According to the Centers for Disease Control (CDC) website
https://www.cdc.gov/shingles/index.html (accessed 9/6/2018) almost 1 out of every 3 people in the US
will develop shingles in their lifetime. The risk of shingles increases with age.
Shingles causes a painful rash or blisters that usually resolve in 2 to 4 weeks, but can also cause a
complication called post-herpetic neuralgia which is nerve pain in the area where the rash was located that
can last for months or years and be severe and debilitating.
A shingles vaccine known as Zostavax has been in use since 2006, but in 2017 the FDA approved a new
vaccine called Shingrix which is > 90% effective in preventing shingles and nerve pain in people 50 years
old and older, and is now the CDC preferred vaccine to prevent shingles. The CDC recommends that
healthy adults 50 years old and older get 2 doses of Shingrix 2 to 6 months apart, including those who
have had shingles in the past and those who previously received Zostavax at least 8 weeks prior.
Shingrix is now covered by many health insurance plans. If you have questions about shingles vaccine
feel free to contact your Holladay Healthcare Pharmacy pharmacist at (800) 848-3446.
Article by: Charlotte Matheny, PharmD, BCGP
Medication non-adherence can be a life-threatening prospect for some long term care facility residents. Nearly 125,000 deaths annually are attributed to failed medication adherence. It can also be a costly problem within your facility. When residents who are on strict or complex medication regimens get off schedule or take the wrong dosage, the result is typically repeated hospitalizations. As they return to your facility, additional time and attention is also required from your staff to properly monitor those residents. Most people don’t intentionally skip a dose or get their pills mixed up, but, sometimes, they just get confused or forget. The good news is that there are many med reminder apps available for those residents who regularly use a smartphone or mobile device.
So, how do you choose one?
Last year, the University of Arkansas conducted a study of 461 medication adherence apps and presented their findings at the American Pharmacist Association annual meeting. This shows us two things. First, a mobile app is now a viable alternative to pill cases and sorters that really only help organize medications. Second, the number of medication tracking apps is incredible. Here are the three top performers. Each application was rated on a scale of 1-5 stars (5 being the best) across five categories: Adherence Attributes, Medication Management, Connectivity, General Features, and Health Literacy.
Overall Rating: 5 stars
To make managing meds easier, Medisafe enlists the help of visuals. The app actually shows an image of every pill once each medication is entered, creating what the app creators refer to as a “virtual pillbox.” Medisafe received an overall rating of five stars with slightly lower marks in the Medication Management and Connectivity categories.
- Intuitive visual interface with easy-to-use medication reminder
- Syncing family members’ devices and medications in real time
- Prescription refill reminders
- Medication progress reports that can be sent to a doctor or nurse
- Reminders come through even if the mobile device is asleep
- Notifications to designated contacts if the main user has forgotten to take medication or has ignored a reminder
Overall Rating: 5 stars
Sporting a clean and simple user interface, MyMeds touts the ease of managing medications. It also received an overall five-star rating, but received four stars in the Adherence Attributes and General Features categories.
- Daily medication and refill reminders via text, email or push notification
- Clear information for helping users understand why to take their meds
- Analysis of medication usage history
- Price shopping of prescriptions near the user
- Syncing with a healthcare team and loved ones
Overall Rating: 5 stars
Promoted as a mobile health manager, Care4Today has a broader focus beyond just managing medication schedules. It achieved an overall rating of five stars but fell short in the Connectivity and General Features categories.
- Notifications to help stay on schedule, including dosages
- Reminders for prescription refills
- Front and back stock images of the medications to be taken
- Built-in reports that track medication consumption
Each of these med reminder apps is available for free on the App Store (i0S) and Google Play (Android). Residents who are able should consider downloading the best medication reminder app for their individual needs. This will ensure they’re taking the proper medications, in the right dosage, at the right time. They’ll be healthier in the long run and it might just save their life. For long term care administrators, financial and staffing resources will be better allocated toward providing the best proactive resident care possible.
Prevnar 13: What are the benefits?
The Prevnar 13 vaccine is a single injection approved for adults over the age of 50 to help prevent infection caused by pneumococcal bacteria. Prevnar 13 contains 13 different strains of the pneumococcal bacteria that can lead to serious infection; infecting the sinuses and inner ear, the lungs, blood, and the brain. These conditions can be fatal if they are not treated properly.
