September is Healthy Aging Month and has been created to bring national awareness to positive aspects of aging. According to the US Census Bureau, in July of 2019, there were more than 54 million people 65 and older living in the U.S.¹ The number of older adults is projected to continue to increase over time. This article is here to give tips to those 65 and older to improve all areas of their health and wellness.

1. Monitor Chronic Conditions – Older age brings a higher risk of chronic conditions, such as diabetes, heart disease, high blood pressure, dementia, and cancer. A study by the CDC found that eighty percent of those 65 and older have at least one chronic condition, and nearly 70% of Medicare beneficiaries have two or more.² To help manage these problems, companies like ours (PharmD Live®) have programs to assist patients with disease and drug/medication management. 
2. Avoid Falls – Each year, 3 million older people are treated in emergency departments for fall injuries.³ Many falls do not cause injury, but some can cause broken bones or head injuries.⁴ Many conditions, such as vitamin D deficiency, vision problems, and some medications can put you at a higher risk of a fall and bone fracture. Check with your doctor (or see if they are working with a medication therapy management solutions company) to see if any medications you are taking can cause drowsiness or dizziness which may lead to a fall. 
3. Exercise – The CDC found that 31 million adults age 50 or older were inactive in 2014.⁵ Those age 18-64, need at least 150 minutes of moderate intensity physical activity per week or 75 minutes of vigorous aerobic exercise.⁶
   • Moderate intensity excercise activities include:
     • brisk walking 
     • water aerobics 
     • dancing 
     • doubles tennis 
     • gardening 
     • biking slower than 10 miles per hour 
   • Vigorous intensity exercise include:
     • hiking uphill or with a heavy backpack 
     • running 
     • swimming laps 
     • heavy yard work (hoeing or digging) 
     • singles tennis 
     • cycling ten miles per hour or faster
     • jumping-rope.

If some of these activities seem impossible, start with small, achievable goals and continue to increase their difficulty. Some exercise is better than none at all. Get up and get moving today!

4. Mitigate Alzheimers and dementia – Alzheimer’s Disease is not a normal part of aging.⁷ In 2021, 6.2 million Americans are estimated to have Alzheimer’s Disease. Normal brain aging can mean symptoms such as slower processing and trouble multitasking. Abnormal symptoms of aging would be confusion with normal tasks or trouble recalling the date or time. If you are experiencing these symptoms, you should contact your physician. Stopping smoking, controlling blood pressure, maintaining a healthy lifestyle, and getting the recommended amount of sleep are all ways to prevent cognitive decline.
5. Monitor behavioral health – One in 4 older adults experience mental health problems such as depression, anxiety, or substance abuse.² There are many available interventions and treatments to help with these. Reach out to your healthcare provider today for help. We also recommend reaching out to a loved one and asking for help. Lastly, try surrounding yourself with positive, energetic people, you may find their characteristics contagious! 
6. Treat incontinence- 10-20% of all women and 70% of women in nursing homes have urinary incontinence.⁸ Urinary incontinence can affect physical, mental, and social health of women if left untreated and is not a normal part of aging. Ask your doctor if they are working with a specialist service (such as PharmD Live®) who can review your medication list and history of urinary incontinence and recommend a personalized treatment for you. Speak with your healthcare provider today. 
7. Stop COVID-19 – The risk of being hospitalized or dying from COVID-19 is much greater for older adults. Preventative measures such as getting vaccinated, wearing a mask, socially distancing, and washing your hands can prevent you and your loved ones from getting the virus.⁹ 
8. Preventive Services – Did you know that fewer than half of those age 65 and older are up to date on their core preventive services?¹⁰ Likewise, fewer than 30% of those ages 50-64 are up to date with their preventive services. 

Preventive services can include: 

• immunizations 
• screening tests 
• counseling 

These preventive services can mitigate chronic diseases, identify them early on, or even prevent further complications. 

9. Caregiver Resources- Approximately 40 million adults are unpaid caregivers to older adults and adults with disabilities;¹¹ taking on the role of caregiver can cause both physical and emotional stress. There are many organizations that provide caregiver resources. The National Council on Aging, Family Caregiver Alliance, AARP, and Health and Human Services are a few examples of organizations that provide resources for caregivers.^12,13,14 You can also reach out to your provider or loved one’s provider for resources. If you feel as though you are struggling to be a caregiver, speak with your provider or someone from a dedicated organization today for help.
10.  Act the Age You Feel and Not the Age You Are. This means discussing with patients  realistic physical capabilities, and encouraging new things. Maybe recommend they call friends and family they have not seen in a while. Another option would be to recommend volunteering, cooking or dance classes, travel or hometown touring. You may be surprised how many people  have never seen some of the attractions in your own hometown or nearby. 

