Patients to Have a Say in Decisions About Their Medicine

  • Author: Health Informer
  • Filed under: Health News
  • Date: Jan 28,2009

Up to 50 per cent of medicines prescribed for long-term conditions are not taken as recommended. This can have dire consequences for patients leading to treatment failure and a worsening of their condition.

The pharmacy bodies have jointly welcomed the new guidance published by NICE, aiming to help all health professionals to engage with patients and to ensure that patients are involved in decisions about their treatment. Pharmacists have a key role to play in helping patients to understand more about their medicines and the options that they have.

“The guidance is a golden opportunity for all healthcare professionals involved in prescribing, dispensing or reviewing medicines to take their relationship with patients further, by working together to achieve the best results from the treatment of their patients. Pharmacists are critical to this process, if we are to solve the problem of non-adherence to medicines.” Beth Taylor, Chair, English Pharmacy Board of the Royal Pharmaceutical Society of Great Britain (RPSGB).

The new guidelines apply across all sectors of the pharmacy profession and cover all parts of the medicines management process from prescribing, dispensing medication review, including Medicine Use Reviews (MURs), through to admission, discharge and medicine reconciliation.

The pharmacy bodies will work in partnership to support pharmacists to implement the recommendations outlined in the guidelines and to improve communication with other healthcare professionals involved in the patient’s care.

“This guidance puts patients at the centre of medicines use and provides an opportunity for pharmacists to play a key role, as envisaged in the White Paper, Pharmacy in England: Building on strengths – delivering the future, published in April 2008, helping individual patients to take their medicines as intended.

Pharmacists across primary and secondary care have an important contribution to make to this process – at the point of supply, as part of MURs and as prescribers.” Jonathan Mason and Martin Stephens, National Clinical Directors.

John Turk, Chief Executive, National Pharmacy Association (NPA), said:

“The most expensive medicines prescribed by the NHS are those that aren’t taken correctly, or at all. This guidance recognises that the best way of improving adherence is to involve patients in decisions about treatments, to inform them of risks and benefits and view each patient as an individual, rounded person, not merely the embodiment of a disease group.

“Pharmacists, as the health professionals seen more frequently than any other by people taking long term prescribed medicines, are carrying out interventions such as MURs and repeat dispensing, to support patients. These guidelines will focus the NHS, pharmacists and other health professionals on creating opportunities for greater patient involvement, improving clinical outcomes through greater adherence.”

“All the evidence tells us that patients will open up to pharmacists about their use of medicines – appropriate and inappropriate. On this occasion we believe that pharmacists should be centre stage in working with general practice to ensure a coherent patient-centred approach. The guidance should just be the focus adherence needs to make it centre-stage in NHS planning.” Rob Darracotte, Chief Executive, Company Chemists’ Association (CCA).

Sue Wright, Chair, Pharmaceutical Services Negotiation Committee (PSCN) said: “Community pharmacy has a central role in helping people understand more about the medicines they use; the MUR service was introduced in 2005 to focus community pharmacy efforts on this task and to tackle problems with adherence. Over three quarters of pharmacies in England are now providing the service and we expect around 1.5 million MURs to be conducted this year.”

The PSNC, CCA, NPA, RPSGB and DH have jointly responded to the guidelines published by NICE, encouraging healthcare professionals to open a two-way dialogue with their patients. This will give patients an opportunity to make an informed decision about the medication available and is crucial in understanding any concerns that they might have about the benefits or the side-effects of taking prescribed medicines and how this may influence their condition in the future.

Royal Pharmaceutical Society of Great Britain (RPSGB)

The RPSGB is the professional and regulatory body for pharmacists in England, Scotland and Wales. It also regulates pharmacy technicians on a voluntary basis, a role that is expected to become statutory under forthcoming legislation. The primary objectives of the RPSGB are to lead, regulate, develop and represent the profession of pharmacy.

Company Chemists Association (CCA)

Through the CCA, its member companies work together to create an environment where community pharmacy can flourish, and where pharmacy contractors compete in a fair and equitable way. Our nine companies – Alliance Boots, Co-operative Group Pharmacy, Lloyds pharmacy, Tesco, J Sainsbury, Wm Morrison Supermarkets, Asda Wal-Mart, Rowlands Pharmacy and Superdrug – together operate over 6,000 pharmacies in the United Kingdom.

National Pharmacy Association (NPA)

The NPA has, in voluntary membership, the vast majority of the UK’s community pharmacy owners. The Association supplies members with a range of services to help them maintain and improve the health of the communities they serve.

Pharmaceutical Services Negotiating Committee (PSNC)

The PSNC is the body recognised by the Secretary of State for Health as representing community pharmacy owners in England on NHS matters. It negotiates the national community pharmacy contractual terms with the Department of Health and the NHS.

