Current Issues in Health Care: Diabetic Shoe fitting

womensshoeAs our healthcare system continues to evolve, pharmacy as it is practiced today is changing, and hopefully for the better. Here is the last of four topics hat are in the “hot seat” as we round up the first half of 2014:

Summary

Pharmacies around the state of Iowa pride themselves as being able to provide more than just prescription and over-the-counter medications. One of these services is the fitting and selling of therapeutic shoes. These are most often for diabetic patients suffering from neuropathy (continual loss of sensation) in their feet. Approximately three months ago, Iowa pharmacies were informed that, starting on July 1st of 2014, it was no longer within their legal means to help patients find the right shoe and minimize their discomfort 7.

Current Standing

After receiving this news, the Iowa Pharmacy Association immediately went to work to resolve this issue. To allow pharmacists to keep providing useful assistance to their patients, IPA met with the Iowa Board of Pharmacy and Attorney General’s Office, other accrediting organizations, and even shoe manufacturers. The IPA’s proactive response led to the Iowa Board of Podiatry and Board of Pharmacy writing a total of eight letters to accrediting organizations and the Centers for Medicare and Medicaid Services (CMS). Within the three months of lobbying, it was determined Iowa pharmacies will be able to continue therapeutic shoe fitting 7.

How are YOU, the patient, affected?

Continuing this service will allow pharmacists to help patients achieve these four objectives in shoe fitting as laid out by the American Orthopedic Foot and Ankle Society: (1) relieve areas of excessive pressure, (2) reduce shock and shear, (3) accommodate, stabilize, and support deformities, and (4) limit the motion of joints to decrease inflammation 8. If you have questions or concerns about diabetic neuropathy, ask your local pharmacist today. Therapeutic shoe fitting is also provided at the majority of NuCara stores.

References for all four topics:

1. http://www.ashp.org/DocLibrary/Advocacy/HR-4190.pdf
2. As of June 20th, 2014 on https://beta.congress.gov/bill/113th-congress/house-bill/4190
3. http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror
4. https://beta.congress.gov/bill/113th-congress/house-bill/4577?q=%7B%22search%22%3A%5B%22hr4577%22%5D%7D
5. http://thehill.com/opinion/letters/191831-preferred-pharmacy-networks-limit-choices
6. http://www.iarx.org/documents/Jun%2013_NPM%20Press%20Release%20June%202014.pdf).
7. Letter from CEO of IPA Kate Gainer on June 19th, 2014. Further questions or requests for information can be emailed to ipa@iarx.org.
8. http://www.aofas.org/footcaremd/conditions/diabetic-foot/Pages/Shoes-and-Orthotics-for-Diabetics.aspx

 

Current Issues in Health Care: New Practice Model

7990As our healthcare system continues to evolve, pharmacy as it is practiced today is changing, and hopefully for the better. Here is the third of four topics that are in the “hot seat” as we round up the first half of 2014:

New Practice Model

Summary

Since 2010, the Iowa Pharmacy Association and its New Practice Model (NPM) Task Force have been developing a practice model to let pharmacists allocate more time for clinical analysis and patient service. The idea is to use technology in place and multiple certified pharmacy technicians to verify prescriptions and free more time up for the pharmacist. Ultimately, the New Practice Model promotes patient safety and desired health outcomes 6.

Current Standing

NuCara and the other participating pharmacies began the statewide pilot project on June 2nd. The technician verification process, otherwise known as the tech-check-tech system, is being closely monitored for errors in real time by pharmacists at these stores. Along with that, IPA is getting biweekly feedback from the stores participating in the pilot. The goal is to expand the model in other community settings by November 2014, and eventually reproduce the model nationwide if it is successful 6.

How are YOU, the patient, affected?

Pharmacists today are equipped with wide-ranging clinical skills. Pending on the success of the pilot, you, as the patient, can expect more time to discuss any health-related concerns with your community pharmacist. Third party pricing decisions have lead some pharmacies to demand their pharmacists to sacrifice time with patients. At NuCara, we want to promote the NPM so pharmacists can apply their knowledge and help their patients! More than just counseling on a new prescription, pharmacists can identify medication interactions, assist in over-the-counter purchases, and directly communicate beneficial medication adjustments to doctors.

Current Issues in Health Care: Ensuring Seniors Access to Local Pharmacies

Couple Enjoying A Game Of GolfAs our healthcare system continues to evolve, pharmacy as it is practiced today is changing, and hopefully for the better. Here is the second of four topics (the first two being current legislation) that are in the “hot seat” as we round up the first half of 2014:

H.R. – 4577: Ensuring Seniors Access to Local Pharmacies

Summary

Similar to HR 4190, this legislation would amend the Social Security Act. It also focuses on the same Medicare beneficiary groups as follows: Medically Under-served Areas, Medically Under-served Populations, and Health Professional Shortage Areas. However, the bill is written to affect Part D of Medicare, or the part that is most often used in the pharmacy. Under the law, insurance plans would be required to offer preferred network benefits to pharmacies in the previously defined regions.