References

1. Bureau USC. Older population and aging. The United States Census Bureau. https://www.census.gov/topics/population/older-aging.html#:~:text=According%20to%20the%20U.S.%20 Census,million%20on%20July%201%2C%202019. Published August 21, 2021. Accessed September 2, 2021. 
2. Get the Facts on Healthy Aging. Center for Health Aging for Professionals. https://www.ncoa.org/article/get-the-facts-on-healthy-aging. Published January 1, 2021. Accessed September 2, 2021. 
3. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed August 5, 2016.
4. Facts about falls. Centers for Disease Control and Prevention. https://www.cdc.gov/falls/facts.html. Published August 6, 2021. Accessed September 2, 2021. 
5. Adults need more physical activity. Centers for Disease Control and Prevention. https://www.cdc.gov/physicalactivity/inactivity-among-adults-50plus/index.html. Published June 9, 2021. Accessed September 2, 2021. 
6. American heart Association recommendations for physical activity in adults and kids. www.heart.org. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults. Published April 18, 2018. Accessed September 2, 2021. 
7. Alzheimer’s disease. Centers for Disease Control and Prevention. https://www.cdc.gov/dotw/alzheimers/index.html. Published June 22, 2021. Accessed September 3, 2021. 
8. Batmani S, Mohammadi R, Bokaee S. Urinary incontinence in older adults. National Institute on Aging. https://www.nia.nih.gov/health/urinary-incontinence-older-adults. Published March 29, 2021. Accessed September 3, 2021. 
9. Older adults risks and vaccine information. Centers for Disease Control and Prevention. https://www.cdc.gov/aging/covid19/covid19-older-adults.html. Published August 2, 2021. Accessed September 4, 2021. 
10.  Tangum C, Benson W. CDC Focuses on Need for Older Adults To Receive Clinical Preventive Services. https://www.cdc.gov/aging/pdf/cps-clinical-preventive-services.pdf. Accessed September 4, 2021. 
11. Caregivers. The National Council on Aging. https://www.ncoa.org/caregivers. Accessed September 4, 2021. 
12. We’re here to help you. Home – Family Caregiver Alliance. https://www.caregiver.org/. Accessed September 4, 2021. 
13. AARP resources for caregivers and their families. AARP. https://www.aarp.org/caregiving/?cmp=KNC-BRD-MC-REALPOSS-GOOGLE-SEARCH-CAREGIVING&gclid=Cj0KCQjwssyJBhDXARIsAK98ITRBqZx9w_SAbt6NQjzwni-q10ROhqLt9YpnP9RBJRL-i6672Yc23PcaAkdIEALw_wcB&gclsrc=aw.ds. Accessed September 4, 2021. 
14. (DCD) DCD. Resources for caregivers. HHS.gov. https://www.hhs.gov/programs/providers-and-facilities/resources-for-caregivers/index.html. Published February 1, 2021. Accessed September 4, 2021.

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Safely managing medications is crucial for senior health. Studies have shown that roughly 90% of older adults aged 65+ take one medicine, 40% take more than five, and 20% take more than ten. The older one gets, the odds of taking more medications increase and can lead to increased side effects and adverse drug interactions. As we age, our body also deteriorates, and this process can also change medication effectiveness. Changes in the body can lead to harmful complications if doses are not correctly adjusted.  We asked our board-certified pharmacy team to rank their top five recommendations on what seniors should understand when taking medications. Here’s what they said: 

1. Medication Non-Adherence: this is when patients do not take their medications as prescribed. The issue is common, especially among patients with chronic diseases. Some people may not realize the importance of taking medication as prescribed, even if they feel better after 1 or 2 doses. This is especially true with antibiotics. Many patients are unaware that prematurely stopping antibiotic treatment leads to the growth of drug-resistant bacteria. The most prominent reasons for not taking medications as prescribed might be forgetfulness, cost, or pill burden. Investing in a pillbox is helpful for those who take more than five medications and frequently forget doses. The pillbox can help organize medications for a specific time frame which can help avoid missing doses. If cost is an issue, ask your doctor if switching to a generic brand is an option. Also, suggest changing the daily supply from 30 to 90 days, reducing pharmacy visits for refills.

2. Incomplete Medication List: an updated medication list is essential for preventing any potential side effects. All medication prescriptions, OTCs, vitamins, and herbals should be counted on your list. Medication lists give you or your care provider an overview of all the medications you are currently taking and how they interact with each other. For instance,  certain OTC antihistamine medications are very sedating and should be taken with caution when taking other sedating prescription medications like narcotic pain medication or muscle relaxants. During visits to the doctor, patients should bring an updated medication list. Hence, their providers have an accurate accounting of the start and stop dates, the dosages, directions, and the purpose of the medication.  

3. Unaware of potential side effects/adverse reactions: sadly, older adults are seven times more likely to have unwanted side effects and 2-3 times more likely to experience adverse reactions. We highly recommend that older adults ask their healthcare provider to check for potential interactions and updates on any new medication. Also, if you consume alcohol, tell your doctor as certain medications lose their efficacy with alcohol while the effects of others are enhanced. As we get older, doses need to be adjusted based on how the body can metabolize the medication.  

