Winter 2014 - Issue 8
ELVIS has Entered
the Building
Rx Advantage invested in its first visual
aid verification machine, “Rain man”,
almost five (5) years ago. Not only were
we the first pharmacy in Alabama to
invest in this technology, but as far as we
know, the first LTC pharmacy in the
United States to do so as well.
We are very excited to announce we have
made an investment in another visual aid
verification machine we named Elvis
“Electronic Visual Inspection System”.
Elvis was purchased from Parata who
also manufactures our three (3)
automated dispensing machines,
“Lynyrd, Skynyrd and Free Bird”. Most
LTC pharmacies using systems similar to
ours have purchased their automated
dispensing machine from one vendor and
their visual aid verification machine from
another vendor causing them to rely on
multiple vendors with multiple
interfaces. Rx Advantage will have one
system with one software system driving
all of our solutions. In addition, it will
automatically review each Advantage Pac
for different criteria including: quantity
of pills, size, shape and the color of every
pill. It will also generate a photo of each
pill that is packed into our Advantage
Pacs giving our pharmacy an image
record if needed.
You can check out our new visual aid
verification system by going to
www.parata.com then clicking on
Explore, By Product and Parata Check
Pass.
FDA Issues Safety Warning for Sodium
Phosphate for Constipation
The US Food and Drug Administration (FDA) is warning about possible
harm from exceeding the recommended dose of over-the-counter (OTC)
sodium phosphate products to treat constipation. In a statement posted
online, the agency said using more than 1 dose in 24 hours can cause rare
but serious harm to the kidneys and heart, and even death.
The FDA said it has become aware of reports of severe dehydration and
changes in serum electrolyte levels from taking more than the
recommended dose of OTC sodium phosphate products, resulting in
serious adverse effects on organs, such as the kidneys and heart, and in
some cases resulting in death. "The predominant electrolyte disturbances
were hyperphosphatemia, hypocalcemia, and hypernatremia," the FDA
said.
The problem surfaced in a review of the agency's Adverse Event Reporting
System database and the medical literature, which turned up 54 cases in 25
adults and 29 children of serious adverse events associated with the oral or
rectal use of OTC sodium phosphate drug products used to treat
constipation, the FDA said. "According to the reports, most cases of serious
harm occurred with a single dose of sodium phosphate that was larger than
recommended or with more than 1 dose in a day," the FDA said.
Use With Caution
Individuals who may be at higher risk for potential adverse events when
the recommended dose of OTC sodium phosphate is exceeded include
young children; individuals older than 55 years; patients who are
dehydrated; patients with kidney disease, bowel obstruction, or
inflammation of the bowel; and patients who are using medications that
may affect kidney function.
These medications include diuretics or water pills, angiotensin-converting
enzyme inhibitors and angiotensin receptor blockers used to treat
hypertension, and non-steroidal anti-inflammatory drugs such as aspirin,
ibuprofen, and naproxen. OTC sodium phosphate drug products include
oral solutions taken by mouth and enemas used rectally.
The FDA advises consumers and healthcare professionals to read the drug
facts label for OTC sodium phosphate drugs, use these products as
recommended, and not exceed the labeled dose. "Caregivers should not
give the oral products to children 5 years and younger without first
discussing with a health care professional," the agency advises. "Health
care professionals should use caution when recommending an oral dose of
these products for children 5 years and younger. The rectal form of these
products should never be given to children younger than 2 years."
More information on the FDA warning is available on the agency's Web
site.
Source: Medscape.com
www.rxadvantage-inc.com
An Epidemic of Noncompliance
Featured Employee
If you're baffled by how many of your patients, particularly those with chronic
conditions, don't take their medications as prescribed -- if at all -- you're not
alone. Doctors from coast to coast feel frustrated by the same thing. In 2011,
Consumer Reports published a survey of 660 primary care physicians, "What
Doctors Wish Their Patients Knew." The number-one complaint by far:
Patients didn't take the doctors' advice or otherwise follow treatment
recommendations.