Current Standing

Although only introduced in last month, this legislation is also picking up steam and already has bipartisan support from 31 congressional representatives 4. Community pharmacies not in a preferred network currently have to either charge patients more for medications and/or net a loss from providing expected, quality care. An article from late 2013 suggested that there are approximately 1,800 pharmacies that are the only provider in their community. Also astounding is the fact that 91% of all community pharmacy owners and operators were non-preferred; on average, these patients then have to travel 20 miles to a pharmacy that can provide savings promised by their insurance plans 5.

How are YOU, the patient, affected?

Similar to H.R. 4190, patients across the country, including all five states where NuCara practices pharmacy, would benefit from increased access to affordable health care. The choice of where to pick up medications or seek health services should be left up to YOU, the patient, not an insurance plan! The restrictions this legislation absorbs directly improve the chances that your local pharmacy and trusted pharmacist will continue to provide exceptional health services and keep their doors open.

Current Issues in Health Care: Change to Benefit Patients and Pharmacists – A Four Part Series

US Constitution And Scales Of JusticeAs our healthcare system continues to evolve, pharmacy as it is practiced today is changing, and hopefully for the better. Here is the first of four topics (the first two being current legislation) that are in the “hot seat” as we round up the first half of 2014:

H.R. – 4190: The Push for Provider Status

Summary

This legislation would amend a portion of the Social Security Act to give pharmacists what is known as “Provider Status.” Specifically, this amends Medicare Part B to include pharmacists in the group of professionals that are reimbursed for professional services. The legislation focuses on Medicare beneficiaries in three separate regions as defined by the US Dept. of Health and Human Services’ Health Resources and Service Administration (HRSA): Medically Under-served Areas, Medically Under-served Populations, and Health Professional Shortage Areas 1.

Current Standing

Originally introduced in March of 2014 by a Republican congressman from Kentucky, this legislation now has 56 bipartisan co-sponsors 2. It is gaining support by the day as representatives of congress recognize the benefits this bill would provide. Along with having the most expensive health care system in the world, a recent study also finds that, compared to ten other industrialized and powerful countries, the United States has the worst health outcomes 3.

How are YOU, the patient, affected?

Pharmacists are often considered the most accessible healthcare providers. This legislation manages to further increase that patient access. Additionally, it will assist pharmacists in the provision of high quality and cost-effective services that are within the scope of their education. Both individual households and our government are looking for ways to decrease their healthcare expenditure; this amendment could be a starting point! Check and see at https://beta.congress.gov/bill/113th-congress/house-bill/4190/cosponsors if your district’s congressman is a co-sponsor.

Young Receives Award at the Iowa Pharmacy Association’s Annual Meeting

IMG_4073The Iowa Pharmacy Association (IPA) is pleased to announce the 2014 award recipient of Pharmacy Technician of the Year Award goes to Alissa Young, CPhT, of Ames. The award was presented at the Association’s 2014 Annual Meeting Banquet on June 14 in Altoona.

Alissa Young was born and raised in Spencer, IA. Growing up on a farm, she developed a love of all animals at a young age. She moved to Ames in 2005 to attend Iowa State University and graduated in 2010 with a Bachelor’s Degree in Animal Ecology. In October of 2012, Alissa was hired as a pharmacy technician at NuCara pharmacy in Nevada. She became PTCB-certified the following summer. In March of 2013, she made a career move to Zearing to work at the newly-opened NuCara telepharmacy. Alissa enjoys the rewards and challenges of working with innovative telepharmacy technology and helping the people of Zearing in the process. Alissa and her husband Greg, a Civil Engineer, live in Ames with their two Basset hounds, Brutus and Rocky.

The Pharmacy Technician of the Year Award is an award designed to recognize a pharmacy technician in Iowa who has demonstrated outstanding involvement in the Iowa Pharmacy Association and enthusiasm for the profession of pharmacy in Iowa.

Alissa’s nominator said, “Alissa has a great work ethic and exemplifies the potential brilliant career that one can have as a pharmacy technician and we are grateful to have her on our team.”

 

Brett Barker, Pharm.D. Receives GenerationRx Award

IMG_4066

The Iowa Pharmacy Association (IPA) is pleased to announce the 2014 recipient of the GenerationRx Award is Brett Barker, PharmD, of Nevada. The award was presented at the Association’s 2014 Annual Meeting on June 14 in Altoona.