Source: Royal Pharmaceutical Society of Great Britain


Trust for America’s Health (TFAH) applauds the Senate Appropriations Committee for including $16 billion in funding to improve the health of Americans while stimulating the economy in the American Recovery and Reinvestment Act.

“This funding is desperately needed to revitalize and modernize the country’s ailing public health system, and we’ll be putting more Americans to work in programs that will directly improve the health of communities where they live,” said Jeff Levi, PhD, Executive Director of TFAH. “These investments will have wide and far reaching impact. In addition to the immediate stimulus of creating jobs, we’ll be improving the productivity of our workforce and containing the skyrocketing cost of health care.”

“Getting health care costs under control is critical for getting the country’s economy back on track. Fundamental health care reform, particularly reform that focuses on ways to keep Americans healthier, must be part of solving our current financial crisis. The funding for public health and disease prevention in the stimulus bill is a down payment toward reducing health care costs over the long term,” Levi continued.

Some disease prevention and public health preparedness highlights in the stimulus bill include:

  • $5.8 billion for prevention and wellness to fight preventable diseases and conditions. This includes more than $600 million to bolster the health workforce, $400 million for community prevention (healthy communities) programs, $750 million for immunization programs, $400 million for sexually transmitted disease prevention programs (including HIV/AIDS), $75 million for smoking and other tobacco use prevention programs, $60 million for prevention science research, $40 million for IT improvements at the U.S. Centers for Disease Control and Prevention, and $15 million for newborn screening;
  • $870 million to complete funding for the national pandemic flu plan; and
  • $5 billion to jumpstart modernizing Health Information Technology.

The investment will create new jobs and help revitalize the infrastructure of state, local, and community-based programs aimed at reducing rates of disease, such as providing increased access to affordable nutritious foods and increasing immunization efforts. At the same time, these programs can help reduce health care costs. In 2008, TFAH recently released Prevention for a Healthier America, a study that found that for every $1 spent on proven community-based disease prevention programs, the country could net a return of $5.60 in health care costs within five years.

The bill also provides funding to stimulate research, development, and implementation of technology to modernize the nation’s ability to respond to a potential pandemic flu outbreak, including equipment and medications needed to detect, contain, and treat pandemic flu.

The investment in improving health information technology (HIT) could also lead to advancements in epidemiological research, making it easier to investigate the causes and cures of diseases and detect new infectious outbreaks.

A range of analyses from authorities ranging from the Institute of Medicine to the U.S. Centers for Disease Control and Prevention (CDC) have concluded that America’s public health system is “structurally weak in nearly every area.” TFAH assembled an expert panel in 2008 which found the country currently faces a shortfall of $20 billion annually — across state, local, and federal government — in funding for critical public health programs in the U.S., based on research conducted by The New York Academy of Medicine and a panel of leading experts. Approximately $1 billion of this shortfall is due to cuts to the U.S. Centers for Disease Control and Prevention (CDC) budget from fiscal year 2005 levels.

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

Source: Trust for America’s Health


The American Heart Association recommends that people consume at least 5 percent to 10 percent of calories from omega-6 fatty acids.

It’s recommended that the omega-6 comes from foods, not supplements.

Replacing saturated fats with polyunsaturated fatty acids may lower the risk for heart disease.

Higher intakes of omega-6 may improve insulin resistance, reduce diabetes risk and lower blood pressure.

Omega-6 fatty acids – found in vegetable oils, nuts and seeds – are a beneficial part of a heart-healthy eating plan, according to a science advisory published in Circulation: Journal of the American Heart Association.

The association recommends that people aim for at least 5 percent to 10 percent of calories from omega-6 fatty acids. Most Americans actually get enough of these oils in the foods they are currently eating, such as nuts, cooking oils and salad dressings, the advisory reports. Recommended daily servings of omega-6 depend on physical activity level, age and gender, but range from 12 to 22 grams per day.

Omega-6, and the similarly-named omega-3 fatty acids (found in fattier fish such as tuna, mackerel and salmon), are called polyunsaturated fatty acids (PUFA), and can have health benefits when consumed in the recommended amounts, especially when used to replace saturated fats or trans fats in the diet. Omega-6 and omega-3 PUFA play a crucial role in heart and brain function and in normal growth and development. PUFA are “essential” fats that your body needs but can’t produce, so you must get them from food.

“Of course, as with any news about a single nutrient, it’s important to remember to focus on an overall healthy dietary pattern – one nutrient or one type of food isn’t a cure-all,” said William Harris, Ph.D., lead author of the advisory. “Our goal was simply to let Americans know that foods containing omega-6 fatty acids can be part of a healthy diet, and can even help improve your cardiovascular risk profile.”

