63 posts categorized "Mayes Connections"


Video: Pharmacy Experts Discuss Hotly Debated Painkiller Zohydro on NBC10

Dr. Andrew Peterson, Dean of Mayes College of Healthcare Business and Policy; and Dr. Dan Hussar, Remington Professor of Pharmacy, recently shared their expertise regarding the hotly debated painkiller, Zohydro, on Philadelphia's NBC10 @ Issue. The program aired on Sunday, March 16, and is attached below in two 5-minute clips:

At isssue

Part 1: NBC @ Issue
Part 2: NBC @ Issue (Profs featured here)


Pharmacy, Health Policy Experts to be Featured on NBC10 @ Issue on Sunday

At issueThe U.S. Food and Drug Administration's approval of the potent opioid painkiller Zohydro ER has been met with fierce criticism, both locally and across the nation. Tune into Philadelphia's NBC10  @ Issue on Sunday, March 16, at 11:30 a.m., as University of the Sciences' pharmacy and health policy experts discuss this drug in further detail.

Andrew Peterson PharmD, PhD, Dean of Mayes College of Healthcare Business and Policy; and Dan Hussar, PhD, Remington Professor of Pharmacy, joined reporter Tracy Davidson for a discussion regarding the pros/cons of this drug, as well as its potential dangers and health implications.

NBC10 @ Issue is a weekly public affairs discussion program that takes an in-depth look at local, state and national issues and politics. Watch NBC10 @ Issue every Sunday at 11:30 a.m. on NBC10, or at 6:30 p.m., on NBC10.com


Young Adults and Medication Adherence

There is little focus on the young adult population (ages 16 to 24) when trying to understand the relationship between age and medication adherence. It is important to categorize them separately from other age groups since they are at a distinctly different developmental point in their life compared to children and adults. There are many factors that influence medication adherence in adolescents. Exploring these factors, particularly the barriers, through a disease state such as human immunodeficiency virus (HIV), will allow us to appreciate the many challenges young adults face when taking medications.

Barriers:  Adolescent years are crucial years, behaviorally and developmentally, as it is when children gain independence and start to develop personal opinions. Matsui sheds light on the relationship between parent and adolescents and their involvement in medication adherence, by noting that there may be a chance for family conflict and rebellion. It may be a new concept for adolescents to be in charge of their own health and therefore they may stop taking medications or listening to their parents. Although young adults attain greater independence, these are the years that parents can assist adolescents manage their own health, in contrast to when they were children.  

Besides new gained independence, the lack of knowledge regarding medication therapy may also act as a barrier for young adults to take medications. Once young adults take charge of their own medications, they may worry about adverse events. In a review article, Matsui states that cosmetic changes such as acne and weight gain may prevent young adults from continuing therapy. An unfortunate event of adverse effects may prevent adolescents to better understand their disease state and find a solution to improve medication adherence.

Another barrier that author Huang mentions is that young adults tend to focus on what their peers may think and therefore cancel doctor visits and follow ups. This factor/barrier may influence adolescents to discard their therapies because of the fear being judged for having a specific disease state. Adolescents may not want their friends to know that they have a disease such as diabetes or asthma that needs to be managed with prescription medications.  A disease state that depends on adherence for improvement but adolescents counter many challenges is HIV.

HIV:  It is very important to address adherence issues in adolescents with HIV, because viral load is controlled when adolescents abide to an adequate therapy. A study conducted by MacDonell and colleagues, focuses on the influence of situational temptation and non adherence in young adults with HIV. They defined situational temptations as lack of support, needing a break from medications and not seeing a need for prescribed medications. The study results showed that family support or reminder and limited knowledge regarding purpose of HIV medication, were all significant factors that played a role in the young adults’ temptation to disrupt HIV medications. It was evident that adolescents who experienced optimal adherence had a lower number situational temptations showing that barriers do influence medication adherence.

