-- One in four seniors take between 10 and 19 pills a day --

Older Adults in the U.S. are being overwhelmed by the number of prescription 
medicines they take on a daily basis. According to a new national survey of more 
than 1,000 people ages 65 and older who use medications, more than half (51 
percent) take at least five different prescription drugs regularly and one in four 
take between 10 and 19 pills each day.  The challenge of managing multiple 
medications is clear - nearly three in five (57 percent) of those polled admit that 
they forget to take their medications. Furthermore, the more drugs they use, the 
more likely they are not to remember to take them. Among those using five or 
more medications, 63 percent say they forget doses; a higher rate as compared 
to 51 percent among people who take fewer medicines.

The survey, conducted by Kelton Research on behalf of Medco Health Solutions, 
Inc., also reveals what seniors don't know about their medications could 
potentially harm them, and the more medications they take, the less they seem to 
know.  More than one third (34 percent) of seniors using five or more prescription 
drugs do not feel knowledgeable enough about the drugs they're prescribed or 
their potential side effects, and 35 percent are not sure they can name all the 
medications they use. 

According to the Medco survey, multiple medication use is also taking its toll on 
the financial health of America's seniors. The ability to afford their drugs is the top 
concern among 40 percent of seniors taking five or more prescription medications 
daily, followed by their worry over drug side effects (23 percent) and interactions 
(17 percent). Among those enrolled in a Medicare Part D plan, 37 percent are 
most concerned about not being able to afford their medications, and almost half 
(49 percent) want to know how to delay or avoid falling into the donut hole or 
coverage gap - the phase in which the beneficiary is responsible for the full cost 
of their drugs. The survey found 60 percent of Medicare beneficiaries have taken 
some steps to delay reaching the donut hole, such as using generic medications 
(76 percent) and asking for free samples from their doctors (39 percent). But just 
27 percent use mail order to avoid the donut hole, despite the fact that on 
average, seniors surveyed estimated that using mail order saved them about $540 
a year and 19 percent estimated they saved at least $1,000 annually.

Medco is launching an initiative to assist seniors and Medicare beneficiaries in 
better managing their medications and getting the most out of their Medicare 
plan. As part of the initiative, Medco has developed a free consumer booklet 
called "The Smart Guide to Managing Medications." It provides tips to help seniors 
better manage their medications and their costs, and includes information to 
discuss with their physicians and pharmacists about the drugs they're prescribed. 
The guide also offers ways to manage medication costs within the Medicare Part 
D benefit. "The Smart Guide to Managing Medications" is available free in a 
downloadable version at www.medcomedicare.com

Some drugs commonly prescribed to the elderly either at home or in long-term-
care facilities raise the risk of falls, according to researchers who analyzed 22 
studies that included almost 80,000 people age 60 and older. Three classes of 
drugs that raised the risk of falls most significantly were sedatives and hypnotics, 
such as sleeping aids; antidepressants; and benzodiazepines, such as Xanax.  The 
author of the study advised that older people who are taking any of the drugs 
associated with falls should talk about the medication with their physician and 
their pharmacist. (Source: Archives for Internal Medicine, November 23, 2009).

Over 300 community pharmacies across the state of Iowa recently launched 
TakeAway -- a program is to safely dispose of unused medications due to the fact 
that current medication disposal practices commonly used today compromise the 
integrity of water supplies. Unused and expired drugs pile up in home medicine 
cabinets, which increase the likelihood for teenagers, older adults, pets, or others 
to misuse or abuse them. 

The TakeAway program aims to reverse these trends by providing the public with 
a safe, easy way to properly dispose of unwanted and expired medications. 
TakeAway uses community pharmacies across the state as take-back sites. 

How TakeAway Works 
Iowans are invited to bring unwanted and expired medicines to a participating 
TakeAway community pharmacy. By entering a zip code participating pharmacies 
can be found. The pharmacist disposes of the returned medications (excluding 
controlled substances) into a TakeAway system, a waste bin specially designed to 
safely store discarded pharmaceutical products along with their packaging. Once 
filled, the TakeAway system is sealed and shipped to a medication disposal facility 
where the entire TakeAway system and its contents are incinerated. This ensures 
unused and expired medications do not enter water supplies. In addition, the 
incineration facility used by the TakeAway program employs a waste-to-energy 
incineration process - meaning the energy produced by incineration is harnessed 
into electricity. Some participating pharmacies also sell TakeAway envelopes, pre-
addressed, pre-postage paid large envelopes that can be taken into the home, 
filled with unused and expired medicine, and mailed through the United States 
Postal Service to the disposal facility. 

Pharmacists prompting physicians not to write prescriptions for excessive 
quantities of inhalers used to treat acute asthma attacks can help reduce over 
prescription of the inhalers without compromising patient safety while saving 
money, according to a Medco study released last week. at the annual meeting of 
the American College of Allergy, Asthma and Immunology.   The study shows that 
when physicians receive educational materials and follow-up communications 
outreach, and have to give a response before the pharmacist can dispense a 
prescription, the number of new prescriptions for excessive quantities of rescue 
inhalers – defined as more than one inhaler per month – decreased by 60%. 

The Medco study, conducted between July 2007 and June 2008 on 250,000 
patients, found that as a result of the intervention, 200,000 fewer inhalers were 
used, saving $4.2 million. The researchers also looked at pharmacy and medical 
claims for a 1,835-patient subset of the study population. During the 12 months 
following the intervention, 67% of the patients no longer were prescribed 
excessive quantities of rescue inhalers, while the number of hospitalizations and 
emergency room visits stayed the same.

Rescue inhalers, also known as short-acting beta2 agonists, are meant for 
patients experiencing acute asthma attacks, though many physicians will 
prescribe them for daily, long-term use. While wasting medicine, this also can 
have dangerous implications for patient health by masking exacerbations of the 
disease and causing more serious problems down the road.  “Excessive use of 
rescue inhalers wastes medicine, but even more importantly, it can be masking an 
asthma exacerbation,” study researcher Luis Salmun stated. “Rather than over-
relying on rescue inhalers, patients should speak to their physicians to make sure 
that they’re using their daily asthma medications properly or to determine if an 
adjustment in those medications is needed.”

A new omnibus survey released today by the National Council on Patient 
Information and Education (NCPIE)  and Prescription Solutions, a leading pharmacy 
benefit management organization and a UnitedHealth Group company and recently 
appointed to the NCPIE Board of Directors, finds that 54 percent of Americans say 
they do not consistently take prescriptions as instructed even though 87 percent 
believe prescription medicines are important to their health – pointing to a growing 
public health problem. 

Poor adherence to medications – the extent to which people take their 
medications as prescribed by their doctor – can have adverse effects on people's 
health.  It diminishes the ability to treat chronic conditions like diabetes, heart 
disease, cancer, asthma and many other diseases; and it can result in suffering, 
an increase in hospitalizations and even death. This and other findings confirm the 
need for immediate action to address 10 key recommendations made by the NCPIE 
widely-recognized 2007 report, "Enhancing Prescription Medicine Adherence: A 
National Action Plan" which include: 
	
Immediately implement professional training and increase the funding 
for professional education on patient medication adherence.
Develop a curriculum on medication adherence for use in medical schools and 
allied health care institutions.
Address the barriers to patient adherence for patients with low health literacy.
Create the means to share information about best practices in adherence 
education and management.
Download the Key-Findings Summary and a list of practical adherence-improvement 
tips for consumers.