Improve Your Health and Healthcare Costs – Talk to Your Pharmacist by Bob King, CEO, GOAL/QPC
Well Care Well Care
Eleven years ago Bob King
in January 2000, the Salem Chamber and five of New Hampshire’s largest chambers started a project to determine what was driving the cost of healthcare. What they learned was that the number-one cost driver was chronic illness. Only about 15 percent of the New Hampshire residents with diabetes, asthma, and heart problems practiced self-
care; i.e., took meds, checked blood pressure and blood sugar, and managed their diet. The 85 percent who didn’t practice self-care got sicker and often ended up in the emergency room and hospital. The cost of treating them was 45 percent of the total cost of healthcare in the state. Many experiments have been conducted in the
last five years to improve the situation; e.g., support group meetings for diabetics, medical homes with doctors keeping better records, and more involvement of nurses. But the number-one best approach is getting the pharmacist involved to check that meds are right and coaching to help the patient set and reach improvement goals.
by Bernadine Croteau, OTR/L CLT, Northeast Rehabilitation Hospital Network Fibromyalgia (FM) is a health condition that primarily affects women
(80 percent of individuals diagnosed are women). These symptoms can influence a women’s ability to function at a level that allows her to enjoy and pursue a full life. Symptoms usually begin at 20 to 50 years of age and may include the following: • Chronic pain/soft tissue ache with multiple tender points • Fatigue and sleep disturbance • Symptoms come and go; good and bad days • Feelings of stiffness • Chronic headaches Secondary symptoms may include irritable bowel or bladder, low stress
tolerance, temperature/humidity sensitivity, eye problems, pelvic pain, and menstrual cramps. What causes fibromyalgia? Fibromyalgia appears to have a group of possible causes, including genetic, immunologic abnormalities and possibility of neuro-hormonal dysfunction. It appears that flare-ups of initial symptoms may be brought on by precipitating factors or events such as physical trauma, emotional stress, life changes, and illness. This condition can worsen seasonally and is most pronounced in spring and fall. How is fibromyalgia treated and managed? Treatment and management of FM can vary and may include medication, psychology services, and therapy services. The best approaches encompass a mind/body connection, allowing the individual to understand, take control, and manage their symptoms more effectively. To do this, symptoms must first be validated by a health professional. Since symptoms are diffuse, varied, and not diagnostically proven through lab tests, this can become a frustrating goal to achieve.
Proper management should start with patient education, including pain management, pacing, diet, stress management, and exercise. Therapy often consists of gentle stretching and aerobics, physical therapy treatment tools to reduce intensity of pain and trigger point symptoms, and soft tissue techniques like massage to reduce soft tissue irritability. To avoid aggravating symptoms, an assessment of posture and body mechanics in both the home and workplace will help to develop strategies to help manage symptoms. This can be as basic as eliminating caffeine and incorporating quiet time activities, like a relaxation tape one hour before bedtime for managing sleep disturbance. Aquatic exercises are a very effective management strategy, as they provide a comfortable medium for stretching, strengthening, and conditioning. Once properly trained by a therapist, an individual can independently perform exercises in health club and other community or home settings. Northeast Rehab provides comprehensive services to assist in managing fibromyalgia at our Outpatient Clinics in Windham and Haverhill, MA. We promote the mind/body connection in our approach and our services include therapeutic exercise, patient education, and stress management techniques. For more information on our women’s health services, call Bernadine Croteau, OTR/L CLT, at (978) 521-1186.
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Why is the pharmacist key? Sometimes, the meds are wrong, too high a dosage, too low a dosage, wrong med, wrong combination of meds, no improvement, not enough improvement, and side effects. All these problems can lead to the patient not taking the meds. Often, the sickest patients see a number of specialists. Each physician gives their own list of meds. Often, no one coordinates these meds to make sure they work well together. All pharmacists are trained to help with these issues. Many local pharmacists have received special training to help coach patients on one or more chronic illnesses. The pharmacists are not taking over the doctor’s primary role, but when they are used effectively, the pharmacist can be a more valuable part of the healthcare team. What can you do? Everyone should take a list of all pharmacy meds, all over-the-counter meds, and all naturopathic meds and vitamins, etc., to all doctor appointments. AARP recently used southern New Hampshire as a pilot site to test a program to encourage patients to prepare and submit these lists to their doctors. Evidence has shown that patients who use pharmacists to help them practice self-care can reduce their medical costs by 40 percent the
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first year and up to 75 percent by five years. Companies who are self-insured can see this savings immediately. Commercially insured companies who have high deductibles can greatly reduce the chance that employees or companies will have to tap into those deductibles because of the significant reduction in emergency room visits and hospitalizations. Participating companies often save $1,000 to $3,000 per employee per year.
Greater Salem is now providing help in starting this effort in your company for your employees. For more information on this program,
attend the Greater Salem Chamber Health Fair at Holy Family Hospital (Methuen, MA) on February 15, 5:30-7:30 p.m. If you are not a member of the Chamber, contact Monique Mazejka at 890-8800, ext. 120, for a guest pass. If you are a healthcare professional, please consider joining the Salem Chamber Health Resources Committee. This program is quickly expanding in our area. It is not limited to Chamber members, but Chamber members will receive more information and
Derry Managing Fibromyalgia: Chronic Pain of the Soft Tissue University.
can help shape the program. The new Medicare Medicaid Innovation Center is studying how to use the Salem effort throughout the country. You, too, can improve your health and healthcare costs. For more information, contact Bob King at 275-0555 or email@example.com
, re: pharmacy.
Bob King is CEO and Founder of GOAL/QPC, one of the world’s leading non-profit quality and innovation organizations. He was the first to apply advanced quality methods to healthcare from 1987 to 1995 with a research project of 25 of the nation’s leading hospitals. Bob has led world research in new directions for Quality and Innovation for the American Society for Quality from 2001-2006, and he is one of only 10 Americans who serve on the International Academy of Quality. Bob holds a MA in Adult Education from Boston
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