Color Me Non-Adherent

 

Photo by Sage Ross (ragesoss.com), from Wikimedia Commons. Creative Commons Attribution-Share Alike 3.0 Unported.

# 6814

 

 

A fascinating bit of research, published yesterday in JAMA Internal Medicine, looks at the effects of generic pill appearance on how dutifully patients will continue to take their medications.

 

While generic drugs must meet strict standards as far as their active ingredients, they often are of a different color, size, or shape than their `brand name’ equivalents.

 

As it turns out, patients in this study were far less likely to refill, and take, dissimilar looking generic drugs, than they were the brand name drug.

 

First a link to the abstract (the full article is behind a pay wall), then some excerpts from the press release, after which I’ll return with a little more.

 

Original Investigation | ONLINE FIRST

Variations in Pill Appearance of Antiepileptic Drugs and the Risk of Nonadherence

Aaron S. Kesselheim, MD, JD, MPH; Alexander S. Misono, MD, MBA; William H. Shrank, MD, MSHS; Jeremy A. Greene, MD, PhD; Michael Doherty; Jerry Avorn, MD; Niteesh K. Choudhry, MD, PhD

Arch Intern Med. 2012;():1-7. doi:10.1001/2013.jamainternmed.997.

Background

Generic prescription drugs are bioequivalent to brand-name versions but may not have consistent color or shape, which can cause confusion and lead to interruptions in medication use. We sought to determine whether switching among different-appearing antiepileptic drugs (AEDs) is associated with increased rates of medication nonpersistence, which can have serious medical, financial, and social consequences.

<SNIP>

Conclusions 

Changes in pill color significantly increase the odds of nonpersistence; this may have important clinical implications. Our study supports a reconsideration of current regulatory policy that permits wide variation in the appearance of bioequivalent drugs.

 

And the press release from Brigham and Women's Hospital.

 

Differences in generic pill characteristics may lead to interruptions in essential medication use

Changes in pill appearance significantly increase the odds that patients will stop taking their drugs as prescribed

Boston, MA—Generic medications currently account for over 70 percent of prescriptions dispensed. However, while generic drugs are clinically bioequivalent to the brand-name version, they often differ in their physical characteristics, such as color and shape. Researchers from Brigham and Women's Hospital (BWH) have found that some patients who receive generic drugs that vary in their color are over 50 percent more likely to stop taking the drug, leading to potentially important and potentially adverse clinical effects.

 

The study will be published electronically on December 31, 2012 in the Archives of Internal Medicine.

 

"Pill appearance has long been suspected to be linked to medication adherence, yet this is the first empirical analysis that we know of that directly links pills' physical characteristics to patients' adherence behavior," explained Aaron S. Kesselheim MD, JD, MPH, assistant professor of medicine in the Division of Pharmacoepidemiology and Pharmacoeconomics at BWH, and principal investigator of this study. "We found that changes in pill color significantly increase the odds that patients will stop taking their drugs as prescribed."

 

The researchers conducted a case-control study of patients taking antiepileptic drugs and compared the odds that patients who did not refill their medication had been given pills that differed in color or shape from the prior prescriptions. Using a large national database of filled prescriptions, when the researchers identified a break in the patient's use of the drug, they looked at the previous two prescription fillings to see if they were the same color and shape. They found that interruptions in the prescription filling occurred significantly more frequently when the pills had different color. Interruptions in antiepileptic drug use for even a few days can raise the risk of seizure and have important medical and social consequences for patients.

 

(Continue . . . )

 

 

Somewhat connected to all of this are studies that have shown that the color, size, and shape of a pill (including placebos) has an effect on the the patient’s perception of how well they work.

 

In a 1996 edition of the BMJ, we find:

 

Effect of colour of drugs: systematic review of perceived effect of drugs and of their effectiveness.

