Medication Safety: It's Everyone's Concern

Commemorate Medication Safety Week April 1 - 7 and draw more attention to this health problem as the 6th leading cause of death. The Women's Heart Foundation started a Medication Safety Week, offering communities strategies to reduce risk while raising awareness. WHF developed a MS Power Point slide program with handouts based on guidelines from the U.S. Food and Drug Administration and the National Council for Patient Information and Education (NCPIE). The program is meant to be administered by both a registered nurse and a pharmacist.

Are you taking what your doctor ordered? The Women's Heart Foundation recommends maintaining an up-to-date medication record that includes both the generic and trade (brand) names being listed. This can help clear some of the confusion with medicine-taking and may reduce risk of a medication-related illness. Print out a Medication Record and download the Healthy Hearts guides: Taking Medications Safely .

FOCUS DAYS

Medication Safety Week starts APRIL FOOLS DAY with seven Focus Days created to help you commemorate. Outreach may take place at the workplace, and in collaboration with your local pharmacy.

• April 1: Clean Out Your Medicine Cabinet
  Start with a clean slate. Discard outdated medicines and old prescriptions. Many drugs lose their potency over time. Store medicines in their original containers and in a cool, dry place. Locate medicines away from children and pets and from those who do not understand.
  
  
• April 2: Know Your Medicines
  Make a list of your medicines and know what each is for. Learn to identify each pill size, shape and color by name. Note times to take, drug action and any side effects. Know both the generic and trade names of your medicines and what each is for. This may prevent inadvertently double-dosing. Include in your list over-the-counter medicines, birth control pills, patches and supplements. Keep the list updated and keep it with you at all times. Print out your free Medication Record (pdf format) by double-clicking on Medication Record (English version) or Medication Record (Spanish version). Discuss taking a dietary supplement with your doctor or practitioner and with your pharmacist before you start it. Herbal medicines and other dietary supplements can react with medicines and have an unknown synergistic effect. All herbal preparations are contraindicated while pregnant or breastfeeding. more information, go to Dietary Supplements. Don't mix medicine with alcohol - a combination that can be lethal.
  
  
• April 3: Read Medicine Labels Carefully
  Are you taking what your doctor ordered and the way he ordered it? Note precautionary stickers on the label. Note the route, dose and frequency of your medicines. Keep medicines in their original containers. Pay attention to warnings. Note that some medicines can react with foods. Others have to be taken on an empty stomach. Some lose potency quickly and must be kept in an air-tight container. The effectiveness of many medicines is dependent upon taking them at the correct times. How the medicine is to be taken ––the route–– is also important (i.e. by mouth, through the skin, under the tongue, inhaling, rectal or vaginal suppository, enema or douche). Be careful! Download detailed package insert information from the web. Know that gender, age, race, preexisting health conditions - all affect drug action and side effects.
  
  
• April 4: Organize Your Medicines
  Keep an updated record listing all medicines and supplements you are taking. Use of a medicine organizer box may be helpful, especially for those taking more than one pill several times a day, however, a medicine organizer box requires close monitoring, especially when there is a change in medicines. Be aware that use of an organizer box violates the rule of keeping medicines in their original containers. Managing pills with a medicine organizer box, while convenient, is not without risk. Also, certain drugs (i.e. chemotherapy agents) should not be mixed into a medicine box with other pills. Take medicines as prescribed. New drugs with time-released action can offer some help with organizing, offering once-a-day medicating convenience. Ask your doctor about these newer medicines. Go to Taking Medications Safely.
  
  
• April 5: Transitional Care Aware
  Changes in care (i.e. being moved from one hospital floor to another, being transferred from one care facility to another, being discharged home) all require intense coordination of services and good communication amongst health providers. When there are lapses, you are at risk of an adverse event or hospital readmission. One study estimated that 80 percent of serious medical errors involve miscommunication during the hand-off between medical providers. Therefore, be especially diligent about communication with all healthcare professionals during transitional care. If necessary, ask a family member to be your watchful advocate during the transition process. Speak up if a pill being dispensed does not look familiar. (It may be a generic of the same drug you were taking, however, if you don't ask, you won't know!). Upon discharge, make sure you understand your medicinces and how you are to take them. Ask for written instructions of your entire medical regimen and follow-up care. When picking up your medicines from the pharmacy, double-check all prescriptions for accuracy. Insist that both the generic and brand names of each drug be listed on the label, as well as what the medicine is for. Follow the tips from the Healthy Hearts Guide Taking Medications Safely.
  
  
• April 6: Know Your Individual Risk before Starting a New Rx
  Talk to your pharmacist. Discuss your possible risk of a serious side effect to occur. Learn if the new medicine is one known to adversely affect heart rhythm and increase chance of sudden cardiac arrest. Go to https://www.crediblemeds.org/pdftemp/pdf/CompositeList.pdf for a list of medicines that contribute to a potentially fatal heart rhythm known as prolonged QT and/or Torsades de Pointes (TDP). Excess alcohol intake and binge drinking, recreational drugs and weight-loss supplements (i.e. with ephedra) also affect heart rhythm as does having health conditions such as atrial fibrillation, hypothryroid, chronic alcoholism, congestive heart failure (this is NOT a complete list and does not include drugdrug interactions). Inherited long QT syndrome significantly increases risk of episodes of TDP, young women experiencing the highest rate of sudden death. Be sure your pharmacist is aware of your up-to-date health history and of all the medicines and supplements you are taking, including OTC remedies. This discussion may help avert a serious incident. Never hesitate to discuss any of your concerns. Report serious side effects such as irregular heart rate or rhythm, palpitations, lightheadedness, dizziness and/or fainting, to your doctor and pharmacist promptly. More on Torsades de Pointe at https://en.wikipedia.org/wiki/Torsades_de_pointes
  
  
• April 7: Better Communication with Health Professionals is Key
  Share information with all your prescribing practitioners and with your pharmacist about every medicine and supplement you are taking. Discuss all risks and benefits with your prescribing practitioner. Discuss expected effects and possible side effects. Discuss if there are any serious side-effects that your doctor needs to know about right away. Report adverse drug effects promptly and never hesitate to ask questions when it comes your health and the use of medicines and supplements. Your doctor, healthcare practitioner and pharmacist are there to help... just ask! Go to Taking Medications Safely. Go to Taking Coumadin® at Home for safety tips when taking warfarin – a blood thinner.

