Welcome to the AccuPax blog! We started this blog last year as a service for our AccuPax Pharmacy customers (both caregivers & patients,) as well as friends and visitors to our site. AccuPax customers are a diverse group in terms of age, health and abilities, but they all have one thing in common. All our patients regularly take multiple medications for one or more chronic health condition and have found our innovative, single dose packaging helps them manage their medications. We designed our site and especially this blog as a way to provide useful information to improve the lives of our customers, their caregivers and anyone taking multiple medications on an ongoing basis. AccuPax Pharmacists & Pharmacist Techs are all experts on medication management and the challenges faced by people living with chronic conditions. In this blog, we help you address some of those challenges, while focusing on three main areas:

• Medication Management – Ideas for organizing & remembering your medications, coping with side effects & more.
• Living a Healthy Life – Information on living your best life including easy tips on making healthier choices.
• Saving Time & Money to Get More Out of Life – For patients & caregivers, coping with a chronic health condition is often time consuming and expensive. We give ideas for saving time & money, leaving you more of both to enjoy life.

Please leave comments! We encourage your input on our blog posts and we hope you’ll join the conversation. Add ideas about what works for you and ask questions.  And please let us know what topics you’d like to see covered in future posts. We truly hope you enjoy the blog and that you find new information that proves to be helpful.

Several of our posts focus on specific areas of Medicare coverage, like in-home care or prescriptions, with links & resources for a specific topic. To get the most from your Medicare coverage & benefits, it’s also worthwhile to have some general resources for researching Medicare and getting your questions answered. Here are some ways to find help and access information:

• Call Medicare at 800-MEDICARE (633-4227) 24 hours a day, every day. (TTY users: 1-877-486-2048.) * * See below for a “QUICK TIP” on the fastest way to get through to a real person when you call Medicare.
  
• The Medicare website is Medicare.gov.  You can also try the site’s Help & Support section.
• To verify coverage under an individual Medicare policy, use the Your Medicare Coverage page on Medicare.gov:
  1. Enter the policy ID number at the top of the page, then under #1, select your state.
  2. Under #2, scroll through the list & select up to 5 “coverage topics” (a specific service, item, or test.)
  3. Click “View Results >” to get coverage information specific to the policy ID # you provided.
• Your local Area Agency on Aging can also help with Medicare questions. If you prefer to talk to someone in person, you can find a local Medicare counselor who will help you. There are three ways to find the nearest Area Agency on Aging office:
  1. Call an Information Specialist at Eldercare Locator: 800/677-1116 (Mon – Fri, 9 AM – 8 PM, Eastern Time.)
  2. Use the Eldercare Locator website, eldercare.gov (illustrated below.)On the homepage, locate the box called “Find Help in your Community.” The easiest way to find your local Area Agency on Aging is to enter your zip code in the “Search by Location” option on the left side of this box. (Note: if you use the “Search by Topic” feature, found to the right of “Search by Location,” you get national, not local information. You can only search by location or topic, but not both. Once you identify your local Area Agency on Aging, they can provide local info, resources & referrals on specific topics.)
  3. The national site for Area Agencies on Aging, n4a.org lists all the local agencies. Just click on your state near the top to see a list of agencies in your state: List of Member Agencies, by State (Note: This provides a list of all the agencies in your state. It may not be immediately clear which agency is closest to you, so you may prefer to search by zip code using the “Search by Location” option listed in B, above.)

Eldercare.gov Can Help You Find a Medicare Counselor at Your Local Area Agency on Aging

* *  lQUICKlTIP - TO TALK TO A REAL PERSON RIGHT AWAY & AVOID ANSWERING QUESTIONS FROM THEIR AUTOMATED SYSTEM; THE WEBSITE GETHUMAN.COM (WHICH WE TOLD YOU ABOUT HERE) SUGGESTS THE FOLLOWING: AFTER DIALING 800-633-4227, SAY “AGENT” OR HIT ZERO (“0”) AT EACH PROMPT. EVERY TIME THEY ASK FOR INFORMATION (MEDICARE #, SOCIAL SECURITY #, REASON FOR CALLING, ETC) SAY “AGENT” OR PRESS “0″ INSTEAD OF GIVING THE INFORMATION REQUESTED. THIS WILL QUICKLY ROUTE YOU TO A REAL, LIVE CUSTOMER SERVICE AGENT.