A. J. de Craen, P. J. Roos, A. Leonard de Vries, and J. Kleijnen

 

RESULTS: The studies on perceived action of coloured drugs showed that red, yellow, and orange are associated with a stimulant effect, while blue and green are related to a tranquillising effect. The trials that assessed the impact of the colour of drugs on their effectiveness showed inconsistent differences between colours. The quality of the methods of these trials was variable. Hypnotic, sedative, and anxiolytic drugs were more likely than antidepressants to be green, blue, or purple.

CONCLUSIONS: Colours affect the perceived action of a drug and seem to influence the effectiveness of a drug. Moreover, a relation exists between the colouring of drugs that affect the central nervous system and the indications for which they are used. Research contributing to a better understanding of the effect of the colour of drugs is warranted.

  

Other research has shown that – with placebos – shots are deemed more effective than oral drugs, and capsules are perceived as being more effective than pills.

 

From a much earlier study, we get an idea of the pre-conceived notions that many patients have regarding pill color:

 

Percept Mot Skills. 1979 Oct;49(2):367-72.

Classification of placebo drugs: effect of color.

Jacobs KW, Nordan FM.

Abstract

To study the role of color in the pscyhological effects of placebo drugs, 100 subjects were asked to place each of six different colored capsules into one of three classifications of drug effects. Results indicate that red and yellow placebos are classified as stimulants while blue placebos are classified as depressants.

 

While the color of a pill may seem irrelevant to many people, the non-adherence of patients to their prescribed medications costs the health care system hundreds of billions of dollars each year.

 

NEHI Research Shows Patient Medication Nonadherence Costs Health Care System $290 Billion Annually

August 11, 2009

CAMBRIDGE, MA – The New England Healthcare Institute (NEHI) today released new research showing that patients who do not take their medications as prescribed by their doctors cost the U.S. health care system an estimated $290 billion in avoidable medical spending every year. NEHI, a nonprofit health policy organization, recommends four key actions that can best improve medication adherence.

 

Given the human, and economic costs of non-adherent patients, there may very well be substantial benefits to applying `pill psychology’ to generic prescription drug design.

»» Read More

Referral: McKenna On Resistant Gonorrhea

 

Credit CDC

 

# 6487

 

A topic that Maryn McKenna and I have both blogged about at length over the past year – Increasingly Drug Resistant Gonorrhea - was the subject of a major announcement out of the CDC yesterday.

 

In the wake of rising treatment failures with the existing treatment protocol, Thursday’s MMWR contained new guidelines on the treatment of gonorrhea, making the oral antibiotic cefixamine no longer the first line drug of choice, and substituting injectable ceftriaxone along with oral doses of either azithromycin or doxycycline.

 

 

Last night, Maryn McKenna – Flublogia’s expert in all things antibiotic resistant  - wrote about this bulletin in her SUPERBUG BLOG, and so I would invite you to jump  over to her site to read:

 

Resistant Gonorrhea: CDC Says Just One Drug Left

• By Maryn McKenna 
• August 9, 2012 | 

 

This problem extends far beyond the growing incidence of resistant Neisseria gonorrhoeae. You’ll find Maryn’s 2010 book Superbug: The Fatal Menace of MRSA serves as a terrific wakeup call and primer covering a wide range of these resistance issues. 

 

We’ve known this day was coming, of course. Over the past year I’ve written about the warning signs in:

 

ECDC Response Plan To Multi-Drug Resistant Gonorrhea

WHO: Urgent Action Needed On Resistant Gonorrhea

CDC Grand Rounds: Multidrug-Resistant Gonorrhea

Going, Going, Gonorrhea

The Path Of Increased Resistance

 

 

History has taught us – that given enough time – bacterial pathogens often manage to evolve resistance to whatever antibiotics we use against them.

 

With few new classes of antimicrobials in the developmental pipeline, the fear is that a few years down the road, our ability to treat even the simplest of infections may be compromised.

 

Director-General Margaret Chan of the WHO warned earlier this year during a keynote address to the Conference on Combating Antimicrobial Resistance in  Copenhagen, Denmark that our World Faces A `Post-Antibiotic Era’.