4. Not storing medication properly: Properly storing medications is important to keep them safe and effective. Not storing medications properly can cause them not to work as well or can cause harm to the patient. The best storage for most medications is in a cool, dry place like a dresser drawer, storage box, closet shelf, or kitchen cabinet. Do not store medications in the bathroom, where exposure to temperature fluctuations caused by heat and humidity will alter the efficacy of the medication. Certain medications, like insulin, need to be in the fridge. Special storage labels such as “refrigerate only” will be on these types of medications. It is important to pay attention to all the labels the pharmacist attaches to the medication. 

5. Not knowing what the medication is for: patients need to be well informed about why they are taking medication to recognize its importance and motivate them to take it. This helps with compliance and overall improved health. This is an opportunity for the patients to ask questions of their pharmacists if they are unsure what the medication is. The pharmacist will thoroughly review the medication’s purpose, how to take it, and any special instructions. It’s important to know whether it needs to be taken with or without food. Studies have shown that when patients are armed with information about their medication, they become more invested in improving their health.  

In conclusion, seniors, in particular, should take special precautions when prescribed more than one medication. These helpful tips will enable you to have better control of your overall health. That is what we do at PharmD Live®.  We are a pharmacist-led company that provides personalized care to Medicare patients with chronic diseases. In addition to managing a patient’s disease state, our board-certified pharmacists offer a thorough evaluation of a patient’s medication regimen to identify therapy gaps, mitigate medication risks and optimize medication therapy.  We are a great resource to guide patients to understand the importance of their medications and keep them safe from adverse drug events. 

References: 

1. Medication Overload and Older Americans. Lown Institute. Retrieved from: https://lowninstitute.org/projects/medication-overload-how-the-drive-to-prescribe-is-harming-older-americans/
2. 4 Medication Safety Tips for Older Adults. US Food and Drug Administration. Retrieved from: https://www.fda.gov/consumers/consumer-updates/4-medication-safety-tips-older-adults
3. Salvi, Fabio. Marchetti, Annalisa etc. Adverse drug events as a cause of hospitalization in older adults. PubMed. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/23446784/

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Susan Widmar – content writer

Some say aging isn’t for sissies. At her 100th birthday party, the celebrant answered what it was like to be 100, “Don’t work for it, honey.”

Dan Buettner’s Blue Zone¹ studies have made healthy aging part of our daily lexicon. He offers step-by-step ways to improve life and longevity. 

• Who is he speaking to?
• What of those age 65+ who have chronic conditions?
• Can patients enhance their quality of life—even in the face of chronic diseases?
• Can physicians support a Medicare patient with chronic conditions?

Medicare patients with two or more chronic conditions depend on their primary care provider to lead them to their best health and quality of life. Medicare is now fine-tuning its medical reimbursement models to the quality of care for each patient. MIPS (Merit-based Incentive Payment System) calculates rewards for medical practices, hospitals, and Accountable Care Organizations through multiple criteria. Payment adjustments are measured on these criteria and against peer performance. 

The pharmaceutical industry wants support to develop medications that can address additional conditions of aging. Vaccinations and treatments already in the development pipeline could advance faster with an infusion of government money.  

The current administration sees merit in the approach. It proposes a department within the National Institutes of Health (NIH) to authorize development projects much like the Defense Advanced Research Projects Agency (DARPA) at the Department of Defense (DOD). For more than 60 years, the DOD has been allowed to be agile and flexible and even to fail.²

• This approach may be a burden to physicians and a polypharmacy nightmare for patients.
• Physicians will have to balance the burden of additional medications to prescribe against worldwide health illiteracy. 
• In addition, the CDC says, Boomers are notorious rule-breakers and will do as they please.

A study from Mahatma Gandhi University, India,³ concluded that 

• 21.1% of their targeted study group, age 60+, have access to health literacy skills. 
• The majority had limited access through non-formal and informal communications about health issues. 
• Only 6% have a regular program to update their health literacy skills. 
• Of the studied group, 80.8% show no use of learned health literacy skills to maintain health. 

Medicare’s reimbursement for chronic care older adults depends on developing a patient’s self-knowledge and self-care. Medical providers in the US can ease the burden of adapting to the incentives and disincentives of the reimbursement program by recognizing where the majority of issues lie with patients with multiple chronic conditions. 

• Adverse drug events (ADE) account for prolonged hospital length-of-stay by nearly 2-5 days. 
• In outpatient settings, an estimated 1 million visits are due to ADEs.  

Care coordinators, by many definitions, develop relationships with patients to monitor their adherence to health management. The patient-care coordinator interactions now are billable with specific codes that reimburse for the additional time spent through telehealth. Physicians are well aware of the annual changes and increasingly stringent penalties–sometimes at the expense of knowing how to bend the arc in favor of the medical practice. 

PharmD Live® uses clinical pharmacists as care coordinators. There is an opportunity for patients to build health literacy skills and a relationship with the pharmacist-coordinator, who can recognize the potential for ADEs. The knowledge and experience of a clinical pharmacist available 24/7/365 give patients access to a trusted health care coordinator for information when it is needed.  