Well Spouse Association • (WellSpouse.org) . . The Well Spouse Association advocates for and supports people caring for a chronically ill and/or disabled spouse or partner. They educate health care professionals and the general public about the special challenges and unique issues “well” spouses face every day. They are especially strong in providing peer support in a wide variety of forms. To access all their programs, you need a Supporting Membership, starting at $30. They are sensitive to the financial demands on caregivers and offer several options for those on a tight budget. If you cannot afford their full membership dues, you can pay what you are able to (minimum $5) for a Supporting Membership. They currently offer a free Supporting Membership for Military Spousal Caregivers. Or, you can become a Non-Supporting Member which is free for the first year.

Non-Supporting Member benefits include:

• Full access to the many active forums on their website.
• Basic Access to the many resources on their website. Their site has audio and video programs ranging from a presentation by a Family Therapist on “Dealing with a Difficult Spouse” to excerpts from a very funny speaker on the power of humor, at their National Conference. You’ll also find interesting quotes, stories and blogs written by caregivers. The site also has many resource lists including books, TV shows, websites and programs of interest to caregivers.

In addition to the benefits above, Supporting Member benefits include:

• Local and national events.
• A network of nearly a hundred local support groups, located in throughout the United States and Canada.
• Respite events designed to provide a chance for caregivers to relax and recharge.
• A mentoring program that matches experienced caregivers with individuals who have recently taken on the role of caregiver.
• “Round Robin” letter writing groups that serve as support groups for those unable to attend local support groups in person.

What other caregiver websites or organizations have you found to be helpful? Please leave a comment below and tell us about them.

RESEARCHING DOCTORS – PART 1 . . Choosing a doctor, hospital and pharmacy are critical decisions directly impacting health. The right doctor can help identify the best treatments for a chronic medical condition, and it’s symptoms, so you can live life to the fullest. The best hospital can have a positive affect on health and provide peace of mind for the loved ones of the individual hospitalized. The right pharmacy can make managing one’s medications easier, which helps manage chronic health conditions, and often makes symptoms much more tolerable. Over several posts, we’ll identify strategies and resources for finding the best health care providers. We first look at finding the best doctor for your needs. Even if you’re really happy with your Primary Care Physician, you’ll likely need a second opinion, or a specialist at some point. And if you’re not sure your current doctor is a good fit, the right research tools are even more important in helping you identify and evaluate potential doctors. Here are some suggestions:

STEP ONE – ASK THE RIGHT QUESTIONS & FIND OUT WHAT KIND OF DOCTOR YOU NEED.

• If you need a Primary Care Physician, most people see a General Practioner, Family Doctor or Internist. For Seniors, also consider a Geriatrician. Geriatricians are board-certified in family or internal medicine with additional training & experience in Geriatrics, which focuses on treating older adults. A Geriatrician is likely to have more experience with the types of conditions most often affecting Seniors. They also may be more attuned to the unique challenges of managing multiple health conditions & multiple medications and to the unique ways they affect older adults.
• If you need a Specialist, identify all your options. If your Father’s Arthritis has become more painful, and is limiting his activities, your current doctor will probably suggest a Rheumatologist. But you can learn more if you follow-up with, “Are there other specialists we should consider?” For example, they may refer you to a Physiatrist (Doctor of Physical & Rehabilitation Medicine) who might suggest Physical Therapy, an Orthopaedic Surgeon to evaluate your Dad as a candidate for joint replacement surgery, and / or to an Anesthesiologist specializing in Pain Management.

STEP TWO – GET RECOMMENDATIONS

Good Sources Of Recommendations

• Your current doctor(s) and other health care providers.
• Friends, family, neighbors and co-workers.
• Local support groups you attend can be a great source for specialists when dealing with a specific health condition. You can also post in online forums and ask for recommendations within your local area. (For ideas on finding local and online support groups, see our earlier post on Online Support Resources.)

Other suggestions when asking for recommendations:

• Ask about specific qualities most important to you, like a doctor open to discussing alternative treatments, or a practice with a reasonable wait time.
• Doctors may give somewhat generic recommendations, based on which doctors are in their building, or in the same health system with them. It can be helpful to rephrase your question something like this: “I’ve really been struggling with the _______ related to my condition & having a hard time finding a doctor who _________. If your mother was in this situation, who would you suggest she see?”

STEP THREE – CONSULT THE DIRECTORY OF PARTICIPATING DOCTORS FOR YOUR HEALTH INSURANCE PLAN. Try to identify several doctors from various recommendation sources, then check to see if they participate with your health plan. If applicable, check to see if they are In-Network or Out-Of-Network.

Now that you have a few doctors to consider, our next post will look at additional research you can do, to help you narrow down your choice.

Sources:  American Geriatric Society ( http://www.americangeriatrics.org/,) Aging In The Know (http://www.healthinaging.org) and Everyday Health (http://www.everydayhealth.com.)