As healthcare providers it is essential that pharmacists identify and help overcome the challenges that many adolescents face when managing medication therapies.  Pharmacists can recommend solutions such as getting parents involved to improve support and providing prescription information to increase the patient’s medical knowledge. Pharmacists also have the opportunity to help young adults navigate negative peer influence that may act as an obstacle to optimal adherence. Therefore, it is important for pharmacists to recognize and address adherence barriers unique to this population of patients.

Sheenu Joseph, PharmD '15


Social Media in Healthcare - A New Lecture Series at USciences

As healthcare conversations between providers and patients continue evolving into global, participatory discussions via social media, Mayes College of Healthcare Business and Policy at University of the Sciences will kick off an informative three-part lecture series on March 13 regarding social media as a means of communicating with patients.  The first lecture, presented by Matt Prior, MPH, Director of Communications and Policy Coordinator, Philadelphia Department of Health, will focus on how that department used social media to improve the use of condoms in Philly. 
At the conclusion of the lecture series, the University's Mayes College of Healthcare Business and Policy will hold its annual “Making the Connections” program on Tuesday, April 22, from 5:30-7:30 p.m., in the University’s AstraZeneca Auditorium, located in the McNeil Science and Technology Center. This year’s program will highlight social media in healthcare.
Murray Aitken, Executive Director of the IMS Institute, will be a panelist on April 22, speaking on the new report Engaging Patients Through Social Media.  Find out more information about the program email MayesCollegeConnections@usciences.edu.


The Biggest Mistakes Transfer Students Make

Viggiani_aimeeChoosing which college to attend is a huge decision for students. Whether they’ve earned their associate’s degrees from community colleges and ready to move on to earn their bachelor’s degrees, or currently enrolled in four-year schools that aren’t the right fit, one-third of all students transfer at least once before earning a degree.

Aimee Viggiani, associate director of transfer admissions, was recently featured in two articles which provide helpful tips for transfer students. She said, "All too often, students wait until too late in their college careers to ask why a certain class didn't transfer. Even if you don't need the credit right away, you may need it in the future. So ask transfer credit questions as soon as possible."


What can Obamacare do for you?

               Over the past several months, we’ve delved into two separate yet very important aspects of healthcare and pharmacy practice. We have followed the birthing pains of President Obama’s signature legislation some weeks while discussing the importance of medication adherence other weeks. We will now discuss how these two seemingly isolated realms of healthcare are indeed intertwined.

               The goal of the Affordable Care Act (ACA) is to improve the well-being of American citizens, rein in costs associated with healthcare in our country, and provide health insurance to those that could otherwise not afford it. As a future pharmacist, I will focus on the goal I perceive to be most important to my chosen profession: improving the well-being of my fellow Americans.

As we’ve discussed in previous posts, medication adherence is paramount in the constant battle to improve patient care. In the past, topics such as technology and techniques to monitor patients were assessed in Mission Impossible: How to tell if your patients are taking their medications; as well as why patients don’t take their medications in Why Don’t You Take Your Medication? in Part I and Part II installments. While it is the responsibility and duty of us as pharmacists to make sure that patients are taking their medications as directed, Uncle Sam has taken matters into his own hands by passing legislation to encourage health care professionals to improve outcomes.

Why has Washington taken such an interest in medication adherence? The reality is that medication non-adherence is estimated to cost $290 billion per year in additional healthcare costs. With almost 13% of the total yearly expenditure in healthcare being spent on preventable diseases and procedures, law makers and healthcare professionals alike see an opportunity to make medicine more affordable to the American patient.

The ACA has multiple provisions aimed at improving patient outcomes. Under the ACA and Medicaid expansion, hospital re-admission for certain conditions will result in penalties to the institution. With the real threat of not being compensated for services provided to re-admitted patients, hospitals across the country are revising procedures and doing their best to increase medication adherence and lower re-admission rates. As pharmacists, we will have a pivotal role in this revision of policy.

Along the same lines as re-admission rates, hospitals will now be subjected to quality assurance measures to hold them accountable. The Pharmacy Quality Alliance (PQA) is a non-profit organization that has developed measures related to medication use; PQA has adopted ten such measures that will cover a range of services, including medication adherence.  In addition to such assurance measures, there is something known as Medicare Advantage “Star” ratings that will provide financial incentives to plans in the Medication Advantage (MA) program. In the Star Ratings system, medication adherence is weighted HEAVILY because of its importance (medication adherence accounts for 11% of the total star score). This “Star” rating system has the opportunity to influence the care of over 12 million Medicare beneficiaries.

