Healthline member newsletter

Medications and Older Persons: How to Avoid Problems

Receiving a medication is one of the most common outcomes of a trip to your health care provider. Every day we are bombarded by television commercials, advertisements in almost every magazine, and full-page newspaper ads for the latest "discovery" of miracle drugs. Many patients expect a medication after an office visit, and believe they "didn’t get their money’s worth" if a new prescription wasn’t offered. But the hidden story is somewhat darker. Often medications aren’t the best approach, and sometimes they can be downright dangerous. So what’s an informed patient going to do to ensure they get exactly which medications are likely to work, be safe, and avoid complications?

Medications have done a lot to help older persons cope with the common conditions associated with aging. Blood pressure control, relief of heart pain, better ability to live with arthritis, treatment of infections, and help with low thyroid are great examples of how medications can provide a lot of benefit. But there are also risks. Annually, about 7,000 people a year die from medication errors. In fact, 30% more money is spent on dealing with the complications of medicines than on the medicines themselves! In the 1980s, most problems were related to hospital medications but now 55% are occurring in the community setting. Because the chance of taking multiple medications is higher as we get older, it is not surprising that 57% of people over age 65 have a medication problem (called an "Adverse Drug Event") each year.

As we get older, the risk of a problem occurring increases dramatically. Changes in our bodies (more fat, less water), changes in kidney function (less efficient clearing of medications out of our system), and sensitivity of our organs (brain, heart, kidneys, digestive system) all increase the likelihood of a medication problem. Add to that the chance that a person is taking multiple medications for different problems and the risk becomes even greater. Finally, most recommendations for treatment that health care providers follow are made on the basis of a single problem. For instance, experts recommend 2 or 3 different medications to prevent another heart attack after the first heart attack. But if the person also has diabetes, acid reflux, and arthritis suddenly "expert guidelines" are recommending 6 or more drugs.

Certain medications are particularly risky. Most of those are in the category we call "psychoactive" medications – drugs for anxiety, sleep, depression, or psychosis and narcotic pain medications. In fact, any drug that works directly on the brain is risky in terms of causing falls, confusion, or even epileptic fits (seizures) if suddenly stopped. Heart medications, such as blood pressure medications, blood thinners, and medications to control the rhythm of the heart are also risky. Finally, medications that are called "anticholinergic" have a special risk to older persons. Acetylcholine is an important chemical in the brain that we need to think clearly. Certain antidepressants and bladder relaxants can lower the acetylcholine in the brain and cause confusion.

Finally, there is the problem of new drugs coming on the market. Even though the Federal Drug Administration (FDA) has to approve a drug before it is released on the market, the number of people involved in studies is always much smaller than the number in the general population using it once it is released. That is why we’ve seen some major "blockbuster" drugs taken off the market in a few years after being released. For instance, Vioxx and Bextra (for arthritis) were removed from the market due to it causing heart problems after over 80 million people had taken it. Fifty percent of withdrawals from the market happen within two years of the drugs release on the open market.

So what can you do to protect yourself from having a medication problem?

  • Keep a list of your current medications - prescription and over-the-counter - and show it to all of your doctors at every visit.
  • Use one pharmacy for all your prescriptions.
    • The pharmacisit can catch a potential bad interaction between medications
  • Never ask for a medication that is advertised on television.
    • If prescribed a new medication, ask whether it's been on the market for over 2 years.
    • If it hasn't, asl for a substitute that has a known history of safety.
  • When a medication is recommended, always ask:
    • Is there anything I can do to treat my problem instead of taking a medication? For instance, exercise is better at controlling the lef pain of preipheral vascular disease than any drug.
    • Will this react with any of the medications on my list? Be especially wary of taking two or more psychoactive drugs.
    • Is there any medication on my list I can stop before starting this new medication?

 

Dr. Brummel-Smith holds the Charlotte Edwards Maguire Professorship at the Florida State University of Medicine. He leads the Department of Geriatrics, one of the give academic departments in the FSU College of Medicine. Geriatrics is one of the priority areas in the college's mission.

Live Well & Eat Well This Holiday Season

Gathering with friends and family over the holiday season is something that everyone looks forward to year round. There's delicious gravy, casseroles galore, and exquisite desserts at each gathering...but these savory dishes tend to add on the unwanted pounds. Want to avoid tipping the scales this season? Make sure you're in control of what you each by following these subsitutions:

WHAT A RECIPE CALLS FOR  USE THIS INSTEAD...
Whole milk (1 cup) 1 cup fat-free or low-fat milk, plus one tablespoon of liquid vegetable oil
Heavy Cream (1 cup) 1 cup evaporated skim milk to 1/2 cup low-fat yogurt and 1/2 cup plain low-fat unstalted cottage cheese
Cream Cheese 4 tablespoons of soft margarine (low in saturated fat and 0 grams trans fat) blended with 1 cup dry, unsalted low-fat cottage cheese; add a small about of fat-free milk if needed
Butter (1 tablespoon) 1 tablespoon of soft margarine (low in saturated fat and 0 grams trans fat) or 3/4 tablespoons liquid vegetable oil
Egg (1) 2 egg whites; or choose a commercially made, cholesterol-free egg substitute (1/4 cup)
Unsweetened Baking Chocolate (1 ounce) 3 tablespoons unsweetended cocoa powder or carob powder plus 1 tablesppon vegetable oul or soft margarine; since carob is sweeter than cocoa, reduce the sugar in the recipe by 25%

You can make many of your favorite recipes and treats healthier by using lower-fat and no-fat ingredients. The healthy substitutions above can help you cut down on saturated fats, trans fats and cholesterol, while noticing little, if any, difference at all.

