Not taking your prescriptions as directed can be harmful, especially for seniors

prescriptions

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via Improperly taking prescription meds can be fatal, clarionledger.com

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Every year, thousands of people die or suffer complications because they misuse their prescription medications, or simply fail to follow their medical provider’s recommendations for taking them. A new study announced recently in a British medical journal suggests elderly people may be at particular risk of what physicians call “prescription noncompliance.”

Prescription noncompliance is a big problem and can result in a variety of issues. The U.S. Centers for Disease Control and Prevention estimates that more than one in five prescriptions are never filled at the pharmacy, and medications are not taken as prescribed half the time. For many patients with chronic diseases (such as high blood pressure), the majority of people take less medication than prescribed or stop taking it altogether. Seniors are more likely to be affected by noncompliance for several reasons, including increased sensitivity to the effects of drugs, but also because they often have multiple prescriptions that could interact with each other, and may experience problems with concentration or memory.

Failing to adhere to your prescription schedule can lead to frightening statistics: The CDC estimates 125,000 people die in the U.S. each year because of prescription noncompliance, and up to half of people being treated with statins (medicines that control cholesterol) are up to a quarter more likely to die if the patients stop taking them.

“It is very important for people to take their medication as prescribed,” noted pharmacist Tommy Shields, owner of Service Drugs in Ridgeland. “Failure to take their medication properly will lead to unfavorable outcomes in their treatment plan. Physicians may then prescribe additional medications to help manage their health, further complicating the patient’s treatment.”

Recently, the British Journal of Clinical Pharmacologypublished a study based on 503 Belgian seniors age 80 and over, which found nearly seven in 10 of them weren’t taking the proper prescriptions for their conditions. Nearly six in 10 of them were taking five or more medications, and only 17 percent were considered free from prescription-related issues. Stunningly, the study found patients were 39 percent more likely to die if they underused their medications, and 26 times more likely to need hospitalization.

“Taking too many medications or unsafe medications are known to cause adverse health outcomes; however, we have shown that not taking essential, beneficial medications is more frequent and can be more strongly associated with negative outcomes,” said lead author Maarten Wauters of Belgium’s Ghent University. “Prescribing medications to older persons should be done after careful thought, balancing the benefits and risk of every medication at regular intervals.”

The results of the study appear to be consistent with others, including some in the U.S. which indicate that failure to follow prescription instructions is a major problem. “Clinical pharmacologists can help prescribers to clearly assess misuse and underuse of medications in full knowledge of the patient, their comorbidities, and their medications,” Wauters said. “They can help to build electronic systems for constant monitoring of the quality of prescribing, using evidence-based criteria of potentially inappropriate prescribing.”

To help avoid the risks of not taking medications properly, it’s important to follow your health care professional’s instructions exactly. When you get a new prescription, be sure you understand all the instructions, and ask your doctor or pharmacist to help you if anything is unclear.

To help you stick to your medication plan, the FDA has some additional recommendations:

  • Take your medication at the same time every day. It may help to tie the habit to routines like brushing your teeth or getting ready for bed. Before choosing mealtime for your routine, check if your medication should be taken on a full or empty stomach.
  • Keep a “medicine calendar” with your pill bottles and note each time you take a dose.
  • Use a pill container. Some types have sections for multiple doses at different times, such as morning, lunch, evening and night. Be sure to refill it at the same time each week.
  • Use technology. Time caps are available, and there also several mobile apps, for example Medisafe, MedCoach and Pill Reminder, which can help you manage your medication schedule.

Feds warn eye doctors: provide prescriptions

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Glasses on eye chart

Glasses on eye chart

via Moak: Feds scope out eye docs

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Did you know that, if you go to an eye doctor for a prescription or contact-lens fitting, he or she is bound by law to provide you with the prescription, and can’t make you buy any products (other than paying for the exam) as a condition of getting it?

I confess I was unaware of that, as are many consumers. And since I’ve dealt with ophthalmologists and optometrists most of my life, I have found this group of people to be among the most caring, competent and compassionate health care professionals out there. But — at least according to some consumers — a few of them may have violated a law known as the Eyeglass Rule.

Last week, the Federal Trade Commission sent letters to 38 prescribers, warning them of alleged potential violations of the rule. While the FTC released the contents of the letter, it didn’t say to which prescribers it was sent, or their locations. Failure to abide by this rule can result in stiff fines and penalties, including fines of up to $16,000 per violation. But in each case, consumers had complained to the FTC that they had not gotten a copy of their prescription.

