This has nothing to do with Medication Adherence or Healthcare, but an email scam I discovered and am passing along, which could directly relate to how you pay for healthcare.
I have never been one to put too much trust in online banking, although I do pay some bills online ( for 8 months) and check my balance every few days (for 3 years). I find it very annoying and helpful at the same time. Today I got the following email from customers_department-num-996dvy@bankofamerica.com:
"Dear Bank of America customer,
Security and confidentiality are at the heart of the Bank of America. Your details (and your money) is protected by a number of technologies, including Secure Sockets Layer (SSL) encryption.
We would like to notify you that Bank of America carries out customer details confirmation procedure that is compulsory for all our customers. This procedure is attributed to a routine banking software update.
Please visit our Customer Verification Form using the link below and follow the instructions on the screen.
http://www9.bankofamerica.com/confirmdetails.jsp?site=25cydmOezksdDzrndydkcsdOkhb
Bank of America Customer Service"
Clicking on the link brought me to a very official looking B of A page that asked me to "Confirm your Bank of America credit/debit card details". It asked for my state, ATM or Credit Card Number, Exiration date, ATM or Credit Card PIN.
All very official looking as I stated (you can cut and paste if you want to check it out), except for the grammatical and spelling errors.
Interesting I thought. I do not have a personal B of A account, but we have a business account for BONDA Restaurant, which I co-own, and am a signatory but not the primary account holder. After looking at the page for 30 secs of so, I realized the email was send to an address I do not use for BONDA. Still strange, I thought, then I looked at the URL "www9.bankofamerica.com".
I can't remember the name of this type of URL, but I know it is some sort of scam.
The email has the B of A logo, and looks ligit. If I had a personal account, I might have have started to enter my info without really thinking, but most likely I would have taken a step back and asked why they would have wanted this information. I count myself somewhat savvy to the ways of scams, but I sometimes live in a bubble where I think I am immune to them.
Point being, this is a warning if anyone gets a similar email or would like to pass around the specifics to any B of A customers they know who might not have internet banking scams top of mind.
Thank you and beware!
Wednesday, August 6, 2008
Another Report On QuiqMeds
I feel like I am becoming a cheerleader or spokesperson for QuiqMeds, without even seeing it in action. In any case, I have nothing to do with the company, but I think it is a neat technology /device that allows for patients and caregivers to get their medications at the doctor's office and eliminate that step of going to the pharmacy.
As I can attest second hand, when my wife takes our kids to the pediatrician and gets a script, she doesn't go directly the pharmacy unless it is on her way home (which it is not). Even if she leaves the kids with the nanny and gets her own script from her MD, chances are it will sit in the car, her purse or drawer for at least two or three days.
With QuikMeds, the doctor can dispense medications from a machine with a few touches of a screen. I have some problems with this, but I assume that he company has already taken security, and compliance measures into account. My worries being the "freshness" of the medications, the waste of the medications not filled, the accuracy, etc... All the issues that arise without the human touch of a pharmacist - plus the trust that the medication is the proper medication.
Can I trust that the person who checked the machine and loaded the meds is not a junkie or thief who replaced all the narcotics with OTC generic headache pills? Maybe they do not even dispense these types of meds? That being said, I will check into the company and try to get a demonstration.
Here is a link to a short article and the video of a story that ran last week on CBS 3.
As I can attest second hand, when my wife takes our kids to the pediatrician and gets a script, she doesn't go directly the pharmacy unless it is on her way home (which it is not). Even if she leaves the kids with the nanny and gets her own script from her MD, chances are it will sit in the car, her purse or drawer for at least two or three days.
With QuikMeds, the doctor can dispense medications from a machine with a few touches of a screen. I have some problems with this, but I assume that he company has already taken security, and compliance measures into account. My worries being the "freshness" of the medications, the waste of the medications not filled, the accuracy, etc... All the issues that arise without the human touch of a pharmacist - plus the trust that the medication is the proper medication.
Can I trust that the person who checked the machine and loaded the meds is not a junkie or thief who replaced all the narcotics with OTC generic headache pills? Maybe they do not even dispense these types of meds? That being said, I will check into the company and try to get a demonstration.
Here is a link to a short article and the video of a story that ran last week on CBS 3.
Book Review of Improving Medication Adherence: How to Talk With Patients About Their Medications
I found a book review for "Improving Medication Adherence: How to Talk With Patients About Their Medications" on Psychiatry OnLine by Dr. Jeffrey Geller. Having never attended medical school, I just assumed medication adherence and how to speak with patients would be covered during one's studies. Maybe I am wrong.