Source: http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/ HealthyCooking/Smart-Substitutions_UCM_302052_Article.jsp

Capital City Senior Games

SAVE THE DATE: March 7- 16, 2015

Capital Health Plan is again a proud sponsor of the Capital City Senior Games.

Lace up your sneakers and get ready to go for the Gold! If you are an active adult or want to be an active adult there is no better way to get in shape than to start training for the Capital City Senior Games. If you are age 50 or older you qualify. All competitions are divided into age groups that range from 50-54 up to 90+.

You don't have to be an athlete to enjoy the games. Fans are welcome to all events including the Torch Run at Lake Ella on Thursday, March 12, 2015. Visit www.talgov.com for more information and what games will be held.

The Capital City Senior Games are certified by the Florida Sports Foundation and gives local athletes a chance to qualify for the Florida Senior Games State Championships and the National Senior Games.

Flu Vaccine: Get Your Flu Shot Today!

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

The flu season has started early this year. Make sure you receive your flu vaccine!

Capital Health Plan Members can receive their flu vaccine thru the following methods:

1. The flu vaccine is a covered benefit through your primary care physician's (PCP) office. Call your PCP to verify if an appointment is needed. There is a $0 copay for flu vaccines and/or pneumococcal vaccine if the office visit is only for the vaccine. Other services may require a copayment.

2. Flu vaccines can be obtained from the local health departments listed below. You should contact the facility directly for scheduling.

3. Additionally, for members who have a prescription drug benefit with Capital Health Plan, retail pharmacies in Capital Health Plan's network can administer the flu vaccine. You will need to work with your pharmacy regarding their specific appointment processes and you should have your Capital Health Plan ID card available when receiving the vaccine. The Retail Pharmacy vaccination program applies only to adults 18 and over. Pediatric patients should see their PCP.

If you have questions, please contact Capital Health Plan Member Services.

Ask Dr. Nancy: What is your risk of a heart attack in the next 10 years?

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Through technology, new tools have been made available to help us understand our personal health risks.

Heart attack risk assessment tools have gained momentum recently due to recommendations by the American Heart Association (AHA) and the American College of Cardiology (ACC). They recommend the use of a risk calculator to help physicians and patients create individualized treatment plans to reduce cardiovascular risk. Cardiovascular disease is the primary cause of death in the United States;therefore, we can expect that someone we know, or even ourself, will be part of those statistics.

Some of us are at higher risk than others. Our risk depends on numerous factors such as age, lifestyle habits, race, smoking, blood pressure, weight, cholesterol levels and family history. The risk calculators, generally, are programmed for people without known heart disease or diabetes and are 20 years of age or older.

The risk calculator allows users to input of a variety of information and returns an approximate risk number, for example, "20% risk of a heart attack in the next 10 years". You can modify the information to see what will happen if you take action to reduce your risk. For example, if you decide to exercise or keep your blood pressure down, then your overall risk will decrease.

AHA and ACC recommend if you are at high risk already, meaning you have heart disease, are a diabetic between the ages of 40-75 or have an LDL-C level of >190 mg/dL, then use a high dose statin medication (no matter what your cholesterol is on blood testing). If you don’t fall into one of the known high risk categories, use the risk calculator to determine if medications are recommended. If your risk is 7.5% or greater, then it is worth a discussion with your primary care physician (PCP).

If you are already on a statin medication, the guidelines no longer recommend getting cholesterol levels down to a certain number. High dose statins are recommended for people at high risk; lower dose statins are recommended for people at lower risk.

A welcomed trend we are seeing is that there is more emphasis on "outcomes" or what happens to the patients. This means there is a greater emphasis on trying to reduce heart attacks rather than reduce a lab values. As more research is done, we can expect these guidelines to be refined over time. One thing that will not change is the recommendation for a healthy lifestyle. The recommendations are simple. Moderate exercise; 150 minutes a week, and a healthy diet with smaller portions of fresh foods, will go a long way to reduce your risk for many diseases.

For more information regarding the risk calculator for heart attacks from the American Heart Association and the American College of Cardiology please click here.

Ask Your Member Services Department

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

When should I go to Urgent Care?

Understanding your options now will give you peace of mind later when you have to make quick decisions about urgent health care needs.