 

The D-G’s entire remarks may be viewed on the WHO’s website at Antimicrobial resistance in the European Union and the world, but I’ve excerpted a few choice statements below, after which you’ll find a link to the World Health Organization’s latest publication on antibiotic resistance.

 

Excerpts from D-G Chan’s March 14th, 2012 speech.

 

If current trends continue unabated, the future is easy to predict. Some experts say we are moving back to the pre-antibiotic era. No. This will be a post-antibiotic era. In terms of new replacement antibiotics, the pipeline is virtually dry, especially for gram-negative bacteria. The cupboard is nearly bare.

<SNIP>

 

A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill.

 

The World Health Organization recently released a 120 page book that provides options and strategies for combating this global threat.

 

The evolving threat of antimicrobial resistance - Options for action

Authors:
World Health Organization

Publication details

Number of pages: 120
Publication date: 2012
Languages: English
ISBN: 978 92 4 1503181

»» Read More

CDC Grand Rounds: Multidrug-Resistant Gonorrhea

 

 

# 6328

 

 

As I’ve mentioned previously, once a month the CDC  presents a Public Health Grand Rounds webcast, that focuses on a single public health issue. In April of last year I gave considerable blog space to CDC Grand Rounds: Sodium Reduction. 

 

Later today (1 pm EDT) the CDC will live stream their latest Grand Rounds presentation, this time on the growing threat of multi-drug resistant gonorrhea.

 

Tuesday, May 15, 2012 1 p.m. – 2 p.m., EDT

Watch live webcast

 

 

 

This is a subject that both Maryn McKenna (see Drug-Resistant Gonorrhea: How We Lost Track and The Clap Came Back: Multidrug-Resistant Gonorrhea) and I have written about in the past.

 

A couple of my offerings include:

 

The Path Of Increased Resistance

True in the 1940s, but sadly, no longer the case – Photo Credit scdhec.gov

 

and . . .

Going, Going, Gonorrhea

 

 

Here is the CDC’s announcement for today’s Grand Rounds:

 

 

Public Health Grand Rounds

 The Growing Threat of Multidrug-Resistant Gonorrhea

This session of Grand Rounds will explore the development of antibiotic resistance in Neisseria gonorrhoeae as a growing public health concern because the United States gonorrhea control strategy relies on effective antibiotic therapy. Since antibiotics were first used for treatment of gonorrhea, N. gonorrhoeae has progressively developed resistance to the antibiotic drugs prescribed to treat it: sulfonilamides, penicillin, tetracycline, and ciprofloxacin. Currently, CDC STD treatment guidelines recommend dual therapy with a cephalosporin antibiotic (ceftriaxone is preferred) and either azithromycin or doxycycline to treat all uncomplicated gonococcal infections among adults and adolescents in the United States.

 

Given the ability of N. gonorrhoeae to develop antibiotic resistance, it is critical to continuously monitor gonococcal antibiotic resistance and encourage research and development of new treatment regimens for gonorrhea.

(Continue . . . )

 

 

Today’s presenters include:

 

Edward Hook III, MD
Professor of Medicine and Epidemiology
University of Alabama, Birmingham

William Shafer, PhD
Professor of Microbiology and Immunology
Emory University

Carolyn Deal, PhD
Chief, Sexually Transmitted Diseases Branch
National Institute of Allergy and Infectious Diseases
National Institutes of Health

Robert D. Kirkcaldy, MD, MPH
Medical Officer
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

 

 

If you miss the live broadcast, you’ll be able to view this latest Grand Rounds presentation on the CDC’s Streaming Health Youtube Channel in about 48 hours.

»» Read More

Turn In Your Old Rx Drugs Today

 

 

# 6301

 

Millions of medicine cabinets around the country are filled with unused, expired, and potentially dangerous prescription drugs that – for a variety of reasons – never get taken by the person for whom they were intended.

 

Often a doctor changes a prescription, or a patient doesn’t finish their meds.  Sometimes a patient dies with a medicine cabinet full of pills.

 

Whatever the reason, these drugs pose a serious threat, both to people, and to the environment. 