From the review:
"Shawn Christopher Shea's book, Improving Medication Adherence: How to Talk With Patients About Their Medications, should be read by every medical student at the end of his or her first year of medical school and again at the end of his or her fourth year. If read anytime after that, I fear it just might be too late.
Shea's book is about how to approach patients sensitively and how to work with patients as partners in their health care. He chooses to focus on medication adherence, but the lessons could be generalized to almost every aspect of the doctor-patient relationship."
Here is the rest of the book review.
Enjoy!
From the review:
"Shawn Christopher Shea's book, Improving Medication Adherence: How to Talk With Patients About Their Medications, should be read by every medical student at the end of his or her first year of medical school and again at the end of his or her fourth year. If read anytime after that, I fear it just might be too late.
Shea's book is about how to approach patients sensitively and how to work with patients as partners in their health care. He chooses to focus on medication adherence, but the lessons could be generalized to almost every aspect of the doctor-patient relationship."
Here is the rest of the book review.
Enjoy!
Friday, August 1, 2008
A Video Game Improves Behavioral Outcomes in Adolescents and Young Adults With Cancer: A Randomized Trial
BONUS Medication adherence abstract! From the AAP:
OBJECTIVE.
Suboptimal adherence to self-administered medications is a common problem. The purpose of this study was to determine the effectiveness of a video-game intervention for improving adherence and other behavioral outcomes for adolescents and young adults with malignancies including acute leukemia, lymphoma, and soft-tissue sarcoma.
METHODS.
A randomized trial with baseline and 1- and 3-month assessments was conducted from 2004 to 2005 at 34 medical centers in the United States, Canada, and Australia. A total of 375 male and female patients who were 13 to 29 years old, had an initial or relapse diagnosis of a malignancy, and currently undergoing treatment and expected to continue treatment for at least 4 months from baseline assessment were randomly assigned to the intervention or control group.
The intervention was a video game that addressed issues of cancer treatment and care for teenagers and young adults. Outcome measures included adherence, self-efficacy, knowledge, control, stress, and quality of life. For patients who were prescribed prophylactic antibiotics, adherence to trimethoprim-sulfamethoxazole was tracked by electronic pill-monitoring devices (n = 200). Adherence to 6-mercaptopurine was assessed through serum metabolite assays (n = 54).
RESULTS.
Adherence to trimethoprim-sulfamethoxazole and 6-mercaptopurine was greater in the intervention group. Self-efficacy and knowledge also increased in the intervention group compared with the control group. The intervention did not affect self-report measures of adherence, stress, control, or quality of life.
CONCLUSIONS.
The video-game intervention significantly improved treatment adherence and indicators of cancer-related self-efficacy and knowledge in adolescents and young adults who were undergoing cancer therapy. The findings support current efforts to develop effective video-game interventions for education and training in health care.
OBJECTIVE.
Suboptimal adherence to self-administered medications is a common problem. The purpose of this study was to determine the effectiveness of a video-game intervention for improving adherence and other behavioral outcomes for adolescents and young adults with malignancies including acute leukemia, lymphoma, and soft-tissue sarcoma.
METHODS.
A randomized trial with baseline and 1- and 3-month assessments was conducted from 2004 to 2005 at 34 medical centers in the United States, Canada, and Australia. A total of 375 male and female patients who were 13 to 29 years old, had an initial or relapse diagnosis of a malignancy, and currently undergoing treatment and expected to continue treatment for at least 4 months from baseline assessment were randomly assigned to the intervention or control group.
The intervention was a video game that addressed issues of cancer treatment and care for teenagers and young adults. Outcome measures included adherence, self-efficacy, knowledge, control, stress, and quality of life. For patients who were prescribed prophylactic antibiotics, adherence to trimethoprim-sulfamethoxazole was tracked by electronic pill-monitoring devices (n = 200). Adherence to 6-mercaptopurine was assessed through serum metabolite assays (n = 54).
RESULTS.
Adherence to trimethoprim-sulfamethoxazole and 6-mercaptopurine was greater in the intervention group. Self-efficacy and knowledge also increased in the intervention group compared with the control group. The intervention did not affect self-report measures of adherence, stress, control, or quality of life.
CONCLUSIONS.
The video-game intervention significantly improved treatment adherence and indicators of cancer-related self-efficacy and knowledge in adolescents and young adults who were undergoing cancer therapy. The findings support current efforts to develop effective video-game interventions for education and training in health care.
Barriers to Medication Adherence in Poorly Controlled Diabetes Mellitus
Your daily dose of medication non-adherence abstract from Sage Journals.
Purpose
The purpose of this study is to characterize the adherence and medication management barriers for adults with poorly controlled type 2 diabetes mellitus (DM) (those with A1c 9% or above) and to identify specific adherence characteristics associated with poor diabetes control.
