Pharmacists Help Solve Medication Mysteries : Part 2

by Food and Drug Administration (FDA)

(Page 2 of 2)

Computerized Pharmacies

Computers are helping pharmacists personalize their patient services. According to the new U.S. Department of Health and Human Services report Healthy People 2000, an estimated 85 percent of all pharmacies in the United States now use computers. At the most basic level, pharmacists can use the computer to screen for missing or improper dosage information. Or, they can call up information about a drug's side effects.

At a more sophisticated level, a pharmacist can record in the computer a patient's chronic medical problems, allergies, and prescription and over-the-counter drugs. Many pharmacists have relied on "patient profiles" when counseling patients. Now they can call on computers to screen for detailed information on a wide range of drug interactions, including drug-drug, drug-allergy, drug-food, and drug-disease. Pharmacists also can use computers to keep track of patients' refill schedules.

Ron Wilson, a pharmacist and director of FDA's health assessment policy staff, says that as part of the Healthy People 2000 objectives, FDA is coordinating a working group composed of pharmacy groups to develop systems, such as "smart card credit systems," that will enable patients to carry their own prescription medicine records and to share those records with pharmacists and physicians. Another idea FDA is exploring with pharmacy groups is the use of centralized data bases that will contain patients' drug and medical histories and allow authorized users, such as pharmacies, to share records.

For now, though, patients should let their pharmacists know if they get a new medication at another pharmacy, or if their medical conditions change, so the pharmacist can record the new information in the patient profile.

Pharmacists can provide other services to their patients with the use of computers. They can give customers profile sheets for insurance or end-of-the-year tax information. Many pharmacists now can enter insurance claims in the computer and send them directly to claims processors for reimbursement. Since Sept. 1, pharmacists have been required to complete claim forms for Medicare-eligible patients. (Durable medical equipment, such as wheelchairs, are covered under Medicare.) Many pharmacists already have the computer software to help them with this process.

Home Health Care

Orrin Skolnick started out small in the durable medical equipment business in 1971, supplying items like wheelchairs and commodes out of his Sandy Springs Medical Center Pharmacy in Atlanta. The pharmacy then began offering traction equipment and supplies for patients who have undergone colostomy operations. In 1979, Skolnick formed his Home Care Equipment Services firm, which supplies oxygen therapy equipment, blood glucose monitoring, and home IV therapy.

Through continuing education courses and other training, Skolnick has made himself an expert in the home health-care field. Patients come to him for equipment, and also for advice on everything from ostomy products to home care.

Galen Morris, president of B&K Prescription Shop in Salina, Kan., is another pharmacist who specializes in home-care goods and services. "One of the things we do well," he says, "is build custom wheelchair seating for little kids."

Many pharmacists who provide home health-care equipment make sure that the person on the staff who delivers the equipment knows how to put it together for the patient.

Home health-care pharmacists aren't the only pharmacists who deliver products to customers and make home visits. Warren and Gina Meador, who own Meador Drugs in Elk City, Okla., use their delivery system to check on elderly patients who might need special counseling or attention. Evelyn Timmons, owner of Mountain View Pharmacy in Paradise Valley, Ariz., visits cancer patients. Every year, she attends a week-long seminar conducted for pharmacists, and gets a complete update on chemotherapy, pain relief, and other treatments and cures.

In addition, Timmons compounds, or mixes, new medications for oncologists and dermatologists in her area. Compounding is a service that is on the increase, says Gideon. Because patients need individualized dosing, many pharmacists now prepare special dosage forms at the request of physicians. For instance, says Gideon, for many drugs not available in pediatric dosage forms, a pharmacist may prepare a reduced concentration in a dropper or suspension form.

Expect the Best

Ninety-six percent of consumers surveyed by FDA in 1982 said they did not ask their physicians or pharmacists any questions. Yet, according to a 1990 Gallup poll, Americans rated pharmacists as the most trusted of 25 different professionals. Clergy were rated second and medical doctors third.

"It's important for consumers to realize that pharmacists care about the health of their patients," says Gideon. "Being a pharmacist goes beyond filling prescriptions."

As Appel notes, "Consumers should seek a pharmacist who is committed to taking care of them, and that's not hard to find."

The Right Dose at The Right Time

Many pharmacists can supply aids to help patients take their medicines properly. The National Council on Patient Education mentions the following aids:

Medication calendars

The calendar has spaces for patients or professionals to mark off the amount of medicine to take and the time of day to take it. Space can also be provided for the patient to check off after the drug is taken.

Individual medication instruction sheets

Pharmacists tape sample pills next to the dosage time on these sheets with complete instructions on how to take the specific medication.

Color-coded bottles

A sticker the same color as the pill is placed on the bottle to help patients remember which pills go with each bottle's label information.

Clock faces

Clock faces with correct administration times can help patients who can't read or have poor eyesight.

Self-sealing plastic bags

All the medicines to be taken at each dosing time are marked, put in small, individual bags, and sealed. The day's doses are all packed into one larger plastic bag, and the seven daily bags are sealed into a bag that holds a week's supply.

Blister cards

A daily dose for a month is packed in a pop-out container marked or set for calendar days. The empty spaces help patients keep track of doses taken.

Calendar tray

A plastic box for a week's medications has compartments to hold multiple medications for up to four doses per day.

Timer cap

This device fits standard prescription bottles and can be programmed to flash and beep at dose time. Some versions flash each time a dose is taken.

Timer dispenser

A compartmentalized container makes a sound, such as a beep or a buzz, when it's time for a dose. It also shows which compartment holds the appropriate medication.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.