 

 

Too often, they end up flushed down the drain, or tossed into the trash, only to end up in rivers and streams. Or worse, they can end up in the hands of the wrong persons, and are used recreationally – particularly by teenagers.

 

For many, the dilemma is how to properly dispose of these pills. To this end, the National Take Back Initiative was created by the DEA, in conjunction local law enforcement agencies, to provide a safe – no question’s asked - place to take these drugs.

 

Today (April 28th), there will be thousands of drop-off points set up around the country where you can take these drugs.

 

 

You’ll find handy links for a search engine that will provide you with local drop off locations around the country.

 

NATIONAL TAKE-BACK INITIATIVE

April 28, 2012
10:00 AM - 2:00 PM

The Drug Enforcement Administration (DEA) has scheduled another National Prescription Drug Take-Back Day which will take place on Saturday, April 28, 2012, from 10:00 a.m. to 2:00 p.m.  This is a great opportunity for those who missed the previous events, or who have subsequently accumulated unwanted, unused prescription drugs, to safely dispose of those medications.

Americans that participated in the DEA’s third National Prescription Drug Take-Back Day on October 29, 2011, turned in more than 377,086 pounds (188.5 tons) of unwanted or expired medications for safe and proper disposal at the 5,327 take-back sites that were available in all 50 states and U.S. territories. When the results of the three prior Take-Back Days are combined, the DEA, and its state, local, and tribal law-enforcement and community partners have removed 995,185 pounds (498.5 tons) of medication from circulation in the past 13 months.

“The amount of prescription drugs turned in by the American public during the past three Take-Back Day events speaks volumes about the need to develop a convenient way to rid homes of unwanted or expired prescription drugs,” said DEA Administrator Michele M. Leonhart. “DEA remains hard at work to establish just such a drug disposal process, and will continue to offer take-back opportunities until the proper regulations are in place.”

“With the continued support and hard work of our more than 3,945 state, local, and tribal law enforcement and community partners, these three events have dramatically reduced the risk of prescription drug diversion and abuse, and increased awareness of this critical public health issue,” said Leonhart.

Collection Site Locator:

Find a collection site near you. Check back frequently as collection sites are continuously being added.

»» Read More

National Take Back Initiative - April 28th

 

 

# 6265

 

 

Every year millions of pills are dispensed in the United States that – for a variety of reasons – never get taken by the person for whom they were intended.

 

Sometimes a doctor changes a prescription, or a patient simply doesn’t take their meds.  Often a patient dies with a medicine cabinet full of pills.

 

Whatever the reason, these drugs pose a serious threat, both to people, and to the environment. 

 

Too often, they end up flushed down the drain, or tossed into the trash, only to end up in rivers and streams.

 

Sometimes they end up in the hands of the wrong persons, and are used recreationally – particularly by teenagers.

 

And for those considering hanging on to these meds `just in case’, you should be aware that most drugs will lose potency over time, and a few can even become toxic with age.

 

 

For many, the dilemma is how to properly dispose of these pills. To this end, the National Take Back Initiative was created by the DEA, in conjunction local law enforcement agencies, to provide a safe place to take these drugs.

 

This from the DEA division of the DOJ.

 

You’ll find handy links for a search engine that will provide you with local drop off locations around the country.

 

NATIONAL TAKE-BACK INITIATIVE

April 28, 2012
10:00 AM - 2:00 PM

The Drug Enforcement Administration (DEA) has scheduled another National Prescription Drug Take-Back Day which will take place on Saturday, April 28, 2012, from 10:00 a.m. to 2:00 p.m.  This is a great opportunity for those who missed the previous events, or who have subsequently accumulated unwanted, unused prescription drugs, to safely dispose of those medications.

 

Americans that participated in the DEA’s third National Prescription Drug Take-Back Day on October 29, 2011, turned in more than 377,086 pounds (188.5 tons) of unwanted or expired medications for safe and proper disposal at the 5,327 take-back sites that were available in all 50 states and U.S. territories. When the results of the three prior Take-Back Days are combined, the DEA, and its state, local, and tribal law-enforcement and community partners have removed 995,185 pounds (498.5 tons) of medication from circulation in the past 13 months.