Patients get advice from a care coordinator with whom they’ve developed a personal relationship—and one who has a direct relationship with the patient’s primary care provider. 

Patients engaged in their healthcare can live well with chronic conditions, and medical practices that engage appropriate care coordinators to intervene before ADEs are an issue can help. Combined with coding and reporting that eases the staff burden of the medical practice, PharmD Live® also contributes to the health of the business of medicine.

Back to Main Blog

Susan Widmar, content writer, PharmD Live® – Ms. Widmar has nearly two decades of experience writing healthcare marketing and communications for one of Minnesota’s largest healthcare organizations. Four of those years she worked with senior defined populations in health, housing and long-term care.

References

1. Dan Buettner –  https://www.bluezones.com/live-longer-better/
2. Scientists are demystifying aging — funding could add decades to our lives https://thehill.com/opinion/healthcare/563337-scientists-are-demystifying-aging-funding-could-add-decades-to-our-lives – Matt Kaeberlein, contributor, 07/16/21
3. Access and Contribution of Health Literacy toward Healthy Aging – https://www.indianjournals.com/ijor.aspx?target=ijor:ijpss&volume=5&issue=10&article=027  Feyisa Reta Melaku, Department of Development Studies, Mahatma Gandhi University, Kottayam, Kerala, India. Dr. Sabukuttan K., Head and Director Department of Lifelong Learning and Extension. Mahatma Gandhi University, Kottayam, Kerala, India. Published online 24 February 2016
4. Life course vaccination and healthy aging – https://link.springer.com/article/10.1007/BF03324907 Article Michael K. Gusmano PhD & Jean-Pierre MichelPublished: 26 July 2013

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Satchel Paige, pitcher and authority on aging, pondered, “How old would you be if you didn’t know how old you was?” A healthy attitude is ageless. Marshall Eidenberg, DO, regional medical director at PharmD Live®, says, “Aging is going to happen if we are lucky enough to live so long. The trick is to become the people we want to be.”

Sound mind and body

About 20 years ago, Healthy Aging® magazine introduced “September is Healthy Aging® Month.” September is an excellent time for doctors to review with patients what they are doing to maximize the quality of their lives through mind, body, and spirit. Eidenberg says, “A shoe company, ASICS, stands for Anima Sana In Corpore Sano. That means, ‘sound mind in a sound body.’ It is this connection between the body and mind that is key. Here’s an inspiring video of Marcia Walker, a cross-fit exerciser. Her message is, “Get off of the fence and just do it,” she says. “Everybody comes into it with different weaknesses and strengths, and if you can’t do a pull-up, then you come in and do what you can do and grow into it.”  

It is our minds that tell us what we can and can’t do. We may have to modify and adapt as we get older, and muscles and joints don’t respond as well. In 2013 a Harvard study showed exercise is as effective as prescription medicines for preventing common conditions like heart disease, strokes, and diabetes. Even better, there are no medication side effects or interactions. But if this isn’t an option, we are here to mitigate problems.”

Strength and balance in attainable doses

Dr. Eidenberg advises, “Have patients adopt a simple program and focus on strength and balance. Make sure it is something they enjoy because the best exercise is of no benefit if it doesn’t happen; it is like medicine kept in the bottle.” For patients on Medicare, it’s well worth educating your patients about how they can avoid some conditions or manage those they have that are chronic. 

Since the top two issues in senior care are falls and adverse drugs events, a Chronic Care Management (CCM) plan can help your patient sort the advantages and disadvantages of certain behaviors and the medications prescribed to manage them. Pharmacists know more about how medications act or cause problems when used with other drugs.

New topics in the field

The National Institute of Aging (NIA) is a subordinate agency of The National Institute of Health. For more than a decade, the NIA has been testing a variety of compounds on mouse models to see which ones extend life. They have found that some simple interventions like aspirin and glycine increase lifespan in these mice by at least 10%. The full list is available here. Since these are pharmaceutical interventions, our clinical pharmacists can incorporate the latest science and minimize interactions between therapeutic compounds. 

PharmD Live® engages patients in extending healthy years

The government doesn’t acknowledge aging as a disease. Ultimately all of this is about the patient’s health. With the increasing burden of more complex patients as society becomes older, we as clinicians may not have the time we want to spend with each patient. 

Several conditions are due to aging, so how do patients and doctors decide whether and how to combat inevitable aging and put more life in a person’s senior years? Especially when the average physician visit is 15 minutes, and less is spent with the patient due to the “meaningful use” government rules. For a more ironic insight, see this article in Forbes. 

Any Medicare patient with two or more chronic diseases is a candidate for the Medicare CCM program. Physicians have an opportunity to take advantage of the revenue stream provided by enrolling eligible patients and help patients improve how well they age. Eidenberg says, “It’s not just about the lifespan; it’s about health span and extending the healthy years.” 

 This is where we can help. By providing more touchpoints with your higher complexity patients, we can keep them engaged in their own health, prevent and mitigate drug interactions, and decrease polypharmacy complications. We can all do well by doing good. 

