Tag Archives: medications

Updated Beers Criteria identifies risky drugs for seniors

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

A panel of experts in geriatric care has identified nearly 100 medications that should be avoided or used with caution among the older population in the latest update to the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.

The recommendations by the American Geriatrics Society are widely used by clinicians, educators, researchers, health care administrators and regulators to ensure medications are appropriately prescribed. Continue reading

More adults over 50 risk benzodiazepine misuse

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Prescription rates of opioids and benzodiazepines are on the rise among the older adult population, according to two recent studies. And that is cause for concern, say researchers.

In one study, Greg Rhee, Ph.D., an adjunct assistant professor in the University of Minnesota College of Pharmacy, examined prescribing trends in outpatient settings of opioids and benzodiazepines. His analysis found that between 2006-07 and 2014-15, the prescription rates of benzodiazepine drugs such as Xanax and Halcion increased from 4.8 percent to 6.2 percent; the rate of prescription opioids alone increased from 5.9 percent to 10 percent, and the co-prescribing rate of both benzodiazepines and opioids increased over time from 1.1 percent to 2.7 percent, respectively. Continue reading

Be cautious about superlatives in cancer drug reporting

About Tara Haelle

Tara Haelle (@TaraHaelle) is AHCJ's medical studies core topic leader, guiding journalists through the jargon-filled shorthand of science and research and enabling them to translate the evidence into accurate information.

Photo: Amy Dame via Flickr

Photo: Amy Dame via Flickr

For much of modern medical history, the elusive holy grail of medical research has been a “cure for cancer.” Today, scientists have a better understanding of cancer, the diversity of cancer types and the fact that “cure” probably is not the correct word – ever – to use in discussing cancer treatment.

Yet not all journalists appear to have gotten that memo. A study posted Oct. 29 in the Research Letter section of JAMA Oncology explored how often “cure” and nine other similarly exaggerated terms were used by the media when describing new cancer medications. What they found is nothing to brag about. Continue reading

Here’s why specialty pharmaceuticals need value-based insurance design

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Image by Bill Brooks via flickr.

Image by Bill Brooks via flickr.

This spring, Gilead Sciences Inc. introduced Solvaldi, a drug that could cure the liver virus that causes hepatitis C. The drawback, however, was the cost of $84,000 or about $1,000 per pill, as Julie Appleby reported at Kaiser Health News.

“And that price tag is prompting outrage from some consumers and a scramble by insurers to figure out which patients should get the drug – and who pays for it,” she wrote.

Bernard Munos wrote in Forbes that the cost of one recently introduced cancer medication was $66,000 and another was $90,000.

At such high prices, consumers may be unable to afford these medications and insurers may not cover them. If insurers do cover these high-priced drugs, they may require patients to pay the typical copayment of 30 percent or more.

In a new report from the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC), researchers argue that insurers need a new approach to paying for specialty medications. Continue reading

Growing challenges to safety, adequacy of drug supply #ahcj13

About Keldy Ortiz

Keldy Ortiz is a health reporter at the Victoria (Texas) Advocate. He is attending Health Journalism 2013 on an AHCJ-Rural Health Journalism Fellowship, which is supported by the Leona M. & Harry B. Helmsley Charitable Trust.

Essential, commonplace drugs are in short supply, including morphine, epinephrine and chemotherapy agents. Those shortages have led to a greater reliance on compounding pharmacies, such as the one blamed for contaminated steroid injections that sickened more than 700 people, of whom 50 died.

In the AHCJ conference session, “From compounders to drug shortages: Covering pharmacies and pharmacists,” pharmacists described the growing challenges to the safety and adequacy of the U.S. drug supply.