 

“The amount of prescription drugs turned in by the American public during the past three Take-Back Day events speaks volumes about the need to develop a convenient way to rid homes of unwanted or expired prescription drugs,” said DEA Administrator Michele M. Leonhart. “DEA remains hard at work to establish just such a drug disposal process, and will continue to offer take-back opportunities until the proper regulations are in place.”

 

“With the continued support and hard work of our more than 3,945 state, local, and tribal law enforcement and community partners, these three events have dramatically reduced the risk of prescription drug diversion and abuse, and increased awareness of this critical public health issue,” said Leonhart.

 

Collection Site Locator:

Find a collection site near you. Check back frequently as collection sites are continuously being added.

»» Read More

A Prescription For Disasters

 

 

 

# 5787

 

 

Photo Credit – Wikipedia Commons

 

I’ve written before of my visit to New Orleans five weeks after Katrina struck to help my twin brother retrieve what belongings we could from his French Quarter apartment.  

 

While we were in town one of his planned tasks was to get refills on his prescriptions from his local pharmacy.  But 5 weeks after the storm, his Mom & Pop pharmacy was still shuttered and vacant.

 

Like thousands of others post-Katrina, he was in a bind.

 

He had no way of contacting his doctor, no way to prove he had refills left at his pharmacy, and would be forced to find a new doctor and schedule an appointment in order to get new prescriptions.

 

For my brother, it wasn’t a life or death situation.  But for many others, daily medications are literally a matter of survival. 

 

Maintaining an adequate supply of essential prescription medication in your emergency kit, along with copies of your prescriptions, is an important part of individual and family preparedness.

 

Most doctors will gladly write an extra 14 or 30 day `disaster stash’ script for your most vital medications if you express your concern, and the AMA endorsed this idea several years ago (see AMA Now Supports Personal Rx Stockpiling For Disasters).

 

Depending upon your insurance coverage, you may have to pay for them out of pocket, but it certainly beats the alternative.

 

And if you do obtain a disaster stash, make sure to use and rotate those meds before they expire.

 

FEMA has long recommended that those with special needs make special preparations.

 

Considerations for people responsible for disabled individuals:

• For those on respirators or other electric-powered medical equipment, make prior arrangements with your physician or check with your oxygen supplier about emergency plans, and be sure to have electrical back-up for any medical equipment.
• Maintain a two-week supply of items such as dressings, nasal cannulas and suction catheters.
• Maintain a two-week supply of both prescription and non-prescription medications.
• Keep copies of your medical records.
• Keep copies of prescriptions for medical equipment, supplies and medications.
• Keep extra contact lenses and supplies, extra eyeglasses and extra batteries for hearing aids.
• Make plans now to have accessible transportation in case of evacuation.
• Shelters may be limited in accommodations to meet some of the needs of those with disabilities. Prepare ahead of time to ensure you will have what you need.

 

There are federal  programs designed to assist those in a federally declared disaster zone with their emergency prescription needs.  It is called EPAP or Emergency Prescription Assistance Program.

The goals of EPAP are to:

• Ensure access to covered prescription drugs and DME for eligible individuals who present at a pharmacy with a valid prescription, at no cost to the affected individual.
• Implement real-time point-of-sale eligibility checks and system edits for claims where the pharmacist has found no other coverage to limit dispensing of EPAP covered drugs and DME to eligible individuals.
• Facilitate legitimate pharmacy claims from new pharmacy locations and other out of network pharmacies on an as-needed basis.

 

But of course, you’ll need to be able to prove you are eligible and that you have a valid prescription (see Eligibility Information Sheet For Emergency Prescription Assistance Program (EPAP)).

 

And depending upon the size and scope of the disaster, there could be delays in getting your prescriptions processed. 

 

So having an extra supply on hand is still important.

 

As is knowing what to do if your prescriptions are damaged in a disaster.   Here, the FDA offers some advice.