Patients engaged in their healthcare can live well with chronic conditions, and medical practices that engage appropriate care coordinators to intervene before issues arise can benefit their practice. Combined with coding and reporting that eases the staff burden of the medical practice, PharmD Live® also contributes to the health of the business of medicine.

About Marshall Eidenberg, DO, MBA

Regional Medical Director Marshall Eidenberg, DO, MBA, PharmD Live®, also works as a chief medical officer in an austere environment. He established medical public health protocols in underserved communities. He previously ran a Direct Primary Care Practice focusing on health and wellness interventions within the community. In his free time, he competes in triathlons and is fumbling his way through learning the guitar.

About PharmD Live® 

PharmD Live® is a network of clinical pharmacists working as care coordinators in partnership with medical practices. The care delivery model improves patient outcomes, drives clinical efficiency, and increases value-based profitability. For more information, call +1 (202) 765-1429 or visit pharmdlive.com.

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The Spanish-speaking patient had a language barrier, among other health literacy issues.

Dr. Salata is a fluent Spanish speaker as well.

She says, “We had a one-hour Medication Therapy Management appointment that took an extra unscheduled hour.” 

Dr. Salata learned that the woman’s standard three-meals-a-day diet was tortillas, beans, and rice.

The woman was unaware of the issue until Dr. Salata carefully explained that each was a form of sugar.

Her choices were responsible for her continued high sugar levels.

Without the language barrier, they could discuss issues at length, and the patient left the meeting armed with small changes that would help her achieve better glycemic control. 

Broad statistical strokes have painted two separate groups of people with different types of literacy—functional literacy and health literacy. 

Functional literacy includes reading, writing, and numbers.

The National Center for Education Statistics (NCES) uses an international study that defines literacy as “understanding, evaluating, using and engaging with written text to participate in society, achieve one’s goals, and develop one’s knowledge and potential.”¹ 

NCES reports that on a 1-5 level scale, in 2017, 19 adults out of 100 in the US performed at or below level 1. At level 2, 33 adults of every 100 and 48 of every 100 performed at level 3 or above.¹ 

Even if a person is functionally literate, he may not be particularly able to understand health information or services.

Healthcare and associated activities are unfamiliar, technical, and complicated to understand.²

Communication, education, health behaviors, and access to healthcare all contribute to health literacy.

Only 12 in 100 Americans have the skills needed to navigate successfully and understand complicated medical information.³ 

Additional national data show that more than 3 in 10 US adults have low health literacy.

The question is whether the expected populations’ profiles truly represent the demographics of all patient groups. 

A literature review by Easton, Entwistle & Williams reported in BMC Public Health that the range and relationship between functional and health literacy have not accounted for confounding factors.

They posit there is a “hidden population” of people with low health literacy.⁴

Screening tools for health literacy have proven ineffective for improving health literacy at a practice level.

As a result, use screenings only for research. 

When physicians don’t question patients about lifestyle or other medications, they may presume adequate health literacy.

Still, patients are disadvantaged by not knowing the potential pitfalls of a course of treatment. 

In another instance, Dr. Salata encountered a patient who seemed to have the literacy skills he needed but wasn’t given proper health education.

The middle-aged man came in seeking advice believing he did everything right—but suffering from a condition he wasn’t sure he could discuss with a young female pharmacist.

“He’d had a heart attack, and his physician told him his best option was to control his cholesterol, which he seized with gusto.”

The patient went all-in on his diet, exercise, and the prescribed medication. 

After further conversation, he shared that he had an inherited condition that gave him unnaturally high C-reactive protein, which exposes the carrier to an increased risk of heart attacks.

The doctor did not warn him about the effects of reducing his cholesterol drastically.

Dr. Salata gained the patient’s trust, and he admitted how he was feeling.

She referred him back to his physician with the rest of his medical story.

Dr. Salata’s pharmacy visitor was not considered to have low health literacy.

He caused himself harm because he didn’t have adequate information from his physician about the side effects of his medication and lifestyle changes.

His confounding factors may make him eligible to count among the hidden population of low health literate.

Dr. Salata says, “Pharmacists are the most accessible healthcare professionals. Unlike Lucy Van Pelt from Peanuts, we don’t charge 5 cents for advice.

Free advice and our large knowledge base and specific skills with medications bring people in with all manner of questions.” 

Stephanie Billecke, director of patient education and technology, Patient Education, Fairview Health Services, Minnesota, says, “Health literacy affects a person’s health status more than anything, including age, race, income, education, and employment.”

She explained that nearly 9 out of 10 adults have difficulty using everyday health information. “The average reading level of American adults is 8th grade, and nearly two in 10 read at or below the 5th-grade level.

Medical terms raise the average health sheet to the 10th-grade level.” Ms. Billecke noted that anyone could have trouble processing and using information when they’re sick, frightened, or otherwise impaired.

When comprehension is poor, patients are more likely to suffer Adverse Drug Events, require readmission with a longer length of stay, lower their health outcomes, increase cost, and become less satisfied. 

The CDC’s Healthy People 2030⁵ project redefines health literacy to emphasize information use, not just understanding.

