medication from their insurance provider.

Prescription Formulary Changes for 2019

At the time of this write-up, the calendar is fast approaching year-end, and new insurance plan-years for 2019. Many formulary lists are likely to change. Two of the largest managers of prescription drug formularies in the U.S. are Express Scripts and CVS Caremark. Here are the details of the medications these two companies are REMOVING from their lists for 2019:

Acanya  Humatrope  Saizen 
Acticlate  Invokamet XR  Savaysa 
Alcortin A  Invokamet  Sorilux 
Alocril  Invokana  Sovaldi 
Alomide  Jentadueto XR  Synerderm 
Alprolix  Jentadueto  Targadox 
Altoprev  Lazanda  Tirosint 
Atripla  Levicyn  Topicort spray 
Avenova  Levorphanol  Tradjenta 
Benzaclin  Lupron Depot-Ped  Uroxatral 
Berinert  Mavyret  Vagifem 
Brisdelle  Maxidex  Vanatol LQ 
Brovana  Nalfon  Vanatol S 
Cambia  Namenda XR  Veltin 
Chorionic Gonadotropin Neupro patch  Verdeso foam 
Climara Pro  Norco  Viagra 
Contrave ER  Norditropin  Vivelle-Dot 
Cortifoam  Nutropin AQ Nuspin  Xadago 
Daklinza  Nuvigil  Xerese cream 
Duzallo  Olysio  Xyntha Solofuse 
Eloctate Omnitrope  Xyntha 
Emadine  Onexton  Yasmin 
Embeda  Oxycodone ER  Zemaira 
Extavia  Pradaxa  Ziana 
Fasenra  Praluent  Zolpimist 
Fenoprofen (capsule) Pred Mild  Zomacton 
Fenortho  Pregnyl  Zonegran 
Flarex  Prolastin-C  Zuplenz 
FML Forte  Qsymia  Zurampic 
FML S.O.P.  Recombinate  Zypitamag

If your medications are listed above (and if your insurer uses Express Scripts or CVS Caremark to manage their formulary) you can speak to your doctor or pharmacist about alternative medications designed to treat the same health condition. You can check these alternatives against your insurer’s new formulary list for 2019.

What If My Drugs Are Excluded?

It may also be worth double-checking the cash-price (i.e., the price without insurance) for your current medication. You can do this by clicking the drug name link in the list above. This can be a worthwhile effort, as the cash-price can often be lower than an insurance copay [Read more about Always Ask Cash Price]

What If I Can’t Switch to a Covered Alternative Drug?

If you’re unable to switch medications, you may be able to get some help from the FREE ScriptSave WellRx program. We negotiate savings on the cash-prices of medications at over 65,000 retail pharmacies across the United States. Patients can save up to 80% (relative to the cash price of their prescription).

Our price-check tool is available for free — no sign-up necessary. Go to www.wellrx.com or download the ScriptSave WellRx mobile app on iOS and Android to see how much you’ll save on your prescription costs!

 

 

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


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obesity in the U.S. - scriptsave wellrx blog image

by Randall Flores, PharmD Candidate 2019
University of Arizona

In the past few decades, there has been an alarming and steady increase in obesity rates in the U.S. This affects people of all races and ages. More Americans live with obesity than breast cancer, Alzheimer’s, Parkinson’s and HIV all together. The medical community has been aware of the rising epidemic for many years, yet its response has not been effective at addressing the problem.

What is a Healthy Weight (BMI)?

Obese or overweight is defined as weight that is higher than what is considered a healthy weight for a given height measured as Body Mass Index (BMI)1. The levels of weight measured by BMI are listed below:

  • BMI < 18.5 = underweight
  • BMI 18.5 to <25 = within normal weight
  • BMI 25 to <30 = overweight
  • BMI >30 = obese

The Facts About Obesity

With an estimated population of 328.73 million people in the U.S.,6 the prevalence of obesity was 39.8% between 2015-2016, affecting nearly 93.3 million people.1 The estimated health care cost of obesity was $147 billion in 2008 which was $1,429 higher than those of normal weight. Obesity seems to have a racial/genetic link as Hispanic and non-Hispanic blacks had the highest prevalence with 47% and 46.8% respectively.2 Much of the obesity seen in the U.S. starts at a younger age and transcends into adulthood with a prevalence of 18.5% (ages 2-19) nearly affecting 13.7 million children.2 Similar to adults, obesity in children is more common in certain populations; Hispanics having the highest prevalence (25.8%) followed by non-Hispanic blacks (22%).2

Obesity-Related Health Conditions

The most common obesity-related diseases that result in premature deaths include type 2 diabetes, heart disease, stroke, and certain types of cancers such as colorectal, pancreatic, and endometrial cancer.1,4 People who have obesity are also at increased risk for serious diseases including the following;3

High blood pressure Low quality of life
High levels of bad cholesterol &
low levels of good cholesterol
Sleep apnea & breathing problems
Gallbladder disease Mental illness, depression, anxiety, &
other mental disorders
Osteoarthritis Body pain & difficulty with physical functioning

A Push for Prevention

The epidemic of overweight and obese citizens in the nation is complex and has no simple solution. There are many factors that play a role in obesity. Due to its complexity, the epidemic of obesity needs to be approached through multiple outlets, with tactics in local, state, and federal organizations as well as professional health organizations.5 The long-term goal to decreasing obesity is shifting to norms of a healthy lifestyle, which include healthy eating and regular physical activity.5 Healthcare should also shift more of its efforts towards preventing obesity. Another key player in reversing the obesity epidemic is implementing community efforts that support a healthy lifestyle, such as food services, schools, childhood care, and clinics/hospitals.

Obesity and being overweight affects millions of people in our nation and worldwide. Obesity is associated with an increased risk of many serious diseases that are otherwise preventable. We must shift our efforts to the epidemic of obesity to halt its progression and strive towards a healthier future for younger generations to come.

 

References:

  1. Adult Obesity Facts | Overweight & Obesity | CDC. (2018). Retrieved from https://www.cdc.gov/obesity/data/adult.html
  2. Children Obesity Facts | Overweight & Obesity | CDC. (2018). Retrieved from https://www.cdc.gov/obesity/childhood/index.html
  3. Adult Obesity Causes & Consequences | Overweight & Obesity | CDC. (2018). Retrieved from https://www.cdc.gov/obesity/childhood/index.html
  4. Obesity and Cancer. (2018). Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet
  5. Strategies to Prevent Obesity. (2015). Retrieved from https://www.cdc.gov/obesity/strategies/index.html
  6. S. and World Population Clock. (2018). Retrieved from https://www.census.gov/popclock/

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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.

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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:


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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

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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,
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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.

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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,
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