“We are writing to inform you that such a practice would violate the FTC’s Ophthalmic Practice Rules, 16 C.F.R. Part 456, known as the Eyeglass Rule, which requires prescribers to provide a copy of the eyeglass prescription immediately after the eye examination, even if the patient does not request it, and prohibits prescribers from requiring that patients buy eyeglasses as a condition of providing a copy of the prescription,” noted the lengthy missive from Mary K. Engle, associate director of the FTC’s Division of Advertising Practices.

The Eyeglass Rule not only requires the eye doctor to provide you with a copy of your prescription, it also specifies what must be in the prescription, such as your name; the date of the exam; when it was issued and when it expires; the doctor’s name, address, phone number and fax number. Here in the Magnolia State, the Mississippi State Board of Optometry is tasked with enforcing state law, which gives additional detailsabout what must appear on the prescription. For glasses and contact lenses, the prescription must include a variety of scientific measurements such as sphere power, cylinder and axis power, and other terms that likely won’t be familiar to you unless you’ve worn glasses or contacts.

Once you have the prescription, you can take it and use it anywhere, including using it to buy glasses or contacts from an online provider or discounter. Keep in mind this doesn’t mean the exam has to be free; optometrists are allowed to charge you normal and customary fees, as long as they are charged to all patients, regardless of whether they need a prescription.

Caring for our eyes is a lifelong commitment; if you’re blessed with great vision, be thankful. But the sense of sight is so important to us that it’s worth the time to make sure everything’s OK.

For more information about what to expect from a visit to the eye doctor, the National Institutes of Health has some good advice on its website athttp://nei.nih.gov/healthyeyes/eyeexam.

Animation brings drugs to life

Capsule

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via Moak: Animation brings drugs to life, clarionledger.com, 04/01/2016

It seems a little disconcerting; maybe terrifying is the right word. A giant big toe with a determined face, football helmet and — strangely, gloved hands — battles against toenail fungus. A leering, disgusting monster named “Digger the Dermatophyte” burrows under the toenails of an unwitting victim. A twisted-up, miserable-looking intestine with a face, legs and arms haunts a victim by giving her Irritable Bowel Syndrome.

These are not the stuff of nightmares, although you’d be forgiven for thinking that. These three are among dozens of animated characters designed to hawk prescription drugs. You can’t turn on commercial TV without seeing ads for some type of prescription medicine. The menagerie has included giant, glowing luna moths invading sleepers’ bedrooms (Lunesta), animated “pipe people” advertising continence drugs (Vesicare) and cartoonish, personified internal organs such as bladders (Myrbetric) and even prostate glands (Rapaflo).

One recent example is an ad for the insomnia drug Belsomra, which features a woman with insomnia, for whom “sleep” is a fluffy, cat-like creature in the shape of the word “sleep”, while “wake” is quite dog-like. As she tries to sleep, the “sleep” eludes her grasp while the “wake” wags its tail playfully. It’s actually a little endearing, and if you’ve ever had insomnia, you could relate.

Direct-to-consumer pharmaceutical advertising (DTCPA; yes, it’s a thing) now dominates the airwaves. Most countries don’t allow it, with the U.S. and New Zealand being the only exceptions. The well-funded lobbyists for the drug industry have been trying to get the European Union and other countries to drop their bans on the practice. Nevertheless, there’s big money involved. Drug companies spent $4.5 billion per year on drug advertising, according to the AMA, and many reports indicate advertising can accelerate demand considerably.

We’ve gotten used to these commercials, but it’s a relatively new phenomenon. Until the 1980s, there were few (if any) ads for prescription medications. Patients might hear about some new drug from a friend, and would mention it to their physicians, but usually it was the other way around. Then, in the 1980s, ad executives decided to try something new; direct-to-consumer advertising for prescription drugs. Practically overnight, we were being barraged with commercials to pique our interest in particular brands of drugs.

The U.S. Food and Drug Administration has recently made news by announcing it’s studying whether these characters help to overcome patients’ doubts or concerns about the medications’ possible side effects. It’s well-known in advertising that people tend to react more positively to a concept that is friendlier or relatable, and the FDA is concerned about whether they might be making people more susceptible to asking their doctor to prescribe them.

“The positive effects these animations induce might transfer to the brands being advertised,” the FDA wrote. “It is also possible that animated characters may lead to lower perceived risk by minimizing or camouflaging side effects.”

The American Medical Association called last year for a halt in these ads, saying they create demand for costly drugs patients don’t need, driving up costs for everyone when often there are effective alternatives at lower cost.

“Personifying animated characters may interfere with message communication,” the FDA noted. “Whether personified characters lead to reduced comprehension of risk and benefit information in drug ads is an important and unanswered question.”