It also sharpens the need for patients to make well-informed decisions in place of appropriate decision-making. 

Universal health literacy precautions are steps and techniques to take with all patients.

Say It, Check It, Print It

Grounded in the Teach-back technique, Ms. Billecke developed a mnemonic, “Say It, Check It, Print It.”⁶ from resources offered by the US Department of Health and Human Service a way to organize the elements of universal health literacy precautions. ^{7, 8 ,9}Name *FirstLastEmail *

The promise of high-quality, affordable care aligning with the individual needs of patients remains elusive. Increasingly, the missing ingredient seems obvious: trust.¹⁰ 

For several years running, the Gallop organization ranked nurses, physicians, and pharmacists among the most trusted professions in the US.¹¹

The American public agrees that these professionals are honest and ethical.

Growing trust through efforts to boost health literacy will help physicians translate the admiration into results for transforming the medical landscape and improving patient care while decreasing costs.  

October is Health Literacy Month.

Also, it is the anniversary of the Plain Writing Act, signed into law on Oct. 13, 2010.

In addition, October is National Pharmacist Appreciation Month.

PharmD Live® salutes pharmacists who provide valuable services in medication management, health literacy, and enriching patients’ lives with ready advice.

Take a bow and take a breath.

You deserve both.

About PharmD Live®: PharmD Live® partners with medical practices, healthcare systems, hospitals, and ACOs delivering Chronic Care Management and Remote Patient Monitoring telehealth solutions to Medicare patients. Our care coordinator/clinical pharmacists use our proprietary AI platform to benefit your patients’ health outcomes, as well as your bottom line. For more information, call +1 (202) 765-1429 or visit pharmdlive.com.

__________________

1 Briggs, Calvin. “The Policy of STEM Diversity: Diversifying STEM Programs in Higher Education.” Journal of STEM Education: Innovations and Research, vol. 17, no. 4, Institute for SMET Education and Research, Oct. 2016, p. 5. https://nces.ed.gov/fastfacts/display.asp?id=69

2 https://www.cdc.gov/healthliteracy/learn/Understanding.html#ReportsandEvidenceonLimitedHealthLiteracy

3 https://www.himss.org/resources/evaluating-impact-meducationr-smart-application-medication-adherence-need-evaluate-ehr

4 BMC Public Health 10, 459 (2010). https://doi.org/10.1186/1471-2458-10-459

5 https://www.cdc.gov/healthliteracy/learn/

6 Say It, Check It, Print It: Billecke, S., Patient Education Department, Fairview Health Services, Minnesota. modified 2019, © 1998-2014 Fairview Health Services. All rights reserved

7 Resources for Implementation: A Universal Precautions Approach https://health.gov/our-work/national-health-initiatives/health-literacy/health-literate-care-model/resources-implementation

8 Communicating Risks and Benefits:  An Evidence-Based User’s Guide PDF – 3,128KB Baruch Fischhoff, PhD, Noel T. Brewer, PhD, & Julie S. Downs, PhD, editors, US Department of Health and Human Services, Food and Drug Administration

9. Use the Teach-Back Method: Tool #5. Content last reviewed September 2020. Agency for Healthcare Research and Quality, Rockville, MD.  

Retrieved from https://www.ahrq.gov/health-literacy/improve/precautions/tool5.html 

10 The American Journal of Accountable Care. 2019;7(3):24-25 

11 https://news.gallup.com/poll/328136/ethics-ratings-rise-medical-workers-teachers.aspx

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Ageism can be explicit or implicit in its execution and can manifest in various ways, but at its core, there are three components that can result in ageism.

Age discrimination, or the harmful treatment of older people, encompasses actions that damage older people psychologically or physically due to their age. This can look like dismissing a treatable pathology as a feature of old age or excluding elderly adults with multiple chronic illnesses from clinical trials in order to focus on a “general population.” These actions can be detrimental to a patient’s health and wellbeing, and yet they remain widely practiced and unaddressed in the industry.

Negative age stereotypes are implicit beliefs regarding older people in general that are dismissive, cynical, or uncooperative. Often, negative age stereotypes are instilled in the population at an early age. Negative age stereotypes also manifest in the form of negative self-perceptions of aging, the third and final component of ageism. Of course, stereotypes imprinted into people at a young age can remain with them as they grow older, and thus result in these biases damaging their own self-perceptions down the line. Similarly, older people being exposed to younger people’s negative age stereotypes can influence their own self-worth detrimentally.

Psychologist Becca Levy, Ph.D, explains that these negative age stereotypes exacerbate stress, which is widely known to factor into higher blood pressure and cholesterol levels, leaving them more at risk for issues like heart attacks and strokes. Levy also posits that, on the behavioral level, research has found that negative self-perceptions of aging predict worse health behaviors over time, such as non-compliance with prescribed medications

The ways that physicians and staff interact with older patients can reveal implicit ageist beliefs, which is why it’s important to be more intentional with providing care to older patients and take a closer look at these implicit biases. Doctors and nurses can frequently be less patient and less engaged with, and less responsive to issues raised by older patients. In some cases, providers may use a form of speech that is more slow-paced, exaggerated in intonation, elevated in pitch and volume and simplified in vocabulary. Assuming elderly patients are cognitively impaired may even lead some physicians to not explain the full details of an illness [Regis College].