"Most of the doctors we surveyed said it affected their ability to provide optimal
care," the editors wrote. "Thirty-seven percent said it did so 'a lot.'" In fact, the
number of patients who are noncompliant has reached epidemic proportions,
and doctors' inability to provide optimal care as a result has mushroomed into
one of the most pressing problems in healthcare today.
• In the United States, some 3.8 billion prescriptions are written every year, yet
over 50% of them are taken incorrectly or not at all.
• In a survey of 1000 patients, nearly 75% admitted to not always taking their
medications as directed.
• A study of over 75,000 commercially insured patients found that 30% failed
to fill a new prescription, and new prescriptions for chronic conditions such as
high blood pressure, diabetes, and high cholesterol were not filled 20%-22% of
the time.
• Even among chronically ill patients who regularly fill their prescriptions, only
about half the doses taken are taken as their physicians intend.
• Poor compliance accounts for 33%-69% of drug-related adverse events that
result in hospital admissions.
• Poor compliance with medication regimens is associated with up to 40% of
nursing home admissions.
• In a study of over 8400 senior health plan enrollees, only 1 in 3 of those who
began treatment with concurrent antihypertensive and lipid-lowering drugs
were taking both medications as directed or at all at 6 months.
• In a study of over 240,000 patients who were given a new prescription for an
antidepressant, less than 30% were still taking the medication 6 months later.
• Compared with patients who follow instructions, patients who don't take their
medications as intended have a risk for hospitalization, rehospitalization, and
premature death that is 5.4 times higher if they have hypertension, 2.8 times
higher if they have dyslipidemia, and 1.5 times higher if they have heart
disease.
Kristin Reid is our Controller
and has been with Rx
Advantage for 2 years. She
received her BS in Finance
from The University of
Alabama in 2007.
Kristin has worked in
accounting and finance for 7
years and is currently
working towards her CPA
designation. Kristin and her
husband, Hampton, have been
married for 4 years and
currently reside in Mobile.
In her spare time, Kristin
enjoys reading, traveling, and
of course, Alabama football.
• The number of patients with serious cardiac conditions who don't take their
medications is especially baffling and problematic. In a study of 34,501 patients
age 65 or older, only 26% of those who began a statin regimen to reduce the
risk for coronary heart disease maintained a high level of use 5 years later; the
greatest decline occurred during the first 6 months of treatment.
• Even after a life-threatening event, compliance with medication regimens
remains surprisingly poor. Within 2 years of initiating therapy, only half of
patients hospitalized for acute myocardial infarction (MI) were still taking their
prescribed statins, beta-blockers, angiotensin-converting enzyme (ACE)
inhibitors, or angiotensin receptor blockers (ARBs).
Poor medication compliance is implicated in over 125,000 US deaths per year.
Source: Medscape.com
Rx Advantage Patient Safety Through Innovation
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E-prescribing is Here!
Rx advantage is pleased to
announce the ability to accept eprescribed prescriptions.
Electronic prescribing or eprescribing (e-Rx) is the computerbased electronic generation,
transmission and filling of a
medical prescription, taking the
place of paper and faxed
prescriptions.
E-prescribing allows a physician,
nurse practitioner, or physician
assistant to electronically transmit
a new prescription or renewal
authorization to a community or
mail-order pharmacy. It outlines
the ability to send error-free,
accurate, and understandable
prescriptions electronically from
the healthcare provider to the
pharmacy.
E-prescribing is meant to reduce
the risks associated with traditional
prescription script writing. It is
also one of the major reasons for
the push for electronic medical
records. By sharing medical
prescription information, eprescribing seeks to connect the
patient's team of healthcare
providers to facilitate
knowledgeable decision making.
Rx Advantage can accept controlled
and non-controlled prescriptions.
Physicians wanting to e-prescribe
narcotics will need to check with
their electronic medical record
vendor to discuss availability.
Rx Advantage Patient Safety Through Innovation
Which Girl Scout
Cookie for You?