For its study, the FDA will conduct two experiments with made-up drugs, both based on real-life counterpart drugs for dry eye and psoriasis. “Medications for psoriasis have very long, serious lists of risks and side effects, whereas chronic dry eye medications have relatively few risks and side effects,” the FDA noted. The agency will enroll people who actually have chronic dry eye or psoriasis in the studies.

The FDA will enlist ad agencies to create commercials of similar quality to those now being aired, to study live-action vs. animated ads. One experiment will examine whether it makes any difference what type of animation technique is used. For example, some ads — such as ads for the depression drug Abilify, look more like traditional cartoons (using a method called “rotoscoping” to trace over live-action shots to create a cartoon effect), while others use more sophisticated methods, such as those used by big-budget animation studios. The other study will create a new animated, anthromorphic “mascot,” and conduct studies on how viewing the ads affect viewers.

Until these issues are settled, though, one fact remains: no one is better-qualified than your physician to figure out what drugs you might need, and though a cartoon character may be cute or creepy, they probably haven’t been to medical school.

Watch for fake diet pills, Hood warns

via Moak: Watch for fake diet pills, Hood warns.

If you are looking for diet pills online, you need to be careful, as Attorney General Jim Hood’s office warned Mississippians that they be fake and potentially harmful.

“The Internet is a leading source for the sale of counterfeit pharmaceuticals and other such dangerous goods,” Hood said in a news release. “Counterfeit drugs are normally loaded with unsafe or ineffective substances, either of which can be deadly or cause permanent damage.”

A recent federal multi-state investigation showed diet pills containing Sibutramine, a Schedule IV controlled substance, have been falsely labeled and marketed as “all natural” dietary supplements with herbal ingredients.

Sibutramine is the active pharmaceutical ingredient in Meridia, a prescription weight loss drug removed from the market in 2010 following studies that showed significantly increased risk of strokes and heart attacks. Since the removal of Meridia, no drug containing Sibutramine has been approved for use in humans in the United States. The Chinese-manufactured drug has been sold under various names including “Slim Forte Slimming Capsules,” “Slim Forte Double Power Slimming Capsules,” “Slim-Vie Slimming Capsules,” and “Slim-Vie Double Power Slimming Capsules.”

“Although our office has not yet received information of a Mississippi consumer who purchased these specific pills,” Hood noted, “new scams arise almost daily and we make a diligent effort to educate the public as we discover them.”

If you have purchased these pills, you’re advised to stop taking them immediately, and call the Consumer Protection Division of the Attorney General’s Office at 1-800-281-4418 for more assistance. Health care professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA. For more information regarding dietary supplements and to report adverse events, please visit the FDA’s website at www.fda.gov/Food/DietarySupplements.

Unscrupulous company targeting seniors

Originally published in the Clarion-Ledger on 5/14/2015.

PDF: Unscrupulous company targeting seniors

If you’re a senior — especially a senior living alone — you might own medical alert device. These are really clever little pieces of technology. You wear a small transmitter device around your neck or on your wrist, and can call for help by pushing one button if you fall or need immediate help and can’t get to the phone.

Although the “I’ve fallen and I can’t get up” tagline is a little campy and worn (it’s been used for 26 years), and companies are using what can only be called scare tactics (remember the horrifying commercial with the woman who had fallen down the stairs?), the devices have sold millions.

In the past couple of years, as competition has heated up in the medical alert industry, the potential is there for seniors to be abused by unscrupulous salesmen. Last fall, I wrote about a business that had been shut down by federal regulators. And a few weeks ago, a U.S. District Court in New York shut down a New York-based company called Instant Response Systems (IRS), accusing the company of “bullying and tricking them into paying for unordered medical alert devices.” The company, and its owner Jason Abraham, have been ordered to pay $3.4 million.

“Instant Response Systems lied to older people to get them to pay for medical alert systems they didn’t order and didn’t want,” said Jessica Rich, Director of the FTC’s Bureau of Consumer Protection. “Their high-pressure, deceptive phone pitches were illegal, and they violated the do not call rules to boot.”

The agency accuses the company of calling elderly consumers – many of them on fixed incomes and some whose numbers were on the “Do-Not-Call” list  – and pressuring them into buying a medical-alert type pendant. In some cases, the company is alleged to have told consumers they owed IRS for previous purchases. The scheme involved sending fake invoices and unordered merchandise to consumers, then threatening legal action if they didn’t pay up. This is the second round for Abraham, who was sanctioned by the FTC in 2003 for doing basically the same thing.