Many sicknesses and injuries may cause you to seek immediate help; however, only severe and life threatening conditions require a trip to the Emergency Room (ER). You will find that you save time and money by going to an Urgent Care Center instead of an ER. When an ER is inappropriately utilized it typically will cost you, in premiums and increased cost shares, twenty times more than an Urgent Care Center. If you have an illness or injury that requires immediate attention that you would normally see your primary care physician (PCP) for and cannot get an appointment that same day, Urgent Care is the right choice.

Your PCP is your health care partner and central coordinator for everything pertaining to your good health. S/he knows you well and provides health care advice tailored to your needs. We therefore encourage you to see your PCP, if possible.

Go Paperless! Benefit Materials on CHPConnect

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Capital Health Plan is pleased to announce that your benefit documents are now accessible through CHPConnect, your secure online personal health record. All Capital Health Plan Members have access to this online system at no additional cost. This allows you, our member, to view important information related to your health care 24 hours per day, 7 days a week.

Within CHPConnect, you will have access to the following:

Benefit Documents: Have questions about your benefits? You can view your benefits documents from the Benefits and Eligibility tab in the left-hand navigation menu. You can access documents such as the Member Handbook, Summary of Benefits & Coverage (SBCs), and more.

Now that all of your benefit documentation is securely posted online, Capital Health Plan is discontinuing the process of sending benefit documents on CDs through the mail. If you still prefer a paper copy of your benefit documents, you may contact Member Services.

2015 Plan Changes

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Our Formulary (list of covered prescription drugs) is changing January 1, 2015.

Capital Health Plan has a nationwide pharmacy network available to our members (who receive their pharmacy benefits through Capital Health Plan) with over 50,000 pharmacies.

The 2015 Commercial and Medicare Formulary is available online beginning on October 1, 2014. Visit our website to see if the 2015 changes affect your prescription drugs. In addition, mail order prescription services will be available through PrimeMail® for all Capital Health Plan members!

New health care regulations and decisions of your employer may have affected your group plan. When it’s time for your 2015 open enrollment, be sure to read your policy information thoroughly and work with your group administrator to understand all the changes.

Notice: Capital Health Plan Recorded Phone Calls

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Call monitoring is an effective method for improving the level of service provided to our customers, our patients and our members.

Part of Capital Health Plan’s overall strategy is to provide top-level customer service throughout the organization, including telephone etiquette and accurate information. Incoming and outgoing calls are recorded in departments in which our staff routinely communicates with you. When our staff places an outbound call to you, they will indicate that the call is recorded, when applicable. You may also hear beeping during your call, letting you know your conversation is being recorded.

Capital Health Plan Again Honored as NCQA’s Highest-Ranked Health Plan in Florida

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

TALLAHASSEE, Fla.– Continuing its long-standing tradition of excellence, Capital Health Plan has once again been recognized as the best health plan in Florida and among the very best in the nation. For the 10th consecutive year, Capital Health Plan earned the exceptional distinction from the National Committee for Quality Assurance (NCQA). In its annual ranking of health plans across theUnited States, NCQA also gave Capital Health Plan’s Medicare Advantage Plan the highest ranking in Florida and one of the top rankings in the nation.

“We are deeply honored to once again be ranked as the top health plan in Florida,” said Dr. Nancy Van Vessem, Capital Health Plan’s Chief Medical Officer. “We are continually pursuing new and innovative ways to serve our members’ health care needs, and we are grateful to be recognized for a full decade of outstanding member-focused approach by experts in our industry.”

Since NCQA began releasing national rankings in 2005, Capital Health Plan has consistently been recognized among the highest ranked plans in the nation. According to the report “NCQA’s Private Health Insurance Plan Rankings 2014-2015,”Capital Health Plan’s commercial plan is the top private plan in Florida and the 16th best in the country, out of 617 plans. Similarly, Capital Health Plan’s Medicare Advantage HMO plans were also deemed the best in Florida, while earning the fourth highest spot in America in NCQA’s national assessment.

“We are deeply committed to this community and take great pride in being recognized for the 10th year in a row,” said John Hogan,CEO of Capital Health Plan. “This distinction reflects the hard work and dedication of our staff and medical team, and the positive response of the members we serve every day.”

The National Committee for Quality Assurance is based on several of the most widely used measurement tools in health care, including scores from HEDIS®, CAHPS® and NCQA Accreditation standards to calculate plan rankings. Scores reflect the results of consumer surveys and the plan’s success, compared to other plans, in preventing and treating medical conditions.

Since 2001, Capital Health Plan has also maintained an “Excellent” accreditation rating from NCQA. Capital Health Plan currently holds an “Excellent” status for both its Commercial HMO and Medicare HMO plans, meaning Capital Health Plan met or exceeded NCQA's rigorous requirements for consumer protection and quality improvement.

Capital Health Plan’s commitment to member satisfaction shows in the outstanding results of member surveys. Those surveys show high satisfaction with members rating of health plan and members rating of health care.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. For more information on NCQA rankings, visit www.ncqa.org.

For more information about the rankings, please click here