There are numerous organizations for caregivers, including several nonprofits providing educational resources, emotional support and legislative advocacy. We plan to highlight some of the best organizations, and give you a sense of some of the most valuable services and resources offered by each one. The first featured organization is the National Family Caregivers Association. Look for more caregiver organizations to be highlighted in future blog posts.

The National Family Caregivers Association (NFCA) • (TheFamilyCaregiver.org) . . The National Family Caregivers Association was founded to educate, support and empower people who care for parents, children, spouses and other relatives with a chronic illness or disability or the frailties of old age. One of the strongest parts of their website is the resources section, which includes:

• Tips & Tools – Their own guides to topics like Support Groups, Choosing a Nursing Home, Improving Doctor – Caregiver Communications, The Stress of Family Caregiving and Tips for When Your Loved One is Hospitalized.
• Agencies and Organizations – A list of hundreds of websites and resources in categories of interest to Caregivers including insurance, Medicare, disease-specific health and medical information, eldercare, Assisted Living, Nursing Homes, Hospice, homecare, medical transportation, respite care, and much more.
• CCAN – Caregiver Community Action Network – A network of dedicated state and local volunteers created to provide vital information, education, and support to other caregivers in their local communities.
• Health Information – Helpful information on specific diseases, conditions, and symptoms for both the caregiver and the person they are caring for. Topics include Caregiver Stress, Alzheimer’s Disease, Hearing Loss and Pain Management.
• More – NFCA Publications, Quarterly Newsletter, and more.

Membership in the NFCA is free if you are a family caregiver to a spouse, partner, parent, child, sibling, or friend who is chronically ill, disabled, or aged. In addition to their great resources section, NFCA also offers several ways for caregivers to connect and share support, both in person, and online. These programs are detailed on their Connecting Caregivers page. They also have other educational programs, important advocacy programs and more, all of which you can check out on their website.

Do you know of other websites or organizations for caregivers we should feature in upcoming posts? Please leave a comment about them.

It turns out, doing good for others is good for you, too! Volunteering, doing good deeds, donating to charity or even just thinking about giving can improve your health. In one Harvard study, participating students watched a video of Mother Teresa, while a control group saw a video of people peeling potatoes. They were tested for levels of immunoglobulin Aa, a marker for immune function, and students who watched the Mother Teresa video had higher levels. Students were then asked to just think about helping others and their markers were also higher than the control group!

Both patients and caregivers can benefit from this research, even if you feel like you don’t have the time or the energy to do anything for anyone right now. Just think about something you’d like to do in the future; for someone you care about, or a way you’d like to help a charity or cause you support.

FOR DETAILS: For more on the health benefits of helping, see this article from Science Buzz. The source for the original Harvard study is:  McClelland, D., and C. Kirshnit. 1988. The effect of motivational arousal through films on salivary immunoglobulin. Psychology and Health 2:31-52.

If you are unable to find the type of drug take-back program discussed in our previous post, here’s what you need to know to safely dispose of your medication at home:

1. As a general rule, do not put expired medications down the drain or in the toilet, to prevent any adverse impact on animals and the environment. There are however, exceptions to this guideline. The Food and Drug Administration (FDA) recommends disposal by flushing for a small number of very specific medications. These medications may have a high potential for abuse or can be very harmful if they are used by someone other than the person they were prescribed for.
   • To find out if your medication is on the list, see the Medications List on the Safe Disposal of Medicines section of the FDA website.
   • For more information on disposing of these medications, go to the Safe Disposal of Medicines section of the FDA website.
2. All other medications can be carefully disposed of with your regular household trash. The SMAR_XT DISPOSAL* program recommends:

• Add water to solid medications (tablets, capsules, etc.), to dissolve them. Then, pour the medication into a sealable plastic bag.
• Mix in something to make it less appealing to pets and children. Examples include cat litter, sawdust or coffee grounds.
• Seal up the bag and place it in the trash.
• When disposing of medication containers, be sure to remove and shred labels and any other identifying personal information before you recycle them or throw them away.

* The SMAR_XT DISPOSAL ^TM public awareness campaign is a partnership between the American Pharmacists Association, the Pharmaceutical Research and Manufacturers of America and the U.S. Fish and Wildlife Service. You can find more information on the  SMAR_XT DISPOSAL website.

In the past, you may have disposed of old medications by tossing them in a trash can, pouring them down the drain, or flushing them down the toilet. However, there are concerns about those methods. Children or animals can find medicines in the trash and could be seriously harmed by ingesting them. Research by the Environmental Protection Agency (EPA) shows that water treatment plants may not be able to remove all traces of medicines from our water when they are disposed of in our water system. This water contaminated with these medications may harm fish and wildlife.

