need for collaborative drug regimen evaluation

Personal Finances Taking Care of Parents
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This informative piece points to the incredibly high risk of damage and death due to harmful drug interactions that treating physicians are all too typically unaware of. Seniors are particularly vulnerable. These negative drug interactions are the fourth leading cause of death in the US—pretty scary! Here are the salient facts, and the link for the full news piece.

=sheila

**adverse drug events (ADEs) in the U.S. are estimated to be the fourth leading cause of death. Drug interactions are tied to 1.3 million emergency department visits each year, and 350,000 annual hospitalizations, according to the CDC.**

**They are costly, as well. Research estimates the annual cost of ADEs is between $30 billion and $130 billion.**

**Combined with the phenomenon of medication overload, we spend more money to correct problems related to medication (an estimated $528 billion in 2016) than the amount we spend on the medications themselves ($329 billion in 2016).**

**To address the problem, the Center for Medicare and Medicaid Innovation (CMMI), which runs experimental model designs within the Medicare and Medicaid programs, launched a model in 2017, called Enhanced Medication Therapy Management (EMTM). It created financial incentives for private prescription drug plans — the entities administering Medicare’s drug program — to develop solutions to prevent ADEs. One of those solutions involved pharmacists and physicians working collaboratively to improve the coordination and assessment of all medications. The results were significant.**

**A study published in 2021 evaluated the impact of pharmacist-delivered medication safety reviews (MSRs) on total medical expenditures, hospitalizations, emergency department visits, and mortality in Medicare Part D beneficiaries whose plan was a participant of the EMTM model. Those who received these holistic reviews demonstrated significant improvements in every metric compared with eligible beneficiaries who did not receive the EMTM services.**

**While the model ended in December 2021, it showed it was possible to reduce emergency department visits, improve patient quality of care and save lives, reducing net Medicare expenditures by addressing medication interactions prior to the development of ADEs.**

**These results are a clear call to action.**

https://thehill.com/opinion/healthcare/3260179-why-we-need-a…

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Interesting. I thought pharmacies routinely did interaction checks before issuing drugs. Pretty sure ours does.

1poorguy

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Interesting. I thought pharmacies routinely did interaction checks before issuing drugs. Pretty sure ours does.

No—it’s not standard procedure. If yours does, you are very lucky. I know that psychopharmacologists review drug regimens that involve at least one med prescribed for psychiatric/psychological reasons, and they determine which drugs cannot interact to cause problems, which drugs are not needed, and which drugs are too high a dose. One major problem caused by drug interactions adverse effects is that a drug, or drug combo, causing an adverse response isn’t recognized as the cause, so the doctor simply prescribes yet another drug to attempt countering the side effects, and that can lead to more adverse side effects, and additional drugs…until it looks like a shopping list.

=sheila

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Ours is (usually) Walgreens. With 1poorlady’s chemo I got in the habit of asking about interactions before paying for meds. They always answered “we check that before we fill it”. So either they’re lying to me (possible), or they really do it.

Of course, if we get some stuff from different pharmacies, that is of no help. We actually do get one because it is cheaper (by a lot), but Walgreens used to fill that one too, so they know about it.

1poorguy (she hasn’t had any new meds in a while…just continuing what they gave her after her chemo was done)

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There was a story line on this issue on The Resident this week.

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What is The Resident?

=sheila

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TV show on Fox…Tuesdays at 8 Eastern.

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Our last several pharmacies provided drug interaction warnings and the CVS we use still
does. All our doctors - and DW sees a bunch - all request a list of current prescription as
well as OTC drugs/drops/sprays/patches/rinses and review them each time we go. Now that does not
prevent us from needing to correct the meds list the doctors office print out after a visit.
And some doctors seem to pay more attention to details than others. Quite a few seem to keep
old meds on the list unless we poke the folks keeping the records with a sharp stick.

Howie52
Always carry a sharp pointy stick with you to doctor visits.

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The Resident…the TV show! Silly me. I should have realized.

=sheila

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that does not
prevent us from needing to correct the meds list the doctors office print out after a visit.
And some doctors seem to pay more attention to details than others. Quite a few seem to keep
old meds on the list unless we poke the folks keeping the records with a sharp stick.

Makes me wonder if they’re looking carefully at all of the items on the list. And I hope enough of them are sufficiently knowledgeable about all of the relevant interactions—given that DW is on a sizeable number of meds. Are they up to date? Or do they only think they’re sufficiently informed? Hope that is not an issue with you!

=sheila

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"Hope that is not an issue with you!

=sheila "

DW has been taken off a lot of medication over the past couple years. Out list used to take two
8 1/2" x 11’ sheets for her alone. Now she is down to one sheet plus a short portion to list
allergies and meds that she has a prescription for but is not actively taking - i.e. seasonal
allergy items, digestive items and breathing medications she has not needed since losing weight.

My list is a quarter of a sheet of paper - and should drop a bit once the meds prescribed when I
was released from hospital run out.

Howie52

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