Directions on Pill Bottles Confusing for Patients, Shingles

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Many older patients, who take an average of seven medicines a day, are so

confused by the vague instructions on prescription bottles that they don't

realize they can combine their medications to take them more efficiently. A new

Northwestern Medicine study shows patients thought they had to take seven

medicines at least seven and up to 14 separate times a day.

" A complex and confusing regimen means people are less likely to take their

drugs properly, and that means they are not getting the full benefits of their

medicine, " said Wolf, associate professor of medicine and of learning

sciences at Northwestern University Feinberg School of Medicine. He is lead

author of the study, funded by the National Institute on Aging, published

February 28 in Archives of Internal Medicine.

Wolf and colleagues have proposed a universal medication schedule that

standardizes medicine prescriptions into doses at four clearly identified

periods of day - morning, noon, evening and bedtime (instead of twice daily or

every eight hours.)

" Standardizing the times to take medicine will help patients safely take their

medicine, make their lives easier and improve their health outcomes, " Wolf said.

He was on the panel of the U.S. Pharmacopeia that recently released guidance for

drug labeling praising the four daily doses approach.

For the study, Wolf and colleagues interviewed 464 patients, with an average age

of 63, at an academic general medicine practice and three federally qualified

health centers in Chicago to see how patients would schedule a typical

seven-drug regimen. The majority of participants were well educated, but nearly

half had low or marginal health literacy skills.

Wolf found people overcomplicate . Even if two drugs were prescribed in the same

manner (one pill twice daily), nearly a third of patients (30.8 percent) would

not take them together. When two drugs could have been taken together but doctor

instructions were written differently (one pill twice daily versus one pill

every 12 hours) 79 percent of patients would not consolidate these medicines and

take them at the same time. If instructions for two drugs were the same with the

only exception that one said " with food and water, " half the patients would not

take the two drugs at the same time.

Low health literacy was the greatest predictor of patients dosing their

medications a greater number of times per day.

http://www.medicalnewstoday.com/articles/217789.php

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RISK OF SHINGLES GREATER FOR PATIENTS WITH C.O.P.D.

Patients with chronic obstructive pulmonary disease (COPD) are at greater risk

of shingles compared with the general population, according to a study published

in CMAJ (Canadian Medical Association Journal). The risk is greatest for

patients taking oral steroids to treat COPD.

Shingles, or herpes zoster, is a reactivation of the chicken pox virus resulting

in a painful rash with lesions. People with a compromised immune system are at

greater risk of developing shingles although it has not been previously studied

in patients with COPD.

There is increasing evidence that COPD is an autoimmune disease. " Given that

various immune-mediated diseases, such as rheumatoid arthritis and inflammatory

bowel disease, have been reported to be associated with an increased risk of

herpes zoster, it is reasonable to hypothesize that immune dysregulation found

in COPD may put patients at higher risk of developing herpes zoster, " writes Dr.

Hui-Wen Lin, Taipei Medical University, Taiwan with coauthors.

This study, using data from the Taiwan Longitudinal Health Insurance Database,

included 8486 patients with COPD and 33 944 subjects from the comparison cohort.

Of the total sample of 42 430 patients, 1080 had incident of herpes zoster

during the follow-up period. There were 321 cases of shingles identified in the

COPD cohort, 16.4 per 1000 person years, and 759 cases in the comparison cohort,

8.8 per 1000 person years.

http://www.medicalnewstoday.com/articles/217249.php

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FYI,

Lottie Duthu