Three models being experimented with now are patient-centered medical homes, accountable care organizations (ACOs), and episode-based payments. These models are intended to lower health care costs and improve the overall quality of care being distributed to patients. And as is the case with hospitals, they will be evaluated on measures established by the ACA. ACOs for example will be assessed by the same kind of quality assurance measures as previously discussed. And as discussed before, medication adherence is a number one priority in those measures with 20 of the 33 measures relating directly to medication adherence.

When we discussed in previous posts why patients don’t take their medications, cost was a major factor. An important aspect of the ACA is to lower costs that would deter a patient from seeking care or filling a potentially life-saving prescription at a pharmacy counter. A portion of the ACA that doesn’t get much publicity is that it has a provision that impacts Medicare and Medicaid benefits. Under the new healthcare law, the threatening “doughnut hole” has been closed. This effort to close the gap in Medicare coverage is estimated to save beneficiaries $3.4 billion in prescription drug costs which comes out to $837 per person, per year. This is no small amount of money and could indeed encourage people to get that necessary prescription filled. When the decision for a retired individual on a fixed income to choose between their groceries or medicine is no longer necessary, everybody wins.

While this is an exciting time for healthcare, we as pharmacists are entering a brave new world. As I’ve discussed, the ACA calls for many changes in the way healthcare will be administered with an emphasis on medication adherence; and with pharmacists being the medication experts, we will be expected to lead the charge in making many of these changes a reality. This presents our profession of choice with an opportunity to not only create value as health care professionals, but also put our foot in the door and establish ourselves as vital cogs in the 21st century healthcare machine. At this time the ACA does not establish a system by which we as pharmacists will be compensated for our increased duties and responsibilities which is obviously not a desirable situation. But don’t be discouraged. We as pharmacists should take this opportunity to not only elevate the prestige of our profession, but also establish value that will positively impact the way we are compensated in the future. Pharmacists are no longer ‘pill counters.’ We are well respected experts in a vital facet of medicine and it is time we are recognized as such. As Horace so eloquently put it: Carpe diem!

Mackenzie F. Blair, PharmD '15


What Happens to Philly's Homeless Community During Frigid Weather?

MetrauxStephen Metraux, PhD, associate professor of health policy and public health, has done extensive research on homelessness and housing,as well as other aspects of urban health. He is also working with the U.S. Department of Veterans Affairs as part of their commitment to ending homelessness among veterans by 2015.

With the recent streak of bone-chilling weather, Dr. Metraux weighed in on how this weather impacts Philadelphia's homeless community. Here's what he had to say:

If you were fortunate enough to be somewhere warm during this recent cold snap, you may have been wondering what happens to those who do not have access to warm shelter.  In particular, how do people who are homeless and subsisting on the streets go about surviving in this cold?

Data on how many homeless are stuck out in the cold are difficult to come by. The homeless population is notoriously challenging to count, as they usually strive to stay inconspicuous amidst the public spaces to which they are relegated. The best available number comes from the City of Philadelphia’s annual “Point in Time” count, when teams of volunteers canvass the shelters and the streets and count the homeless people and families that they encounter.  Of the 5,625 homeless persons counted on a January night in 2012, 526 (9%) were unsheltered.

So how do these 526 persons survive the elements on nights like those we have recently had? The first line of defense is provided by the City of Philadelphia, who implement a “Code Blue” on any night when “real feel” temperatures fall under or around 20 degrees. On Code Blue nights, outreach workers and police can bring any homeless person in to stay in a shelter or other public facility temporarily designated for overnight accommodations. No one gets turned away and, if necessary, a Court Ordered Transportation to Shelter (COTS) can be quickly obtained to bring resistant persons indoors on occasions when leaving a person outdoors may subject him or her to danger from the elements.