While the very word “cookie” doesn’t scream healthy, the
Girl Scouts added a new healthier option cookie in 2013 to
the lineup of already delicious cookies. The newest Girl
Scout cookie, the Mango Crème with Nutrifusion™, touts the
combination of a concentrate of cranberry, pomegranate,
orange, grape, strawberry and shiitake mushrooms (yes
mushrooms.) One serving of 3 cookies is fortified with 15
percent of your daily recommendation of vitamin B1
(thiamin) and 6 percent of vitamins A, C, D, E and B6. But, a
cookie is still a cookie and a serving (3 cookies) of the new
“healthy cookie” has 180 calories, 8 grams of fat (4 sat. fat)
and 11 grams of sugar. The better choices may be to reach
for the Shortbread, Savannah Smiles or Trefoils. Four
Shortbread cookies deliver 120 calories, 4.5 grams total fat, 2
grams saturated fat and 4 grams of sugars. Five cookies of
the Savannah Smiles have 140 calories while 5 Trefoils have
160 calories. The old faves: Do-Si-Dos – 55 calories a cookie;
Tagalongs – 70 calories a cookie; Thin Mints have only 40
calories a cookie but have partially hydrogenated oil. The
worst cookie nutritionally: Caramel deLites. They deliver 70
calories a cookie and the most saturated fat (a 2 cookie
serving is 30 percent of your daily value) and although it’s
labeled as containing 0 grams of trans fat, the ingredient list
includes partially hydrogenated oil. (There’s a loophole in
labeling laws: if a serving delivers less than 0.5 gram of trans
fat, it can be labeled as containing 0 grams of trans fat.)
Caramel deLites also have the most sugar of all the cookies—
in fact, sugar is the first ingredient (most of the others list
flour first.)
But it’s only once a year and it’s for a great cause – so enjoy!
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The Advantage Pac
Rx Advantage pioneered the use of multi-unit dose packaging (Advantage Pac) in Alabama
and Florida and has been utilizing and improving this technology for over 15 years. The team
at Rx Advantage has over 300 years of combined experience using multi-unit dose packaging
(Advantage Pac). The Advantage Pac is a multi-unit dose, easy to read, separate, and tear
open, pre-poured package produced by automated dispensing machines. This unique,
“tamper evident, compliance packaging” has the residents name, drug dose, drug description,
and administration time printed on each Advantage Pac. All of our customers can choose
whatever cycle is convenient. (i.e. 7-day, 14- day, etc...) Most customers choose 7-day or less
cycles. Since the Advantage Pacs are dispensed in revolving cycles, it eliminates the need for
nursing staff to process refill requests for routine oral solid medications or “auto-refills.” Rx
Advantage is the only pharmacy that provides a Batch Update when a medication is
discontinued. Our Batch Update gives your nurses instructions on how to handle the
discontinued medication, giving your nurses additional information to help ensure this
change will be handled properly.
Dispensing in cycles allows for a real time split-billing allotment to an
appropriate payor source throughout the month eliminating the manual
re-bill function of traditional pharmacy practices. Dispensing a 7-day supply of routine oral
solid medications versus 30 days, reduces waste at the facility by up to 80%. Studies prove
that utilizing automation and providing detailed information directly on packaging, like our
Advantage Pac, significantly improves accuracy. Nurses using our systems today have seen as
much as a 50% reduction in med pass time after implementing our Advantage Pac System.
CMS required all LTC Pharmacies to dispense brand-name medications in increments of 14
days or less beginning January 1, 2013. Rx Advantage is proud to have exceeded this
requirement for the past 15 years for both brand and generic medications.
Recipe
“The right prescription for good food”
Super Bowl Mexican Dip
1 can refried beans
2 Tbsp. lemon juice
3 ripe avocadoes
½ tsp salt
¼ tsp pepper
8 ounce sour cream
½ cup mayonnaise
¾ package taco mix seasoning packet
Green onions - chopped
1 can chopped black olives
Jalapenos - chopped
2 tomatoes – cubed
8 ounces cheddar cheese - finely grated
•
•
•
•
Combine avocadoes, lemon juice, salt and pepper in a food processor
and set aside.
Mix sour cream, mayo, and taco seasoning together in small bowl.
In 13 x 9x 2 casserole, spread bottom of pan with refried beans, top
with avocado mixture, then sour cream mixture. Then layer onions,
olives, jalapenos, tomatoes and finish with cheese.
Serve with tortilla chips.
Rx Advantage Patient Safety Through Innovation
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