 

Safe Drug Use After a Natural Disaster

The Center for Drug Evaluation and Research (CDER) at the FDA offers the following information on the use of drugs that have been potentially affected by fire, flooding or unsafe water and the use of temperature-sensitive drug products when refrigeration is temporarily unavailable.

(Continue . . . )

 

 

And on a related subject, everyone should have a readily available (preferably carried in your wallet or purse), EMERGENCY medical history.

 

I addressed that issue in a blog called Those Who Forget Their History . . . .   A few excerpts (but follow the link to read the whole thing):

 

Since you can’t always know, in advance, when you might need medical care it is important to carry with you some kind of medical history at all times.  It can tell doctors important information about your history, medications, and allergies when you can’t.

 

Many hospitals and pharmacies provide – either free, or for a very nominal sum – folding wallet medical history forms with a plastic sleeve to protect them.

 

I’ve scanned the one offered by one of our local hospitals below. It is rudimentary, but covers the basics.

In a medical emergency, minutes can make the difference between life and death.  And even in less urgent cases, having all of this information can go a long ways towards speeding your treatment.

 

 

While disasters like hurricanes, floods, and earthquakes are never pleasant experiences, the things we do in advance of them can make the difference between being inconvenienced and uncomfortable, and being irreparably harmed.

 

Those with special medical needs are all the more vulnerable during a disaster, and so extra preparations are warranted.

»» Read More

PNAS: Challenging Drug Resistance Conventional Wisdom

 

 

# 5641

 

 

 

Proving you should never judge a study by it’s title, today we’ve an absolutely intriguing article that appears in today’s early edition of PNAS (Proceedings of the National Academy of Sciences) called:

 

The evolution of drug resistance and the curious orthodoxy of aggressive chemotherapy

Andrew F. Reada, Troy Dayc, and Silvie Huijbena

 

The authors – using malarial resistance as an example – suggest that some of the tactics used today to try to conserve the effectiveness of our drug arsenal may actually be driving the evolution of resistant pathogens.

 

In this article they question several conventional treatment wisdoms including:

 

• whether the standard advice -  that patients must `finish a drug course even after they feel better’ – is always the best strategy to prevent the creation of resistant organisms.
• whether it is always necessary (or even desirable) to hit an infection hard and fast with mono or combo therapy in order to effect a cure.

 

Heresy?

 

Perhaps.

 

But these authors are not advocating that we suddenly abandon our current antibiotic and drug strategies, only that we need to examine them closely to see if, and when, they really make sense.

 

And they suggest that what is appropriate for one type of pathogen, or in one part of the world at a given point in time, may not be the best course for another.

 

While they present a lot of detail (you are going to want to read the entire 7-page article), the basic premise is pretty simple. 

 

Resistant organisms are generally believed to be less biologically fit than their wild type ancestors, which is why we aren’t (yet, anyway) hip deep in resistant organisms.

 

As long as they share a host with a more `fit’ and competitive strain, they are rarely able to establish a toehold and proliferate.

 
But when you start applying heavy drug therapy, killing off only the drug sensitive strains, that small population of resistant pathogens can suddenly swell.

 

It’s almost a Nietzschian concept, really.  

 

Whatever doesn’t completely kill off a pathogen, makes the resistant strains stronger.

 

 

Of course, the issues are a great deal more complicated than I’ve outlined here. Rather than go in greater detail, I’ll simply suggest you read the article in its entirety.

 

The authors suggest that these concepts could apply across a wide range of resistance issues; everything from bacteria, parasites, and viruses to insecticide and cancer chemotherapy resistance. 

 

 

This article is one of many printed this week that results from:

 

. . . the Arthur M. Sackler Colloquium of the National Academy of Sciences, “In the Light of Evolution V: Cooperation and Conflict,” which was held January 7–8, 2011, at the Arnold and Mabel Beckman Center of the National Academies of Sciences and Engineering in Irvine, CA.

The complete program and audio files of most presentations are available on the NAS Web site at www.nasonline.org/SACKLER_cooperation.

