PHARMACY

CDC study: Severe diarrheal illness in children linked to prescribed antibiotics

BY Antoinette Alexander

NEW YORK — The majority of pediatric bacterial infections that cause severe diarrhea and are potentially life-threatening occur among children who recently took antibiotics prescribed by doctors for other conditions, according to a new study by the Centers for Disease Control and Prevention published this week in Pediatrics.

The study showed that 71% of the cases of Clostridium difficile infection identified among children ages 1 year through 17 years were community-associated — that is, not associated with an overnight stay in a healthcare facility. By contrast, two-thirds of C. difficile infections in adults are associated with hospital stays.  

Among the community-associated pediatric cases whose parents were interviewed, 73% were prescribed antibiotics during the 12 weeks prior to their illness, usually in an outpatient setting, such as a doctor’s office. Most of the children who received antibiotics were being treated for ear, sinus or upper respiratory infections. Previous studies show that at least 50% of antibiotics prescribed in doctor’s offices for children are for respiratory infections, most of which do not require antibiotics.

“Improved antibiotic prescribing is critical to protect the health of our nation’s children,” stated CDC director Tom Frieden. “When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems, including C. difficile infection and dangerous antibiotic resistant infections.”

The fiscal year 2015 President’s Budget requests funding for CDC to improve outpatient antibiotic prescribing practices and protect patients from infections, such as those caused by C. difficile. The CDC initiative aims to reduce outpatient prescribing by up to 20% and healthcare-associated C. difficile infections by 50% in five years. A 50% reduction in healthcare-associated C. difficile infections could save 20,000 lives, prevent 150,000 hospitalizations and cut more than $2 billion in healthcare costs.

C. difficile, which causes at least 250,000 infections in hospitalized patients and 14,000 deaths every year among children and adults, remains at all-time high levels. According to preliminary CDC data, an estimated 17,000 children ages 1 year through 17 years get C. difficile infections every year. The Pediatrics study found that there was no difference in the incidence of C. difficile infection among boys and girls, and that the highest numbers were seen in white children and those between the ages of 12 months and 23 months.

Taking antibiotics is the most important risk factor for developing C. difficile infections for both adults and children. When a person takes antibiotics, beneficial bacteria that protect against infection can be altered or even eliminated for several weeks to months. During this time, patients can get sick from C. difficile picked up from contaminated surfaces or spread from a healthcare provider’s hands.

Although there have been significant improvements in antibiotic prescribing for certain acute respiratory infections in children, further improvement is needed. In addition, it is critical that parents avoid asking doctors to prescribe antibiotics for their children and that doctors follow prescribing guidelines, the CDC stated.

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Report: Maryland bill could create hardships for Rx wholesale distributors

BY Antoinette Alexander

WASHINGTON — A Maryland bill that is intended to help pharmacies in managing inventories and avoid potential drug shortages could create hardships for distributors, according to an FDA law blog.

The bill introduced in the Maryland House of Delegates would require wholesale distributors to notify pharmacies at least 30 days before “imposing a limit on the quantity” of medications or devices distributed to the pharmacy. It also would require wholesale distributors to provide regular updates on the quantity of the medication or device available while a limitation is in effect.

However, according to the FDA law blog, the proposed legislation warrants monitoring and will need to be amended to resolve possible conflicts with federal law.

According to the FDA law blog, the proposed bill would not only create hardships for distributors but also could create potential conflicts with Drug Enforcement Administration requirements.

 

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Rite Aid introduces Health Alliance program to enhance patient health, treatment outcomes

BY Antoinette Alexander

CAMP HILL, Pa. — Rite Aid introduced on Monday a new program, dubbed Rite Aid Health Alliance, which is a health management collaboration among various healthcare providers that provides comprehensive care and support to individuals with chronic and poly-chronic health conditions, and helps them achieve health improvement goals established by their physicians.

Rite Aid’s Health Alliance integrated care model is a first for the drug store industry, the retailer stated, as it uniquely leverages the combined expertise of community pharmacists along with specially trained in-store healthcare coaches.

“At Rite Aid, we’re committed to actively working with our customers to keep them well and that includes developing new ways to improve access to high-quality healthcare,” stated Rite Aid chairman and CEO John Standley. “Through our innovative Rite Aid Health Alliance program, we will help patients with the resources and support necessary to successfully manage their conditions and improve their overall health and wellbeing.”

Through Rite Aid Health Alliance, patients with chronic and poly-chronic conditions, like congestive heart failure, COPD, high cholesterol and diabetes, are recommended to the program by their primary care physician. Rite Aid pharmacists and specially trained care coaches, located in Rite Aid pharmacies, work with the physician and patient on an on-going basis to improve the patient’s overall health and self-management abilities. The care team members collaborate with the patient to establish health goals, eliminate barriers and create a personalized health care action plan in coordination with the patient’s physician.

In addition to Buffalo, N.Y., Rite Aid has also established Rite Aid Health Alliance partnerships with High Point, N.C.-based Cornerstone Health Care and Glendale, Calif.-based Apollo Medical Holdings to provide these services in select Rite Aid pharmacies in Greensboro and High Point, N.C., and the greater Los Angeles area, respectively. Since its inception, Rite Aid Health Alliance has delivered during this pilot period over 2,300 coaching visits to almost 1,500 enrolled patients.

In these markets, Rite Aid provides the care coaches on the team through a partnership with Health Dialog, a provider of healthcare patient support, analytics and decision support. Health Dialog coaches will be available in Rite Aid pharmacies, and specialize in behavior change to help patients address lifestyle health issues.

“We are excited about the results of the program to date and believe it presents a significant opportunity to deliver improved health outcomes for those who need them most. We look forward to bringing this unique healthcare model to more Rite Aid markets and customers in the future,” Standley added.

“As a physician, I know firsthand how much patients here in Buffalo with chronic conditions like diabetes and hypertension can benefit from having personalized and frequent contact with their very own healthcare team,” added Dr. Raul Vazquez, president of Greater Buffalo United Accountable Healthcare Network. “Rite Aid’s Health Alliance program serves as an extension of my practice, providing my patients with convenient access to supportive healthcare coaching outside my office. Since partnering with Rite Aid, we’re already seeing some early improvements in the health of my patients and I am looking forward to continued participation in this program.”

The full range of services available to patients participating in Rite Aid Health Alliance includes medication compliance support; comprehensive medication reviews and reconciliation; nutrition and weight management information; disease education; exercise coaching and tobacco cessation support. Records of all interactions, which occur in Rite Aid pharmacies, as well as updates from the physician, are stored electronically, along with patient profiles including medications and lab results. This supports continuity of care and provides convenient access of information to other members of the patient’s healthcare team.

 

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