This vaccine works by exposing the patient to a small amount of the bacteria or a protein from the bacteria so that the body develops an immunity to the Pneumococcal disease. Although Prevnar 13 can cause the patient’s body to develop an immunity to the disease, it will not be able to treat an active infection that has already developed within the body.
There are very few risks associated with Prevnar 13. The most common reactions to the vaccine include redness, swelling, pain at the injection site, and limitation of arm movement. A few other side effects that have been reported include fatigue, headache, muscle pain, joint pain, decreased appetite, and chills. The risk of serious side effects remains extremely low when a patient receives the vaccine.
Pneumovax 23: What are the benefits?
Pneumovax 23 is also a vaccine given in a single injection that has been approved for patients aged 50 and older to prevent infections triggered by pneumococcal bacteria. Unlike Prevnar 13, Pneumovax 23 is able to cover up to 23 different strains of the pneumococcal bacteria.
This vaccine is very similar to Prevnar 13; it exposes the patient to a small amount of the bacteria to cause the body to develop an immunity to the Pneumococcal disease. The most common side effects patients experienced include injection-site pain, soreness, tenderness, swelling, induration, and erythema, as well as headache, fatigue, and myalgia.
How do they compare?
Both Prevnar 13 and Pneumovax 23 are great combattants of pneumococcal bacteria infections that many adults over the age of 50 may experience. With both of these vaccines covering numerous strains of the disease, Pneumovax 23 does cover more and would be more effective against more strains than Prevnar 13. Both of these vaccines are covered by medicare but each one must alternate after one year before a patient can take the next vaccine.
If you have questions about either of these vaccines please contact one of our Holladay pharmacists at 1-800-848-3446.
As advances in technology have continued to evolve, more and more useful tools and machines have allowed geriatric patients to effectively monitor their health. One technology that has continued to improve over the years has been that of Continuous Glucose Monitoring (CGM). Though CGM is not as accurate as traditional methods of measuring blood sugar, it is continuing to make diabetics’ lives easier and safer.
While a traditional blood glucose meter only provides a brief “snapshot” of your glucose level, Continuous Glucose Monitoring devices allow patients to regularly see where their glucose levels are headed, and whether they are increasing or decreasing after certain activities throughout the day. With 288 glucose readings per day (a reading every 5 minutes), CGMs are also able to send early notifications of upcoming high and low points so that you can take action early. This is possible through advanced, wireless technology. By inserting a small sensor underneath the patient’s skin, along with transmitting information through radio waves to a handheld device, a patient is able to see what their glucose level is as well as predict where it will go based on past trends. With these advanced features, diabetic geriatric patients will have the ability to take action early enough to prevent issues from getting worse later in the day.
With Continuous Glucose Monitoring, guesswork is minimized. One large risk that comes with diabetes guesswork is Hypoglycemia. Hypoglycemia occurs when there is too much insulin in the body. When blood-sugar levels drop it can lead to symptoms such as dizziness, sweating, and headaches. It can also cause falls, seizures and loss of consciousness in diabetics. Hypoglycemia is usually more common in people with Type-2 diabetes. Studies have shown that patients over the age of 60 with Type-2 diabetes, who have an average of 40 years with the illness, spend approximately 99 minutes a day in a hypoglycemic state, including 60 minutes with a glucose level of under 60 mg/dL (Hypoglycemia is defined as a level below 70 mg/dL). With the new CGM devices, diabetic patients are able to see at what points in the day they should take action to prevent the life threatening hypoglycemia from occurring. This is especially helpful for geriatric patients that live alone and that experience hypoglycemia day and night. As these patients age, they begin to lose the ability to “feel” if they are hypoglycemic. Therefore, CGM devices can become a life-saving option.
Even though continuous glucose monitoring does not completely eliminate the need for blood glucose meter readings, the CGM’s do provide very valuable information that can lead to quicker and more accurate treatment decisions, as well as improved glucose control. Although these CGM devices are making diabetic patients’ lives easier and safer, it is very important to check on your insurance coverage before purchasing. Because this type of monitoring is such a new technology, currently Medicare and Medicaid are not covering them. These monitors can cost close to $1,000, with ongoing costs of about $400 a year; so these devices do come with a cost. With the expensive costs and the need for calibrating, these CGM devices may not be for everyone, but they can help get a better handle on an individual’s diabetes and hypoglycemic episodes.