»» Read More

National Take Back Initiative

 

 

 

 

 

# 5524

 

Every year millions of pills are dispensed in the United States that – for a variety of reasons – never get taken by the person for whom they were intended.

Sometimes a doctor changes a prescription, or a patient simply doesn’t take their meds.  Often a patient dies with a medicine cabinet full of pills.  

 

Whatever the reason, these drugs pose a serious threat, both to people, and to the environment. 

 

Too often, they end up flushed down the drain, or tossed into the trash, only to end up in rivers and streams.

 

Sometimes they end up in the hands of the wrong persons, and are used recreationally – particularly by teenagers.

 

 

For many, the dilemma is how to properly dispose of these pills.   To this end, the National Take Back Initiative was created by the DEA, in conjunction local law enforcement agencies, to provide a safe place to take these drugs.

 

This from the DEA division of the DOJ.

 

You’ll find handy links for a search engine that will provide you with local drop off locations around the country.

 

 

NATIONAL TAKE BACK INITIATIVE

APRIL 30, 2011
10:00 AM - 2:00 PM

Find a collection site near you

This initiative addresses a vital public safety and public health issue.  More than seven million Americans currently abuse prescription drugs, according to the 2009 Substance Abuse and Mental Health Administration’s National Survey on Drug Use and Health.  Each day, approximately, 2,500 teens use prescription drugs to get high for the first time according to the Partnership for a Drug Free America.  Studies show that a majority of abused prescription drugs are obtained from family and friends, including the home medicine cabinet.

 

In an effort to address this problem, DEA, in conjunction with state and local law enforcement agencies throughout the United States, conducted the first ever National Prescription Drug Take Back Day on Saturday, September 25, 2010.  The purpose of this National Take Back Day was to provide a venue for persons who wanted to dispose of unwanted and unused prescription drugs.  This effort was a huge success in removing potentially dangerous prescription drugs, particularly controlled substances, from our nation’s medicine cabinets.  There were approximately 3,000 state and local law enforcement agencies throughout the nation that participated in the event.  All told, the American Public turned in more than 121 tons of pills on this first National Take Back Day.

 

Due to the overwhelming success of the first event, DEA has scheduled the second National Prescription Drug Take Back Day which will take place on Saturday, April 30, 2011, from 10:00 am - 2:00 pm.  This is a great opportunity for those who missed the first event or who have subsequently accumulated unwanted, unused prescription drugs, to safely dispose of them.

Find a collection site near you

 

 

As a final note, for anyone thinking about hanging on to these medications for `a rainy day’, many lose potency over time – and worse – a few can become toxic with age.

 

Better to turn them in, and let the experts deal with their disposal, than to risk using them or having them fall into the wrong hands.

 

Today is a good day to go through your medicine cabinet in anticipation of Saturday’s event. 

»» Read More

WHO: Global Report On Antimalarial Efficacy And Drug Resistance

 

 

# 5067

 

 

The World Health Organization today has released a new report on the drugs used to treat malaria, along with an appeal to nations to monitor and report any emergence of malarial drug resistance.

 

Roughly half the world’s population lives in areas where they risk infection from the malaria parasite.

 

Each year, roughly 250 million people are infected, and nearly a million people die from the disease  (source WHO 10 Facts on Malaria).

 

CDC Malaria Map.

Map Legend:

 

Over the past couple of years, a new artemisinin resistant form of malaria has appeared along the Cambodian-Thailand border, prompting concerns that it could spread.  

 

Hence the call for heightened monitoring and urgent requests that nations halt the use of oral artemisinin alone for the treatment of uncomplicated falciparum malaria, and use it as part of a drug cocktail instead.   

First the news release, then a link to the report.