In a study conducted in The Gerontologist1 published in 2020, psychologist Becca Levy and colleagues discovered that ageism costs patients $63 billion each year and results in over 17 million cases of eight specific health conditions observed in the study.

In the wake of the impact of growing ageist practices and beliefs, many older patients may be less likely to engage in behaviors necessary to their wellbeing, like having regular examinations and seeking healthcare when needed. Furthermore, ageism may lead physicians and other providers to abstain from giving the holistic care that elderly patients with multiple chronic illnesses truly need.

PharmD Live® remains dedicated to filling the gaps in healthcare that are left by these issues, by providing support where support is needed. We know that the number of adults aged 65 or older will double in the next forty years, resulting in more seniors afflicted with chronic diseases and putting additional strain on an already vulnerable U.S. healthcare system.

We seek to alleviate stresses caused by ageism in the healthcare industry through a holistic approach to patient care that includes remote patient monitoring, transitional care management, medication management and personalized prevention plans. These are just a few of the ways that we strive to adhere to our values.

At PharmD Live®, our mission to close care gaps and improve patient outcomes rests in the knowledge that all patients deserve better — regardless of age.

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References

Becca R Levy, PhD, Martin D Slade, MPH, E-Shien Chang, MA, Sneha Kannoth, MPH, Shi-Yi Wang, MD, PhD – The Gerontologist, Volume 60, Issue 1, February 2020, Pages 174–181, https://doi.org/10.1093/geront/gny131

The post The Affect Ageism Has In Healthcare appeared first on Pharmdlive.

What is Heart Disease?

Heart disease refers to several conditions that affect the heart. These include:

• Blood Vessel Disease (Coronary Artery Disease, CAD): is the most prevalent form in which plaque accumulates in the arteries, narrowing them and leading to reduced blood flow. CAD can result in severe health issues such as myocardial infarction (heart attack) and stroke [[Centers for Disease Control and Prevention, 2023], [American Heart Association, 2024].
• Irregular Heartbeats (Arrhythmias): When the heart beats too fast, slow, or irregularly, leading to symptoms like palpitations, dizziness, or fainting. In severe cases, arrhythmias can cause sudden cardiac arrest [Mayo Clinic, 2024].
• Congenital Heart Defects: Heart abnormalities present from birth, causing symptoms like fatigue, rapid breathing, or cyanosis [Cleveland Clinic, 2023].
• Heart Muscle Disease (Cardiomyopathy): Affects the heart muscle, impairing its ability to pump blood effectively. Symptoms include swelling in the legs, ankles, or abdomen, and shortness of breath [American Heart Association, 2024].
• Heart Valve Disease: Malfunctioning heart valves cause symptoms like shortness of breath, fatigue, swollen feet or ankles, and irregular heartbeats [National Heart, Lung, and Blood Institute, 2024].

Although genetics contribute to heart disease risk, lifestyle changes—such as a healthy diet and regular exercise—play a significant role in reducing the chances of developing heart disease.

Causes of Heart Disease: Understanding Key Risk Factors

The causes of heart disease are multifactorial, with both modifiable and non-modifiable risk factors. Understanding these risk factors is crucial for heart disease prevention. Key causes include:

1. High Blood Pressure (Hypertension): Damages arteries, reducing elasticity and blood flow [Centers for Disease Control and Prevention (CDC)].
2. High Cholesterol: High LDL cholesterol leads to plaque buildup in arteries, increasing heart attack and stroke risk [Mayo Clinic].
3. Smoking: Damages blood vessels, increases plaque buildup, raises blood pressure, and reduces blood oxygen [American Heart Association (AHA)].
4. Lack of Physical Activity: Contributes to weight gain, high blood pressure, and high cholesterol [National Institutes of Health (NIH)].
5. Unhealthy Diet: Diets high in saturated fats, trans fats, sodium, and processed foods contribute to weight gain and related conditions [American Heart Association (AHA)].
6. Diabetes and Insulin Resistance: High blood sugar levels damage blood vessels and nerves controlling the heart [American Diabetes Association].
7. Excessive Alcohol Consumption: Increases blood pressure and can lead to cardiomyopathy and arrhythmias [National Institute on Alcohol Abuse and Alcoholism (NIAAA)].
8. Family History and Genetics: Genetic factors increase susceptibility to heart disease [Centers for Disease Control and Prevention (CDC)].
9. Age and Gender: Risk increases with age, with men developing heart disease earlier than women [National Heart, Lung, and Blood Institute (NHLBI)].
10. Stress: Chronic stress raises blood pressure and promotes unhealthy behaviors [Mayo Clinic].