A important MESSAGE FROM CHRISTY TODD WHITMAN, FORMER GOVERNER OF NEW JERSEY

Medication safety is a national concern. Hello, this is Governor Christy Whitman.

The U.S. Food and Drug Administration estimates that each year, more than 76 billion dollars is spent on preventable medication-related illnesses.  That's why the Women's Heart Foundation, in cooperation of the FDA Office on Women's Health is educating women throughout New Jersey about medication safety.

The Medication Safety Campaign offers this advice:

• Use medication wisely
• Read all labels carefully
• Be careful when taking supplements. Supplements can interact with other pills you are taking or have an adverse affect just like medicine
• Report side effects to your doctor and pharmacist promptly
• Don't hesitate to ask any questions about supplements and the use of medications

Medication Safety - It's EVERYONE'S CONCERN!

KEY MESSAGES

Key messages include how to store, secure, manage and organize pills; understanding difficulties that may arise in identifying new pills introduced, whether they be generics or brand names; pills that look alike but are different; pills that are similar in color; the importance of reporting side-effects promptly; critical importance of being aware of medicines that adversely affect heart hythm; obtaining / requesting drug information sheets from the pharmacist or downloading from the web; reading labels on medicine bottles carefully and paying attention to precautionary stickers; being cautious when combining drugs and herbals and the necessity of discussing this first with your doctor and pharmacist; taking extra precautions during transitional care; and most importantly, the necessity of good, ongoing communication with your prescribing practioners and your pharmacist about what drugs and supplements you are currently taking including other-the-counter medicines, supplements and birth control pills.

PLANNING YOUR EVENT

Having a successful event takes planning. You will first need to establish strategic partnerships - the media to help you to advertise your event; a venue to host it; and health partners to implement it.

One event could take place at a local drug store by planning a "Brown Bag day" - an outreach activity that involves a dedicated day whereby each citizen would be encouraged to place all of her medicines and supplements that she is currently taking into a brown bag and bring it to the pharmacist for evaluation by a registered nurse or pharmacist. Each person could have any concerns or questions personally addressed, such as synergistic combinations. Ill effects may require follow-up with the prescibing practitioner.

Another could take place in the grocery store, drug store or vitamin store, where citizens are invited to tour the shopping aisles of dietary supplements with a pharmacist and herbalist. This would include vitamins, herbals, soy supplements and other items that a person may be taking as an over-the-counter "remedy" in addition to her regular food intake.

After developing a mail list, you may want to consider hosting a larger event. This could take place at a hotel or restaurant, or in a hospital cafeteria. The idea would be to combine an educational presentation with a "Brown Bag day" at a social gathering. Collaborate with a university that offers a Pharmacy Docorate program and ask if their interns would be interested in gaining some "hands-on" experience. The time involved would be 1/2 day and the Pharmacy Doctorate intern would be seated at a table of 8 senior citizens - all with questions and concerns that need to be addressed when take their medications and supplements. Locate an event sponsor, such as a drug store chain or pharmacetical company. Ask if the company would be willing to underwrite a lunch seminar for 200 seniors to learn about medication safety issues.

Consider reaching out to hospital administrators, members of the PTA/PTO, senior daycare centers and nutrition sites, and occupational health and wellness departments to help you market the event. Design an invitational flyer that is easy to copy and ready to go!

SUGGESTED TIMELINE

September, October, November

• Decide goals & objectives. Decide activities to achieve objectives
• Decide kick-off event date, time, place, activity
• Prepare a budget and solicit for sponsors to underwrite activities
• Contact a School of Pharmacy for partnering activities (i.e. Inquire if students could participate at a health fair planned between April 1- 7 as an educational experience)

• Prepare press releases /public relations messages.
• Decide on educational handouts for employees
• Decide on educational handouts for public
• Order educational materials/handouts
• Order promotional items for Health Fair attendees
• Solicit area businesses for free gifts and contest prizes

• Announce the event in company newsletter with theme and slogan
• Plan the April 7 Health Fair
• Secure the facility
• Contract for service providers to do health screenings
• Decide on a menu for April 7 lunch or brunch
• Contract caterer and vendors
• Ask a local radio station to cover your event
• Decide panel discussion topics and on speakers
• Arrange speakers for panel discussion

• Re-announce event in company newsletter in more detail.
• Introduce Focus Days
• Post statistical data on medication safety
• Post flyers and table tents in lunchrooms, at water fountains, elevators, etc.
• Plan kick-off event
• Plan community luncheon event

• April 1 – 7:   Kick-off a celebration with company CEO introducing the event with refreshments, balloons and banners. Follow Focus Days for introducing handouts in cafeteria/lunchroom. Team with a school of pharmacy to hold a health fair with community luncheon. Serve a light meal and assign a pharmacy student to be seated at each table to answer questions about medications.