Code Blue’s success is best indicated by the rarity of hypothermia deaths among homeless persons in the past few years.  But Code Blue is at best a stopgap solution.  The best solution for protecting the homeless from the elements is through renewed efforts to reduce homelessness. The number of street homeless in Philadelphia have been declining over the previous few years, due largely to innovative programs to engage the most recalcitrant homeless persons and provide them with housing and services.  The more this continues, the less we need to worry about homeless persons on nights like these.


First Impressions of the Affordable Care Act Rollout

The rollout has been a bumpy ride to say the least. The website still has its glitches, and the problems are being labeled President Obama’s Hurricane Katrina by many political pundits. In this week’s entry we will try to separate fact from fiction and take an objective view at the law and where we go from here.

The October enrollment numbers were only 20% of predicted targets. More than 106,000 people enrolled, but only 27,000 of those did so by way of the federal website; the vast majority of those that enrolled utilized the state ran exchanges. To put the 106,000 person total in perspective, this is only 1.5% of the anticipated enrollee total at the end of the 2014 period. To bring things closer to home with regards to our local states, Maryland had 1,700 enroll while Pennsylvania enrolled 2,207. These totals are considered low across the board but enrollment numbers seem to be improving with the November enrollment period now concluded.

While these numbers are disconcerting, optimists and supporters of the law stress for us to look at the precedent set by Massachusetts’s model in 2007. The Affordable Care Act relies on young and healthy people (those under 35 years of age) to enroll to offset the cost of those that are older and more prone to illness. If the trends seen in the MA plan stay consistent, these healthy individuals will procrastinate until the last possible second (March 31st deadline) to enroll so as to avoid the financial penalties. Jonathan Gruber, an architect of the Massachusetts plan, advisor to the President on the implementation of the federal system, and proponent of the individual mandate, stresses us to ‘be patient.’

In contrast to the multitude of issues encountered by those enrolling through the federal website, the poster boy for the state ran exchanges appears to have gotten it right. Kentucky enrolled approximately 15,000 people only 21 days after the exchanges opened on October 1st. Governor Steve Beshear heralds their website a success and claims that close to 1,000 Kentuckians enroll every day. The success of Kynect.Ky.gov highlights the advantages of a state-ran exchange and provides a framework for the federal program to glean vital information to ensure its own success.

With the November 30th deadline now past, reports are coming in that healthcare.gov is indeed improved over the debacle that was the October 1st launch, but it is not yet perfect. Concerns are that the very people the ACA relies upon for its success, the young and tech savvy generation, will be turned away if the website does not meet their expectations. This fear has increased the urgency to get the portal working as smoothly as possible, as soon as possible.

As with most laws, the Affordable Care Act is not a perfect law. It has its opponents and it has its obvious flaws. But instead of throwing in the towel, I’d like to see our nation’s leaders work together and find solutions to this law’s problems. Millions of Americans don’t have adequate health insurance and this law was intended to help those people, and those people still need health care now.

Mackenzie F. Blair,  PharmD ’15 Candidate


Why Don’t You Take Your Medication? Part II

In our previous blog, we delved into how fear and confusion can negatively impact medication adherence. Now we will examine how health beliefs and finances can influence patients and a service we as pharmacists can provide to improve outcomes.

Health Beliefs. A difficult barrier pharmacists must overcome to improve adherence is the health beliefs our patients have towards medications, their disease states, and health care in general. A study examined how health beliefs impacted medication adherence in patients being treated for HIV/AIDs and discovered that those patients who were asymptomatic were more likely to be non-adherent, while those who experienced negative effects from their disease were more likely to be adherent to avoid such negative effects. Pharmacists must stress that even if a patients are feeling well and does not physically feel sick, they must continue to take their medications. This challenge arises with disease states like hypertension or mental illness where the person may feel fine after taking their medication for a while and then discontinue there medications thinking that they are now cured.