 

News release

 

WHO calls on malaria-endemic countries to strengthen monitoring of antimalarial drug efficacy

National monitoring essential step in preventing the emergence of malaria drug resistance

18 NOVEMBER 2010 | GENEVA -- WHO is calling on countries to be increasingly vigilant in monitoring antimalarial drug efficacy in order to allow for early detection of artemisinin resistance.¹ This is one among several conclusions of the Global report on antimalarial drug efficacy and drug resistance: 2000–2010, released today. The report is based on 1100 studies conducted by national malaria control programs and research institutes over the ten-year period.

 

The report estimates that only 34% of malaria-endemic countries are complying with WHO recommendations to routinely monitor the efficacy of first- and second-line antimalarial medicines.²

"A greater political commitment to support and sustain national monitoring of the efficacy of antimalarial medicines is critical to prevent a wider emergence of artemisinin resistance", said Dr Pascal Ringwald of the Drug Resistance and Containment Unit, within WHO's Global Malaria Programme and one of the report authors.

Resistance to artemisinin

In February 2009, WHO confirmed that resistance to artemisinin had emerged on the Cambodia-Thailand border. Although patients infected were cured following treatment with an artemisinin-based combination therapy (ACT), the recovery took more time. In artemisinin-resistant areas, the high cure rates observed depend heavily on the efficacy of the non-artemisinin component of the combination.

 

Nonetheless, the report found that ACTs currently recommended by national malaria control programmes remain efficacious in treating malaria, with cure rates generally greater than 90%. In countries where the currently recommended ACT has a cure rate of less than 90%, policy change is ongoing to implement an efficacious replacement treatments for malaria.

 

"The emergence of artemisinin resistance on the Cambodia-Thailand border has been a wake-up call to the world to prevent its spread, increase monitoring, and preserve ACTs as the only effective treatment we have for falciparum malaria", said Dr Robert Newman, Director of WHO's Global Malaria Programme. "Prompt action will be critical to sustain progress in malaria control and achieve the health-related Millennium Development Goals."

 

(Continue . . .)

 

Global report on antimalarial efficacy and drug resistance: 2000-2010

Authors: WHO
Publication date: 2010
Languages: English
ISBN: 9789241500470

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Overview

This report provides a comprehensive, global overview of antimalarial drug efficacy and the resistance of malaria parasites to the antimalarial medicines used between 2000 and June 2010. Policy-makers in national ministries of health will benefit from this document, as it provides both a global and a regional picture of the efficacy of the antimalarial medicines currently used in national treatment programmes. In addition, the report will be a reference for scientists, enhancing their understanding of the complexity of antimalarial drug resistance.

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Inappropriate Use Of OTC Medicines In Children

 

 

# 4850

 

 

From the International Pharmaceutical Federation’s (FIP) conference in Lisbon, Portugal (Aug 28th-Sept 2nd), an illuminating press release on a paper to be presented today on the widespread parental misuse of over-the-counter (OTC) medicines for children.

 

A research team led by Dr. Rebekah Moles of the University of Sydney, New South Wales, reports that the inappropriate use, and incorrect dosing of OTC meds lead to a large number of accidental drug poisonings each year.

 

Running through a  variety of scenarios, nearly 100 adult caregivers were asked to decide what OTC medicines were appropriate for a child given their symptoms, and asked to measure out an appropriate dose.

 

 

A brief excerpt from the press release outlining the abysmal results follows.  By all means, click the link to read it in its entirety.

 

 

Widespread parental misuse of medicines puts children at risk

(Excerpt)

Common OTC medicines were made available, together with different types of dosing devices, including household spoons. Participants then chose whether or not to give a medicine, at what stage, and at what dose. They were asked to measure the dose for the researchers. Because doses for children are often small, the risk of getting the measurement wrong is greatly increased, the researchers say.

 

"Taking all the scenarios together, 44% of participants would have given an incorrect dose, and only 64% were able to measure accurately the dose they intended to give. We found that 15% of participants would give a medicine without taking their child's temperature, and 55% would give medicine when the temperature was less than 38 degrees", said Dr. Moles. Paracetamol was the preferred treatment, even for coughs and cold, and was used most often – 61% of the time – despite the child having no fever. Only 14% of carers managed the fever scenario correctly.

(Continue . . .)

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