Colorado is joining about a dozen other states that are not requiring health insurance companies to revive canceled health plans.
No one mentioned cancellation notices. And no one expressed concerns about costs. Instead, at a sparsely attended public meeting about health insurance issues Tuesday evening, potential customers wanted to know if they could skip filling out Colorado’s complex Medicaid application.
Health exchange board members on Monday pressed for immediate improvements to Colorado’s mandatory Medicaid application, but state officials, who contend that Colorado is a “shining example” among the states, refused to promise that a full slate of short-term fixes will be completed before Dec. 15.
Colorado has no quick fix for a seemingly endless Medicaid application that health exchange board members believe is driving away customers and decreasing the number of people buying health insurance through Colorado’s new multi-million dollar health exchange.
In Choosing Wisely, physicians across the spectrum of medical specialties nationwide have created lists of procedures, tests and drug treatments that deserve second thoughts before doctors order them or patients accept them.
Tips for Preventing Adverse Drug Reactions
By Dr. Art Jones
You can hardly turn on a television these days without seeing commercials for the latest and greatest new drugs. Drug technology has advanced greatly, giving people the potential for healthier, more fulfilled lives.
This is particularly true for seniors, who tend to suffer disproportionally from some of the chronic diseases these drugs were designed to treat.
However, there can be too much of a good thing when it comes to medicine. With more drugs, there is more potential for drug interactions and adverse drug reactions, including everything from drowsiness and minor skin irritation to even fatal consequences.
In a worst case scenario, one medication is prescribed to treat the side effects of another and problems compound.
The use of multiple medicines by the same person at the same time is called polypharmacy. It’s an issue that is getting a great deal of attention from everybody in the health care industry, including doctors, pharmacists, patient care advocates and health benefits companies.
How Dangerous Is the Problem?
• There are 106,000 deaths each year due to adverse drug reactions, ranking it anywhere from fourth to sixth among the leading causes of death, according to the study “Adverse Drug Reactions in United States Hospitals.”
• Among hospitalized patients, adverse drug reactions cause one out of every five injuries or deaths per year, according to a Harvard Medical Practice study.
• Adverse drug reactions cost approximately $136 billion annually, which is more than the total costs of cardiovascular and diabetic care, according to a study on drug-related morbidity and mortality, according to a study published in the Journal of the American Pharmacists Association.[/sidebarContent]
Of course, most people take their medicines without incident. Nevertheless, it makes sense to take the following precautions to prevent polypharmacy.
? Make a list of every medication you take with dosage. It’s important to include over-the-counter drugs, herbal supplements and even vitamins. These can cause interactions, too, yet there is no record of them in your medical history. Share this list with family members who may act on your behalf. You might also want to keep this list, along with a list of drug allergies, in your purse or wallet.
?Communicate with your health care providers. When prescribed a new drug, make sure your doctor knows about your existing medications. Having a good relationship with your primary care physician is critical. Remember the doctor is there to help you. Don’t assume anything. Ask questions.
? Similarly, talk to your pharmacist about the drugs you’re taking. You may want to consider filling all your prescriptions at the same place, rather than moving them around, to ensure consistency. Health benefits companies are developing technologies that keep track of your entire health record, including prescriptions and tests, wherever you go. However, these technologies aren’t available in all areas.
? Participate in a review of your medications. This can be as informal as taking a paper bag of your medications to your doctor or having a more formal review with a clinician. Health benefits companies like Anthem Blue Cross and Blue Shield offer pharmacy reviews to their Medicare Part D members who are most at risk of developing adverse reactions, such as those who have multiple chronic illnesses and are taking multiple medications. These reviews are generally led by a medical professional and are free to the member. Be sure to take advantage of them if you qualify.
? Read and understand prescription drug labels and related materials. Over the years, the amount of paperwork people receive with their prescriptions has exploded. That’s actually a good thing. Read everything you’re given and make sure you understand it. Once again, ask if you have any questions.
? Take the medication that is prescribed at the prescribed dosage. One of the biggest triggers of adverse drug interactions is taking too much or too little of your prescription. There are a number of reasons for this, including everything from forgetting your medicine to being unable to afford it.
There are tools to address these issues. Those who take multiple medications may want to invest in a medication reminder box. Putting each day’s pills in the box will ensure they take the right drugs at the right dosages. It may also help to take the medication at the same time every day. Additionally, there are programs to address the affordability of drugs for those in need. Visit www.socialsecurity.gov/extrahelp or www.benefitscheckuprx.org for details.
? Pay attention to side effects. Don’t dismiss changes in your health or behavior. These could be signs of an adverse reaction. Listen to your friends and family members who may notice changes before you do.
? Don’t take someone else’s prescription. Doses are prescribed based on age, weight and condition, among other factors. Only a health care professional can determine the proper drug and dosage. So don’t risk it.
Your doctor has prescribed your medicine for a reason. By working closely with your physician and your pharmacist, taking the correct dosage at the right time, and educating yourself about possible side effects, you should be able to get that benefit while heading off any problems.
Dr. Art Jones is Anthem Blue Cross and Blue Shield’s medical director in Colorado.
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