“There is no genuine dispute that [the] defendants, in letters and phone calls, made material misrepresentations that consumers ordered medical alert services and owed IRS money when, in fact, they did not,” the court stated, in a release sent by FTC recently. The court also found that Abraham “knowingly made misrepresentations to hundreds of consumers over a five-year period, all while subject to a permanent injunction issued in 2003 . . . which prohibited him from such conduct.”

If you’re considering getting such a device for yourself or for a loved one, the best advice I’ve found is to initiate the shopping process yourself, working with a trusted relative, friend or neighbor, instead of responding to a telemarketer.

When shopping for these devices, I found some great advice from Consumer Reports:

  • Buy a device that fits the user’s specific disability. For example, a stroke survivor may need a device he or she can activate with one hand.
  • Many devices offer either a wristband or neck pendant. A neck pendant could be the answer if you have skin ailments; lanyards could pose a strangulation hazard.
  • Some devices include help buttons that can be wall-mounted near the floor in multiple rooms in case the user falls and isn’t wearing the pendant.
  • Look for devices that offer multiple choices for whom to contact if you need help, from emergency services to a friend or relative who lives nearby.

And finally, if someone calls you on the phone trying to sell you such a device, never make a decision on the phone. A legitimate company will never pressure you to make a decision, avoid answering your questions or refuse to send you some information so you can make the best decision. Always check out the company before doing business with them, and report unscrupulous conduct as soon as possible.

There are more tips on buying a medical alert device on Consumer Reports’ site at http://bit.ly/1v9NXzm.

Shopping for health supplements on line? Consider claims carefully

Originally published on clarionledger.com.

In the wild, wild west of Internet commerce, it’s easy to get taken for a crazy stagecoach ride. Consumers are besieged with offers from companies of every size and shape, making promises which are impossible to evaluate. There are few rules, other than “buyer beware”. But the sheriff does occasionally make an arrest.

In particular, the feds this week put up the red flag on one group of companies trying to take advantage of recent publicity around dietary supplements, including green coffee bean extracts.

The Federal Trade Commission (FTC) busted the parent company behind SimplePure, alleging violations of a 2010 law which prohibits marketers from charging Internet customers unless they have clearly disclosed “all material terms of the transaction and obtained the customers’ express consent.” The company allegedly charged up to $210 per month for products such as “Pure Green Coffee Bean Plus” and RKG Extreme.

A U.S. District Court issued a temporary restraining order against Health Formulas and a slew of related companies under the Restore Online Shoppers’ Confidence Act (ROSCA) at the FTC’s request. You can read the full release here. (link to: http://1.usa.gov/1wzfGKi).

“The defendants behind Simple Pure used nearly every trick in the book to deceive consumers,” said Jessica Rich, Director of the FTC’s Bureau of Consumer Protection. “They not only deceived consumers about the effectiveness of their products, but also repeatedly debited consumers’ accounts without their approval.”

Health Formulas, LLC, its related entities, and principals (Simple Pure) are alleged to have used telemarketing, the Internet, print, radio, and television advertisements to pitch a variety of dietary supplements and other weight-loss, virility, muscle-building, or skin cream products.

“Examples of Simple Pure’s advertising claims include: 1) ‘Burn fat without diet or exercise’; 2) ‘Shed pounds fast!’ and promised 3) ‘Extreme weight loss!’”, noted The FTC, adding that there is no basis for the weight-loss claims.

Health Formulas LLC “In addition, the defendants allegedly trick consumers into disclosing their credit and debit card information, and then enroll them without authorization in a negative option program in which defendants continually charge consumers’ accounts.”

Much of the action surrounds the use of a “negative-option” subscription, meaning basically that — instead of making you proactively subscribe to something — you are automatically subscribed if you don’t tell them to not charge you.

The FTC charges that the defendants failed to provide the disclosures required for a negative-option program, failed to provide a way for consumers to stop the automatic charges, and also failed to disclose material facts about their refund and cancellation policy.

If you’re looking to try a nutritional supplement you’ve seen online, tread carefully:

  • Check out the company first with organizations like the BBB (bbb.org).
  • Carefully evaluate any “free” offers; if you have to pay anything, it’s not free.
  • If you sign up for a “trial offer”, check the fine print carefully to look for your options to cancel.
  • Make sure you’re on a secure site (look for https:// in the web address of the page you enter your information).
  • Be sure to uncheck any “pre-checked” boxes, so you don’t get services you didn’t want.
  • But most importantly, do your homework. If you buy from a reputable company you’ve used successfully in the past, you’re a lot less likely to become a victim.