I'm a consultant pharmacist who manages peoples medications in both Nursing Homes and in the community, especially when they move from hospital to home. My main goal to is to prevent hospitalization, prevent adverse drug events, and reduce medication use.
The cost of medications keeps rising at astronomical rates. Drug companies are raising their prices up to 2000% plus. Insurance companies are then forced to raise their rates and you get stuck with the bill. And if that isn’t enough we now have clinical trials that support combination medication regimens as more effective. The latest coming from the Wall Street Journal article on combination drug therapies for cancer. Drug manufacturers are co-marketing these combinations. Many regimens run in the six digit range.
Healthcare has become a business and the government is not doing a lot to curtail it, so isn’t it about time that we focus on prevention? Lets take a good look at a few countries and their cultures. What is it about their lifestyle that leads to good health? Sardinia, Italy; Ikaria, Greece; Okinawa, Japan; Loma Linda, California; Nicoya Peninsula, Costa Rica are a few that have the oldest and healthiest people.
What habits do we need to change? How do we change them?
Answering these questions will lead us down the path to good health. It may take more effort and time but it would cost a lot less. It is up to each and every one of us to change the business of healthcare.
According to the medical examiner’s report, the autopsy found that the pop star Prince died of an overdose of the opioid fentanyl. As we find ourselves amidst an opioid overdose epidemic, we need to question our approach to pain treatment.
For many years, we were taught to see pain as the 5th vital sign, (with blood pressure, temperature, pulse and respiration being the other four). I can’t help but wonder if we overdid it. No one should live with pain, but pain is perceived differently by everyone. While some people have a high pain tolerance and can get by with non-pharmacological interventions, others need medical interventions. Do we assess pain tolerance? Commonly, we ask the patient to assess the pain themselves by pointing to a face on a wall chart that matches how they feel. So if we are not assessing pain tolerance how do we prescribe a pain regimen? How do we determine what tapering schedule is adequate? Do we have a tapering protocol based on specific pain states?
The DEA and CDC among many organizations are implementing programs to help combat the opioid overdose epidemic by calling in many healthcare professionals. What about psychologist and the use of mental health to assist in the treatment of pain? Can this be a piece of the puzzle?
According to the DEA there were 2000 opioid deaths since the pop stars death. Regardless of how many interventions we implement, we can all agree that urgency is paramount.