Pharmaceutical News 2.0

Tue Apr 28, 2009 5:21pm EDT

Polypharmacy Analysis Indicates Reduced ER Visits, Fewer Hospitalizations, and
Lower Healthcare Costs

MOUNTLAKE TERRACE, Wash.–(Business Wire)– Emergency room visits and hospitalizations fell among patients who received medication safety education, according to an analysis of Premera Blue Cross’s nationally recognized Polypharmacy Program.

In a recent two-year assessment of nearly 13,000 Premera members, Seattle-based health services researchers observed a 1.2 percentage point decrease in persons having ER visits and a 1 percentage point decrease in persons having hospitalizations after members were mailed a simple brown bag with a set of instructions.

PATIENT SAFETY IS THE GOAL

Patients were asked to fill the brown bag with all their prescriptions, over-the-counter medications, and supplements and to take the bag to their next doctor`s appointment for review. Premera had found many of its members not only were receiving multiple medications but also had multiple doctors. By putting all the drugs in one place, a provider could assess the appropriateness of the medications and change dosages if necessary.

The new analysis, whose key findings are now being released, noted that pharmacy utilization did increase after the program materials were mailed. A reduction in total healthcare costs was also observed by Premera based on a review of relevant claims data.

However, Ed Wong, Premera’s vice president of Pharmacy Services, points out that the Polypharmacy Program was never intended to save money on drug costs. “The goal of this program has always been patient safety,” says Wong. “Our intention with this brown bag review is for patients to get a better assortment of drugs and suffer fewer adverse reactions.”

Premera has mailed out approximately 150,000 bags since the program began in 2001. The bags are sent to members in Washington, Oregon and Alaska who are 19 and older and who are taking five or more drugs daily over a three-month period for chronic conditions, such as diabetes, hypertension or high cholesterol.

ANALYSIS INDICATES DECREASED HOSPITALIZATIONS

In one of the key observations, the researchers found that 22.8 percent of the patients had gone to the emergency room in the year before they had received their brown bags, while 21.6 percent went during the year after they had taken part in the program. Meanwhile, 12.9 percent had been hospitalized the year prior to the program, compared to 11.9 percent the year after.

The program has drawn national media coverage and has been highlighted in an advertising campaign by the Blue Cross Blue Shield Association. In annual surveys, an average 51 percent of respondents since 2001 have reported undergoing a medication review, while 51 percent said they found the informational brochures in the bags to be somewhat to very valuable.

Read more about Premera Blue Cross’s drug safety program.

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Updated June 12, 2008

Drug safety requires patient involvement. A patient should take certain measures to ensure drug safety. Patients need to fully understand their prescription after discussing it with their doctor and pharmacist. Patients should not be taking medications they have questions about — for example, “Why am I taking this,” or “How do I take it?” Don’t be shy about getting the answers you need and having the conversations you need to have.

10 Ways to Ensure Drug Safety

Review Prescription Medications With Your Doctor
Your medication regimen may seem arduous, but it becomes quite routine. It becomes almost too routine — second nature, habitual, done without thought. It is drilled into patients that being compliant with their treatment plan is important. Taking pills religiously, on time, everyday is expected. At each doctor appointment, have a conversation about your current pill regimen. Certain questions should be asked each time you see your doctor.

10 Things You Should Do When Given a New Prescription
When your doctor hands you a new prescription, it becomes your responsibility to know what the medication is for, how to take it, and what possible side effects might occur. Here are 10 tips for what you should do when given a new prescription that will help ensure your safety and understanding.

Review Prescription Label Directions
Prescription medication labels are confusing to some patients. Have your doctor read the instructions to you. Also ask your pharmacist to read the directions to you when you fill the prescription. Follow these other tips too.

How to Avoid Medication Errors
A few simple, common-sense tasks can help you avoid medication errors and ensure your safety. Here are 15 important tips which ensure drug safety.

How to Safely Dispose of Unused Medications
Proper drug disposal is an emerging environmental issue. As with any household waste, the disposal method chosen can directly effect the safety and health of the environment. Most strive to be responsible. What are your options?

How to Spot Pharmacy Errors
Pharmacy errors may have serious consequences. Many pharmacy errors go unreported because they remain undetected or cause no obvious harm. Potential problems make it imperative for people taking prescription drugs to always check the medication they receive. Though pharmacy errors are unlikely occurrences, they do happen.

Read more about drug safety.

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Nature Reviews Drug Discovery 6, 937 (November 2007)

There is a pressing need to improve the understanding of safety issues during drug development and post-approval. Our interviewees this month explain their roles in efforts to enhance drug safety.

Julie Barnes, Ph.D. Chief Scientific Officer, BioWisdom Ltd., Cambridge, UK

Recent high-profile issues with drug safety have highlighted the need not only to improve post-marketing pharmacovigilance but also to identify drug candidates with good safety profiles earlier. To address these challenges, healthcare technology companies such as BioWisdom are providing intelligence to support decision-making about safety issues that arise during the development of new drugs. “Our approach is founded on the principles of ontology. This is a traditional science that applies a relationship-based approach to, for example, understand mechanisms of drug action as they pertain to adverse events,” explains CSO Julie Barnes.

Barnes’ career in drug development began when, following her Ph.D. in behavioural neuroscience, she took a postdoctoral position at GlaxoSmithKline (GSK) to develop a series of in vivo models and screens for evaluating new chemical entities for Alzheimer’s disease. Although initially very specialized in her discipline, over the next 15 years, she began to recognize the value of multidisciplinary research to bring different perspectives and technologies to a business problem.

“While at GSK, I saw projects come and go, clinical trials succeed and fail, and markets change,” she says. “Managing change and decision-making in such an environment is an experience that I am pleased to have had the opportunity to acquire.”

During this time, Barnes also experienced the rapid expansion in electronic information, which changed the behaviour of scientists from browsing current journals in company libraries to searching e-publications and other electronic data from their desktops. “Getting access to relevant information without being deluged with too much became an increasing challenge,” she explains.

Learn more about drug safety.

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