The Importance of Early Detection and Intervention

Recognizing heart disease early can make a big difference in treatment outcomes. Therefore, regular screenings for blood pressure, cholesterol, and blood sugar are crucial for identifying potential risks before they become serious issues. For example:

• Heart Attack (Myocardial Infarction): Chest pain, shortness of breath, nausea, and sweating [CDC, 2023].
• Stroke: Sudden numbness, confusion, vision problems, and difficulty speaking [American Heart Association, 2024].
• Heart Failure: Swelling in the abdomen or legs, fatigue, and shortness of breath [National Heart, Lung, and Blood Institute, 2024].

Early intervention can significantly improve outcomes.

Heart Disease: Why It Matters

Heart disease is not just a statistic—it affects individuals and families across the country. 

• Leading Cause of Death: Heart disease is the leading cause of death in the U.S., accounting for nearly one in four deaths [Centers for Disease Control and Prevention, 2023].
• Preventable Risk Factors: Many risk factors are preventable through lifestyle changes, medication, and early intervention [American Heart Association, 2024].
• Early Intervention is Critical: Routine screenings can identify risk factors early, leading to more effective treatment.

PharmD Live®’s Proactive Approach

At PharmD Live®, we focus on prevention through Medication Therapy Management (MTM). Our Pharmacists collaborate with healthcare providers to ensure proper medication use, improve adherence, and enhance overall patient care. By working together, we can help prevent heart disease and reduce its impact. At PharmD Live®, we focus on prevention through Medication Therapy Management (MTM) services. Our clinical pharmacists collaborate with healthcare providers to ensure comprehensive care, optimize medication adherence, and reduce medication errors. By prioritizing proactive care, PharmD Live® helps patients better manage heart disease risks and improve health outcomes.

For more details on how PharmD Live® can assist with heart disease prevention strategies, visit our Solutions page or contact us directly

Take Action: Prioritize Heart Health Today

Prioritizing heart health is critical. Whether you’re an individual looking to reduce your risk or a healthcare provider guiding patients through heart disease prevention, taking the right steps today can improve your health tomorrow. Routine screenings, healthy lifestyle changes, and comprehensive medication management are all effective strategies in combating heart disease.

PharmD Live® partners with healthcare organizations to identify individuals at risk and ensure they receive the appropriate care. By focusing on early detection and proactive care, we can collectively reduce the burden of heart disease and improve health outcomes nationwide

References

1. American Diabetes Association (ADA). “Heart Disease and Diabetes.” https://www.diabetes.org/healthy-living/cardiovascular-disease
2. American Heart Association (AHA). “Cardiomyopathy.” https://www.heart.org/en/health-topics/cardiomyopathy
3. American Heart Association (AHA). “Healthy Eating for a Healthy Heart.” https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/healthy-eating-for-a-healthy-heart
4. American Heart Association (AHA). “Smoking and Cardiovascular Disease.” https://www.heart.org/en/health-topics/quit-smoking/smoking-and-cardiovascular-disease
5. American Heart Association (AHA). “Stroke.” https://www.heart.org/en/health-topics/stroke
6. American Heart Association (AHA), 2024. “Heart Disease and Stroke Statistics – 2024 Update.” https://www.heart.org/en/about-us/statistics
7. Centers for Disease Control and Prevention (CDC). “Family History and Heart Disease.” https://www.cdc.gov/heartdisease/risk_factors.htm
8. Centers for Disease Control and Prevention (CDC). “High Blood Pressure.” https://www.cdc.gov/bloodpressure/index.htm
9. Centers for Disease Control and Prevention (CDC), 2023. “Leading Causes of Death.” https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
10. Cleveland Clinic. “Congenital Heart Defects.” https://my.clevelandclinic.org/health/diseases/22144-congenital-heart-defects
11. Mayo Clinic. “Arrhythmia Symptoms.” https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/symptoms-causes/syc-20350624
12. Mayo Clinic. “Cholesterol Levels.” https://www.mayoclinic.org/tests-procedures/cholesterol-test/about/pac-20384787
13. Mayo Clinic. “Stress and Heart Disease.” https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037
14. National Heart, Lung, and Blood Institute (NHLBI). “Age and Heart Disease.” https://www.nhlbi.nih.gov/health/heart-disease/risk-factors
15. National Heart, Lung, and Blood Institute. “Heart Valve Disease.” https://www.nhlbi.nih.gov/health/heart-valve-disease
16. National Institute on Alcohol Abuse and Alcoholism (NIAAA). “Alcohol and Heart Health.” https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-and-heart-health
17. National Institutes of Health (NIH). “Physical Activity and Heart Disease.” https://www.nhlbi.nih.gov/health/educational/hearttruth/lower-risk/lifestyle.htm
18. National Library of Medicine. “The Decline and Rise of Coronary Heart Disease.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3682614/
19. Columbia Surgery, “Heart Disease Was Common in Ancient Egypt, Too.” https://columbiasurgery.org/news/2016/02/18/heart-disease-was-common-ancient-egypt-too-0
20. PMC, “Coronary Heart Disease: From Mummies to 21st Century.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501035/

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