Michael R. Cohen, R. Ph., M.S., president of the Institute for Safe Medication Practices, gave several reasons for drug shortages, including Medicare payment restrictions that reduce profits and FDA actions that take manufacturing plants off line. Meanwhile, people have been sickened by contaminated drugs from compounding pharmacies for years before the fungal meningitis outbreak of that resulted from the contaminated steroids. Continue reading

Seniors missing out on important wellness exams

About Judith Graham

Judith Graham (@judith_graham), is a freelance journalist based in Denver and former topic leader on aging for AHCJ. She haswritten for the New York Times, Kaiser Health News, the Washington Post, the Journal of the American Medical Association, STAT News, the Chicago Tribune, and other publications.

As health care reporters, we come across this truth time and again:  insurance coverage doesn’t guarantee high quality medical care.

The latest evidence comes from a survey of 1,028 seniors (age 65 and older) by The John A. Hartford Foundation, whose mission is improving the health of older adults. (Editor’s note: The John A. Hartford Foundation is one of the supporters of AHCJ’s core curriculum on Aging.)

It found that a measly 7 percent of older adults surveyed received seven highly recommended services, including a yearly review of all their medications, screening for depression or other mood disorders, a history and assessment of their risk of falling, evaluation of their ability to perform daily activities of living and care for themselves and referral to resources in the community.

Judith GrahamJudith Graham (@judith_graham), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society.

If you have questions or suggestions for future resources on the topic, please send them to judith@healthjournalism.org.

All of these services are covered by Medicare through the program’s new annual wellness visit – a benefit to all beneficiaries on traditional Medicare as of January 2012 – and all are endorsed by geriatric experts.  Yet 52 percent of older adults who participated in the Hartford survey said they had received none or one of the interventions.

“Healthcare isn’t very well adapted to the special needs of older people,” said Christopher Langston, program director at the Hartford Foundation, introducing the findings at a press conference last week.   Most physicians have little if any training in geriatrics and simply apply knowledge of young adults or middle aged adults to seniors, others said.

That’s misguided, since older adults’ changing bodies – different sleep patterns, alterations in metabolism, changes in muscle strength and nutritional requirements, and more – require special attention and special interventions.

Yet, with a few exceptions, medical schools don’t incorporate geriatric training into their curriculums.  And Medicare doesn’t adequately reimburse doctors who treat large numbers of older patients, who tend to require more time and attention because of their complex needs and, often, multiple illnesses.

Rosemary Leipzig, M.D., professor of geriatrics at Mount Sinai School of Medicine in New York City, said it was “really concerning” that one-third of older people surveyed said doctors hadn’t reviewed all their prescriptions and over-the-counter medications, vitamins and supplements over the past year.

Thirty percent of seniors who participated in the survey reported taking five or more prescription medications; another 33 percent were taking up to four medications.

Well-documented harms occur when older adults swallow too many pills with possible adverse side effects, but these can be prevented up to 40 percent of the time with proper oversight, Leipzig said.   The American Geriatrics Society recently published an updated list of medications that can be dangerous for seniors.  (The society’s standards for potentially inappropriate medication use in older adults are known as the Beers criteria.)

Another troubling gap in care arises from doctors’ and nurses’ failure to ask older patients whether they have fallen recently or advise them about how to minimize the risk of falls, as I wrote in a blog post about the Hartford survey.   Dan Kadlec also highlighted the issue in his blog post for Time Moneyland, quoting the Hartford Foundation:

“Falls cause more injury and injury-related death in older people than any other event and cause 90% of all hip fractures, which greatly increase odds of nursing home placement. … Evidence has shown that older people can cut their risk of falling by about 30% by addressing key risk factors.”

For health care reporters, I think the take-home message is that doctors who care for older adults in the community are not doing all they could for this population.  There are several reasons why this is so.  A lack of knowledge about Medicare, inadequate training in geriatric care, harried practices and reimbursement pressures are high on the list.

Also, for their part, older adults don’t really know what kind of care they should be getting, what to ask for from their doctors, and what benefits are available to them under Medicare. (Fifty-four percent of seniors polled by the Lake Research Partners for the Hartford Foundation said they’d never heard of Medicare’s annual wellness visit.)  

This seems a ripe area for coverage by reporters committed to educating older adults about the components of high quality care and Medicare.