Financial Constraints. An estimated 14 million Americans with chronic medical conditions cannot afford their medications. Doctors may not consider the price of a drug when prescribing and as pharmacists, we are at the point of care when a patient must make the difficult decision to pay for this month’s supply of medication or food for their family. Pharmacists must take due diligence to discover whether their patients are adherent as result of financial hardship. It can be a difficult subject to approach, but there are some questions that can be asked to indirectly ascertain this information; examples of such questions include: “Are there circumstances that make it difficult to fill your prescriptions?" or "Are you testing blood glucose less often because you're trying to conserve supplies?" If it is discovered that a patient cannot afford their prescriptions, we as pharmacists could contact the prescribing physician and request a generic alternative or contact the pharmaceutical company for possible discount/assistance programs. Medication adherence is a significant barrier to achieving positive therapeutic outcomes in our patients, but there is a tool that has been developed over the last several years that will make the task of overcoming these barriers much more attainable.

Medication therapy management (MTM) was developed in response to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. MTM provides pharmacists the unique opportunity to be the ‘medication expert’ and improve patient adherence, and thus outcomes. With pharmacists now becoming more integral in the health care team, and being able to interact with patents in a more prominent role, we are now in a great position to correct the factors that interfere with a patient being adherent. By using tools like the interview a pharmacist can glean valuable information from their patient and make adjustments when necessary before the patient is potentially harmed. Communication and information gathering are valuable in improving overall outcomes and MTM gives pharmacists the necessary means to not only communicate but do something about it.

It is our role as pharmacists to communicate, educate, and in turn ensure that our patients take their medications as prescribed. We’ve discussed why a patient might not take their medications and how to counter such obstacles to adherence as well as the ever evolving role of MTM in healthcare.

Mackenzie F. Blair, PharmD ‘15


Why Don’t You Take Your Medication?

It is a question that thousands of pharmacists and health care professionals ask their patients on an almost constant basis; but many times this inquiry falls on deaf ears and the patient remains noncompliant. It is a frustrating reality that approximately 50% of patients are non-adherent to their medication regimens. It is common knowledge that these patients can’t achieve their therapeutic goals if they don’t take their medications as prescribed and adherence is the key mediator between medical practice and patient outcomes. As pharmacists, we should take a closer look at WHY our patients don’t take their medications, and what we can do about it.

Fear:   While modern medicine can save lives and cure disease, the fears many have towards medications can prevent these people from being helped. Fear is a powerful influencer and it can manifest itself in many ways. A patient could be afraid of a startling side effect, the risk of drug addiction, fear of needles, or even the negative stigma that taking a medication has in society as is the case for drugs associated with mental illnesses. Culture can even have an impact if the prescribed medicine is in contradiction to the patient’s religious beliefs.. As pharmacists, it is important for us to interact with patients and assess their attitude towards their therapeutic plan. It is vital to identify fears they may have and help alleviate their anxiety or hesitation. For example, if a patient is frightened of a rare side effect, framing the risk of developing the side effect with real data may reduce the fear.  If the patient has a phobia of needles it might be possible to alter the therapy so that injections or needles can be avoided. While it is unrealistic that we can calm all the fears patients may have, it is possible that with proper communication and education, many of these fears can be minimized.

Confusion and poor health literacy:   "Take two tablets by mouth twice daily." To a trained pharmacist or student like myself, those instructions appear clear and concise, yet a study revealed that nearly half of all people who read them misunderstood them. And with 81% of older adults taking one medication with 29% of them using five or more prescription medications, confusion can easily arise from multiple drug regimens and multiple disease states. It is the pharmacist’s responsibility to limit confusion as much as possible. This can be achieved by writing simple instructions on prescription labels and communicating with the patient in a counseling session. Nothing should be assumed and every aspect of the medication should be addressed with the patient. It should be stressed to the patient that there is no such thing as a stupid question. It is a fact that a poor patient-pharmacist/physician relationship hurts the chances of patients actually taking their medicine as prescribed.

Fear and confusion are only a few of the barriers that pharmacists encounter when trying to improve medication adherence. In the next blog we will examine and discuss health beliefs as a barrier to medication adherence and what we as pharmacists can do to improve outcomes.

Mackenzie F. Blair, PharmD ‘15

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