Methods
This was a cross-sectional analysis of baseline data from a randomized, controlled diabetes intervention conducted in University of Washington (UW) Medicine Clinics in the greater Seattle, Washington, area. The goal of the original study was to evaluate the effect of a pharmacist intervention on improving diabetes control over 12 months.
Evaluation measures for medication adherence included self-reported adherence and medication management challenges using the Morisky question format and difficulty with taking medications for each diabetes medication based on the Brief Medication Questionnaire. Specific adherence characteristics associated with poor diabetes control (A1c >9%) were identified using multivariate regression analysis.
Results
Seventy-seven subjects (mean A1c, 10.4%; mean duration of DM, 7 years) were studied. The most common adherence challenges included paying for medications (34%), remembering doses (31%), reading prescription labels (21%), and obtaining refills (21%). Taking more than 2 doses of DM medication daily (β = .78, SE = 0.32, P = .02) and difficulty reading the DM medication prescription label (β = .76, SE = 0.37, P = .04) were significantly associated with higher hemoglobin A1c. Self-reported adherence was not related to A1c control.
Conclusions
In this study, we identified 2 factors that were associated with poorer A1c control. These findings highlight the importance of identifying potential challenges to medication adherence for those with DM and providing support to minimize or resolve these barriers to control.
MY THOUGHTS
I am glad to see another study that supports cost and forgetfulness as the two major factors of medication non-adherence, but at the same time I am not glad to see it. I had an interesting thought the other day: with companies and health plans reducing and eliminating co-pays for generic medications for chronic diseases, and with pharmacos' PAPs, will this cost factor be eliminated in 10 years?
Most likely distribution and obtaining refills with then rise as factors, and forgetfulness is still #1 with 84% nationally. I have talked about a pharmacy system that will automatically send refills to patients, whether they trigger the refill or not. This eliminates some factors, but, this also has some problems. As one person who commented to a post last week, the way she takes her pills, she is on a 38 day schedule for a 30 day script - thus she would end up with extra pills every month.
As we all know, medication adherence is America's #1 Drug Problem that needs to be addressed by all stake holders. I will continue to report what I find in my research to explore how we can "fix" this issue.
Purpose
The purpose of this study is to characterize the adherence and medication management barriers for adults with poorly controlled type 2 diabetes mellitus (DM) (those with A1c 9% or above) and to identify specific adherence characteristics associated with poor diabetes control.
Methods
This was a cross-sectional analysis of baseline data from a randomized, controlled diabetes intervention conducted in University of Washington (UW) Medicine Clinics in the greater Seattle, Washington, area. The goal of the original study was to evaluate the effect of a pharmacist intervention on improving diabetes control over 12 months.
Evaluation measures for medication adherence included self-reported adherence and medication management challenges using the Morisky question format and difficulty with taking medications for each diabetes medication based on the Brief Medication Questionnaire. Specific adherence characteristics associated with poor diabetes control (A1c >9%) were identified using multivariate regression analysis.
Results
Seventy-seven subjects (mean A1c, 10.4%; mean duration of DM, 7 years) were studied. The most common adherence challenges included paying for medications (34%), remembering doses (31%), reading prescription labels (21%), and obtaining refills (21%). Taking more than 2 doses of DM medication daily (β = .78, SE = 0.32, P = .02) and difficulty reading the DM medication prescription label (β = .76, SE = 0.37, P = .04) were significantly associated with higher hemoglobin A1c. Self-reported adherence was not related to A1c control.
Conclusions
In this study, we identified 2 factors that were associated with poorer A1c control. These findings highlight the importance of identifying potential challenges to medication adherence for those with DM and providing support to minimize or resolve these barriers to control.
MY THOUGHTS
I am glad to see another study that supports cost and forgetfulness as the two major factors of medication non-adherence, but at the same time I am not glad to see it. I had an interesting thought the other day: with companies and health plans reducing and eliminating co-pays for generic medications for chronic diseases, and with pharmacos' PAPs, will this cost factor be eliminated in 10 years?
Most likely distribution and obtaining refills with then rise as factors, and forgetfulness is still #1 with 84% nationally. I have talked about a pharmacy system that will automatically send refills to patients, whether they trigger the refill or not. This eliminates some factors, but, this also has some problems. As one person who commented to a post last week, the way she takes her pills, she is on a 38 day schedule for a 30 day script - thus she would end up with extra pills every month.
As we all know, medication adherence is America's #1 Drug Problem that needs to be addressed by all stake holders. I will continue to report what I find in my research to explore how we can "fix" this issue.
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