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Prescription Solutions' Program Helps Prevent Adverse Drug Reactions, a Significant Health Hazard Especially for the Elderly

Posted on: Monday, 13 November 2006, 09:00 CST

IRVINE, Calif., Nov. 13 /PRNewswire/ -- Interventions by pharmacists at Prescription Solutions with physicians and patients have shown to resolve seven out of 10 situations in which patients are taking either a combination of medications or a specific medication that may increase the patient's risk for a dangerous adverse drug reaction (ADR). The results were revealed following completion of the specially designed clinical program implemented by Prescription Solutions, a pharmacy benefit management company with extensive experience in managing prescription medications, especially for seniors.

"The excessive or unnecessary use of medications, otherwise known as polypharmacy, is potentially dangerous because as people take more drugs, their risk for complications increases," said Edmund Pezalla, M.D., vice president and medical director for Prescription Solutions. "These complications can lead to illness, injury and hospitalization and can even be fatal."

Polypharmacy, which can lead to an ADR, is more likely to occur in the elderly, since they are more likely to be treated for multiple medical conditions and under the care of multiple physicians. A recent analysis by Prescription Solutions that examined seniors age 65 years or older over a three-month period showed that one in six patients had at least one polypharmacy event.(1) Sixty-one percent of older people seeing a physician are taking at least one prescription medication,(2) and most older Americans take an average of three to five medications.(3,4)

Prescription Solutions' polypharmacy intervention program was implemented in a large employee population and quickly identified approximately 3,000 members who were at risk for an ADR. The criteria for identifying members experiencing polypharmacy included:

-- Duplicate or overlapping therapy to treat the same disease or condition -- Concurrent use of interacting medications -- Use of a medication that interacts with a co-existing disease or condition -- Use of an inappropriate drug for the elderly -- Use of drug therapy to treat ADRs

By contacting physicians and patients to alert them to the situation as well as providing educational information about polypharmacy, Prescription Solutions' pharmacists were able to resolve incidents for about two-thirds of the individuals who were identified as at risk for a polypharmacy incident. For the other one-third of polypharmacy cases, neither the physician nor patient responded.

An analysis of the program's results revealed that 62 percent of identified polypharmacy cases were categorized as older adults using drugs not recommended for the elderly due to the increased potential for ADRs. Thirty percent of polypharmacy cases represented patients who had an increased risk for an ADR because they were using a medication that interacted negatively with one or more of their clinical conditions. For example, a patient with asthma and high blood pressure is prescribed a beta-blocker to reduce blood pressure. However, the beta-blocker also prevents widening of the airways in the lungs, which could worsen the asthma (having a negative effect). Fifteen percent were receiving medications with a known potential for interacting with other medications they were also taking. An example of this drug-drug interaction would be a patient with a lipid disorder (i.e., a disorder characterized by excessive fatty substances in the blood) being prescribed both a 'statin' medication and a 'fibrate' medication. Both drugs, when used together, increase the risk for kidney and multiple organ failure.

Medication misuse costs the health care system more than $177 billion and results in more than 200,000 deaths annually,(5) as reported in the Journal of the American Pharmaceutical Association. The Veterans Affairs medical system found that the potential for an ADR among more than 40,000 individuals studied was 6 percent when two drugs were taken, 50 percent when five drugs were taken and nearly 100 percent when eight or more drugs were taken.(6)

"By evaluating the patient's entire prescription medication regimen and notifying physicians and patients about potential problems by telephone or mail, or by alerting the pharmacist at the community or mail-service pharmacy in real-time when a prescription is being filled, we've demonstrated that we can work with physicians and patients to avoid therapies that could be harmful," noted Pezalla. "As a result, physicians have more complete information on their patients, patient safety is improved, and plan sponsors know that their health care dollars are being used cost-effectively and efficiently to promote optimal health for their members and employees."

For more information about Prescription Solutions' programs, call (888) 398-5189 or visit http://www.rxsolutions.com/.

About Prescription Solutions

Prescription Solutions is an innovative pharmacy benefit management company managing the prescription drug benefit of commercial, Medicare and governmental health plans, as well as those of employers and unions. Prescription Solutions serves members through state-of-the-art mail service pharmacy locations in Carlsbad, California and Overland Park, Kansas, as well as through a national network of 60,000 community pharmacies. Online information can be found at http://www.rxsolutions.com/.

(1) Huang, JY; Vanderplas, AM; Lew, KH. "Prevalence of Polypharmacy in the Elderly within a Managed Care Organization," Presented at the Academy of Managed Care Pharmacy 2006 Annual Meeting in Seattle, Wash., April 5-8, 2006. (2) Rathore, SS; Mehta, SS; Boyko, WL, Jr; Schulman, KA. "Prescription medication use in older Americans: a national report card on prescribing," Family Medicine 1998; 30:733-739. (3) Giron, MS; Wang, HX; Bernsten, C; Thorslund, M; Winblad, B; Fastbom, J. "The appropriateness of drug use in an older nondemented and demented population," Journal of the American Geriatrics Society 2001; 49:277-283. (4) American Society of Health-System Pharmacists. "Snapshot of medication use in the U.S.," ASHP Research Report December, 2000. (5) Ernst, FR; Grizzle, AJ. "Drug-Related Morbidity and Mortality: Updating the Cost-of-Illness Model," Journal of the American Pharmaceutical Association, 2001; 41(2):192-199. (6) Farrell, VM; Hill, VL; Hawkins, JB; Newman, LM; Learned, RE, Jr. "Clinic for Identifying and Addressing Polypharmacy," American Journal of Health-System Pharmacy, 2003; 60(18):1830, 1834-1835.

Prescription Solutions

CONTACT: Kimberly Kunody, of Prescription Solutions, +1-949-475-3384,kimberly.kunody@rxsol.com

Web site: http://www.rxsolutions.com/

Source: PRNewswire

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