The American Heart Association’s dietary recommendations suggest a broadly defined healthy eating pattern over time – with an emphasis on fruits, vegetables, high-fiber whole grains, lean meat, poultry, and fish twice a week. Diets rich in fruits, vegetables and whole grains have been associated in a large number of studies with reduced cardiovascular risk.

Linoleic acid (LA) is the main omega-6 fatty acid in foods, accounting for 85 percent to 90 percent of the dietary omega-6 PUFA.

There has been some debate within the nutrition community regarding the benefits of omega-6 based on the belief that they may promote inflammation, thus increasing cardiovascular risk. “That idea is based more on assumptions and extrapolations than on hard data,” said Harris, a research professor for the Sanford School of Medicine at the University of South Dakota and director of the Metabolism and Nutrition Research Center at Sanford Research/USD

The linking of omega-6 intake to inflammation stems from the fact that arachidonic acid (AA), which can be formed from LA, is involved in the early stages of inflammation. However, the advisory explains that AA and LA also give rise to anti-inflammatory molecules.

For example, in the cells that form the lining of blood vessels, omega-6 PUFA have anti-inflammatory properties, suppressing the production of adhesion molecules, chemokines and interleukins – all of which are key mediators of the atherosclerotic process. “Thus, it is incorrect to view the omega-6 fatty acids as ‘pro-inflammatory,’” Harris explained. “Eating less LA will not lower tissue levels of AA (the usual rationale for reducing LA intakes) because the body tightly regulates the synthesis of AA from LA.”

The advisory reviewed a meta-analysis of randomized, controlled trials, and more than two dozen observational, cohort, case/control and ecological reports.

Observational studies showed that people who ate the most omega-6 fatty acids usually had the least heart disease. Other studies examined blood levels of omega-6 in heart patients compared with healthy people and found that patients with heart disease had lower levels of omega-6 in their blood.

In controlled trials in which researchers randomly assigned people to consume diets containing high versus low levels of omega-6 and then recorded the number of heart attacks over several years, those assigned to the higher omega-6 diets had less heart disease.

A meta-analysis of several trials indicated that replacing saturated fats with PUFA lowered risk for heart disease events by 24 percent. “When saturated fat in the diet is replaced by omega-6 PUFA, the blood cholesterol levels go down,” Harris said. “This may be part of the reason why higher omega-6 diets are heart-healthy.”

Co-authors are: Dariush Mozaffarian, M.D.; Eric Rimm, D.Sc.; Penny Kris-Etherton, Ph.D.; Lawrence Rudel, Ph.D.; Lawrence Appel, M.D.; Marguerite Engler, Ph.D.; Mary Engler, Ph.D.; and Frank Sacks, M.D. Author disclosures are on the manuscript.

For more on good fats vs. bad fats, visit AmericanHeart.org/FacetheFats.

The American Heart Association receives funding primarily from individuals, foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are disclosed at www.americanheart.org/corporatefunding.


International Components Corporation (ICC), an established global leader in designing and manufacturing portable rechargeable systems, has released a compact 150-watt AC/DC external power supply for medical applications.

Marketed under the Elpac Power Systems brand, the MWA150 series features best-in-class performance at 5.5 watts per cubic inch power density and converter efficiencies between 90% and 94%. This very high efficiency reduces component temperature which results in a lifetime expectation of more than 5 years at maximum load.

The MWA150 features a hold-up time of more than 25ms at full load and minimum input voltage. Unlike many other products in this category the MWA150 will ride through full cycle line voltage dropouts without depending on a charged back-up battery in the end system.

Expanding upon the success of the MWA100 series, the MWA150 is in a power range suited for high-reliability medical device designs that demand power beyond the 100-watt range and require compliance with stringent, global medical safety standards. With a 180-watt peak rating available under all conditions, this high performance series is especially well suited for electromechanical applications.

The power supply has a universal AC input (85 – 264 VAC) with active PFC to meet EN61000-3-2, -3 and a single output of 12, 15, 18, or 24 VDC. It is offered in a compact frame of 191.98 x 62.16 x 38.65mm (7.56 x 2.45 x 1.52 inches). This unit also offers over-temperature, over-voltage, and over-current protection as standard features and features very low output noise to accommodate noise-sensitive applications … all backed by ICC’s industry-leading 5-year limited warranty.

The MWA150 series features an Energy Star Level V efficiency rating with more than 90% efficiency in active mode and a no load power consumption of less than 0.4W. This series also meets CE, EN, and IEC standards and can be designed to meet non-standard output voltage and connectivity requirements. ICC can also design a 100-percent custom solution to meet specific OEM requirements and private label markings.

The MWA150 is competitively priced at $61.96 in OEM quantities of 1,000 and models are available to ship today. Our full warranty policy and datasheets with complete technical specifications for the MWA150 and MWA100 series can be found 24/7 at http://www.iccus.com/.


Categories

Archives

Blogroll

Meta