The GenerationRx Award is a national awards program sponsored by Cardinal Health. This award is designed to recognize a pharmacist who has demonstrated excellence in community-based prescription drug abuse prevention. The award is intended to recognize outstanding efforts within the pharmacy community to raise awareness of this serious public health problem. It is also intended to encourage educational prevention efforts aimed at patients, youth, and other members of the community. This award includes a $500 donation to the charity of the recipient’s choice.

Dr. Brett Barker is the Vice President of Operations for NuCara Management Group. Brett received his Doctor of Pharmacy in 2008 from the University of Iowa College of Pharmacy. Prior to this current role, Brett managed the NuCara Pharmacy in Nevada, IA and also served as NuCara’s Director of Clinical Services. Throughout his career, Brett has been passionate about increasing pharmacist-provided clinical services, community involvement, mentoring students, and new models of care delivery such as telepharmacy and new practice model pilot programs. He currently serves on the IPA Legislative Advisory Committee, Telepharmacy Joint Task Force, and is Vice Chair of the Iowa Pharmacy Political Action Committee (IPPAC) Advisory Committee. He has coordinated numerous community medication take-back events and brought together all interested stakeholders.

“ Dr. Barker truly sets a new standard in innovative, progressive, and visible pharmacist-led initiatives for proper medication disposal in his community,” said Kate Gainer, Executive Vice President of the Iowa Pharmacy Association.

How to Aaah-Choose the Right Allergy Medicine

Little girl blows her noseBy: Rachel Clemens, PharmD Candidate 2014, Drake University

I love the spring. With it comes warmer weather, bright flowers, sunny skies, and fresh grass. However, spring also brings along pollen and ragweed so when spring has sprung, I get allergies. Have you ever gone to the pharmacy to pick out an allergy medicine and had no idea where to start? Or maybe you’ve tried a few things that haven’t worked great for you and you’re looking for another option? Look no further. I’m here to help.

How do I know if it’s allergies or a cold?

Sometimes, it’s hard to tell if you have allergies acting up or if the lingering winter has given you a cold. Here are some of the symptoms that can help you differentiate between the two:

Allergies: watery eyes, itchy nose/ears/throat, sneezing, congestion, red/irritated eyes

Cold: sore throat, congestion, low fever, chills, headache, feeling tired, feeling sore, possible cough

Now that you know that you definitely have allergies, let’s move on to some of the options available to help you feel better fast.

Over-the-counter options

Antihistamines: there are a lot of antihistamines available to try, and some work better than others for some people, meaning that you may have to try a few to find out which one is best for you. These medications are good for helping with symptoms like itching, sneezing, and runny noses. Here’s an idea of what’s out there to get you started:

  • Fexofenadine (Allegra®, Mucinex® Allergy): non-drowsy medication that can be taken once or twice daily, as it is available in 12- or 24-hour formulations. Can also be given in children (but check with a doctor first!)
  • Cetirizine (Zyrtec®): non-drowsy medication taken once daily. Can also be given in children (but check with a doctor first!)
  • Loratadine (Claritin®): non-drowsy medication taken once daily. Can also be given in children (but check with a doctor first!)
  • Diphenhydramine (Benadryl®): good if you have severe itching. Can make you drowsy, which is good if allergies are worse at night but should be avoided during the daytime. Don’t drive while taking it until you know how it affects you.
  • Chlorpheniramine (Aller-Chlor®, Chlorphen®): good for severe allergies. It will dry you up though, so stay hydrated and watch out for side effects like constipation.

Nasal sprays: if your symptoms are mostly centered around your nose (runny nose, congestion, sneezing, itchy nose), then just using a nasal spray can help without the risk of unnecessary side effects.

  • Afrin®: provides 12-hour relief for nasal congestion. Good to try if you have never used a nasal spray before.
  • Nasacort®: provides 24-hour relief of nasal congestion, sneezing, runny/itchy nose.

If you have tried some of these products and they do not seem to work, talk with your doctor about finding a prescription allergy medication that is right for you.

To “D” or not to “D” – when to add in a decongestant

If you have severe congestion, then it might be time to talk with your pharmacist about getting an allergy medication with a decongestant. You’ll know if your congestion is severe because your head feels heavy and full of “gunk”. You may have trouble breathing through your nose if you lay down, and the sinus pressure may be painful. Combination products like Allegra® D, Claritin® D, and Zyrtec® D are available behind the counter and you will need to show an ID to buy them.

**Remember: it’s always a good idea to speak with your doctor or one of our friendly pharmacists before starting a new medication regimen, even if it’s available over the counter! Everyone is different and they can help ensure you get the best product for you.**