The best best way to dispose of old medications is to take them to a drug take-back program sponsored by law local enforcement. You can contact law enforcement at the city, county or state level to find out about programs in your area. If you don’t find a program in your city, look into programs in neighboring communities. There is also a federal program held in the Spring and Fall. National Prescription Drug Take Back Day is Saturday, October 29, 2011, from 10:00 am – 2:00 pm. The event is designed to provide a venue for people who want to dispose of unwanted, unused or expired prescription drugs. You can find details on the Drug Take Back Day website. You can search for the location nearest you on their Site Search page.

If you are unable to find a drug take-back program, our next post will outline how to safely dispose of medication at home.

IS IT EVER OK TO TAKE EXPIRED MEDICATIONS?

The safe option is simply to throw out anything past it’s expiration date, period. The manufacturer cannot guarantee the potency & safety of the medication past this date and the FDA recommends tossing all expired medications. While some research indicates certain (but not all) medicines may remain safe and effective past the expiration date, it’s better to be cautious and throw it out. Our next blog post will cover the best way to dispose of old medications to protect your family as well as pets and wildlife. If you’re still tempted to take expired medication, here are some considerations to keep in mind.

• Some old medications may become toxic, including some antibiotics & seizure drugs.
• While not all old medications become toxic, others will lose their effectiveness, so consider how crucial a particular medication is to your health.
• If the medication is not one you are currently taking, check with your Doctor or Pharmacist to make sure it’s still safe & appropriate for you to use. They’ll need to consider your current medical condition and other medications you’re taking.
• Medication stored in a warm, moist environment (like a bathroom) or exposed to sunlight will degrade more quickly.
• Some medicines may change texture, color or smell. A cream or liquid may separate, and old aspirin can develop a rancid odor. Such changes indicate the chemical breakdown of the drug and they should definitely be disposed of immediately.
• To see if a drug has been recalled, or has an FDA Safety Alert go to:
  • The U.S. FDA Drug Safety Communications page:  FDA.gov – DrugSafety Communications or
  • The Index to Drug-Specific Information FDA.gov – DrugSafety Index
• If you’re still thinking about using an expired drug, talk to your Doctor or Pharmacist and get their input on the above considerations and any other concerns they have.

Please leave a comment and let us know if you have questions about old medications or safe medication use.

Additional posts on related topics:

• How to Identify Old Pills & Decide What to Throw Out
• The Best Way to Dispose of Old Medications

Old pills and other medications may be cluttering your medicine chest because you’re not sure what they are, if they are still safe to use, or how to dispose of them. Here’s how to determine what you have and what to dispose of.

THE SAFEST, EASIEST OPTION

• The safest, easiest option is to dispose of any medication that is past it’s expiration date. However, in many cases, experts do not advise simply throwing old medications in the trash. Please see our post, “The Best Way to Dispose of Old Medications” for details.
• Prescription medications should always have the expiration date printed on the pharmacy label.
• Over-the-counter medicine usually has an expiration date both on the outer box, and on the bottle or blister packs.
• If you can’t find an expiration date, or the medication has been removed from it’s packaging, you should throw the medication away unless you are certain you purchased it within the past year.

FOR MORE INFORMATION ON CURRENT PILLS OUT OF THEIR PACKAGING

You may have medication you remember purchasing in the past year, that was removed from the bottle. It may have been packed for travel, or stored in a pill box, pill sorter or even a plastic bag. Since many medications are similar in size, shape and color, it’s important to verify what type of medication it is. Even if the pills are still in their original bottle, you may not have the package insert with additional information that originally came with it. This includes details on why the medication was prescribed, warnings of other medications or health conditions that could be a problem when taking the medication, possible side effects and other important information. Here are some tips and resources on how to research your medication to identify it if needed and how to find package insert information.

• For the information found on drug labels and package inserts, go to the FDA website:  www.accessdata.fda.gov
• To confirm the identity of the pills, or to find out what kind of medication you have, even if you don’t know what they are and don’t have a name to search for, try the “Pill Identification Tool” on WebMD, or one of the other sites linked below. You can search based on the color, shape and/or the letters and numbers imprinted on the pill. These search tools will provide you with close-up, full color photos of the pills, so you can compare them to your medication.
  • http://www.webmd.com/pill-identification/default.htm
  • http://www.healthline.com/pill-identifier
  • http://www.drugs.com/imprints.php
• If you’re unable to locate critical information about the pills, call your Pharmacist.

Additional posts on related topics:

• Expired Medications: Is it Ever Okay to Take Them?
• The Best Way to Dispose of Old Medications