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Last Updated
May 27, 2016
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May 25, 2016
Study: Cardiologists Unaware of Patient Nonadherence to Medications
A new study in JAMA Cardiology suggests that some patients do not discuss their adherence to medications with 
their cardiologists.  After administering questionnaires to both patients and physicians at two academic and two 
community-based cardiology practices in the Chicago area, researchers found that 61% of patients rarely or never 
discussed adherence, 45% of whom admitted to sometimes or usually forgetting to take their medications. An 
additional 10% said they had missed one dose or more of medication in the past 2 weeks. About two-thirds of the 
physicians surveyed said they were not aware of how often their patients missed taking their medications, though 
all physicians agreed that talking with patients about adherence was important. Lack of time was cited as the 
greatest barrier to discussing medication adherence. Overall, 12% of patients were considered to have poor 
adherence and 55% had moderate adherence. Of those with poor adherence, only one physician identified them as 
being poorly adherent. Due to the answers being self-reported, the results could be subjected to recall bias.  But 
researchers said that asking a direct question—such as "how many of your heart drugs have you missed in the last 
30 days?"—could help resolve the disconnect between some physicians and patients.

May 25, 2016
FDA Finalizes New Nutrition Facts Label
The FDA today finalized the new Nutrition Facts label for packaged foods to reflect new scientific information, 
including the link between diet and chronic diseases such as obesity and heart disease. The new label will make it 
easier for consumers to make better informed food choices. 
Highlights of the Final Nutrition Facts Label
Label Formats: Original vs. New
What's Different
Serving Size Changes
Questions & Answers

May 24, 2016
Education, Reminders Reduce Risky Prescriptions for Older Adults
A program that provides systematic education and reminders in an emergency department (ED) can greatly reduce 
the risk of inappropriate medications being given to older patients. Researchers, who presented their work at the 
American Geriatrics Society 2016 Annual Scientific Meetings, discussed the EQUiPPED (Enhancing Quality of 
Prescribing Practices for Older Veterans Discharged From the Emergency Department) program. The program is 
made up of a team of geriatricians, gerontologists, geriatric pharmacy specialists, and others—all working to reduce 
the proportion of risky prescriptions prescribed to older veterans to less than 5%. To do this, the team educated the 
providers and scheduled one-on-one meetings to talk about medications that could be risky. Then they collected the 
data and modified prescription order sets to work safer and more effectively for older patients. At four separate 
sites, the proportion of potentially inappropriate medical prescriptions dropped after applying the EQUiPPED 
program. The EQUiPPED program is now being used in eight Veterans Affairs medical centers, and the team is 
helping other EDs and non-VA hospitals to implement the program.  (Source: MedScape)

May 23, 2016
Retail Clinics Drive New Healthcare Use
Once the stepchild of the American health care system, primary care is now the linchpin of efforts to improve the 
health and health care of individuals and communities and to bring down costs. Factors contributing to the demand 
for primary care include the coverage expansion under the Affordable Care Act and an aging and growing 
population.   But here is the problem:  there is a shortage of primary care providers, already acute in some areas of 
the country, and it’s expected to significantly grow in the years ahead.  Coupled with consumer expectations that 
everything should be immediately accessible at the touch of a screen, it comes as no surprise that demand for 
accessible primary care, including through retail clinics, is increasing. What impact are these clinics having on cost, 
access, and quality?   

The researchers found that 58 percent of retail clinic visits represented new utilization and not substitution for more 
costly primary care or emergency department (ED) visits. This net cost of this new utilization was determined to be 
$14 per person per year.  While the study found that retail clinics increased costs by creating new utilization, it did 
not consider the value of the new utilization for patients who previously, for whatever reason, did not or could not 
access such services.

May 17, 2016
Do Electronic Medical Record (EMR) Systems Affect Adherence to Glaucoma Medication Regimens?
Electronic medical record (EMR) systems, defined by the Department of Health and Human Services as "an 
electronic record of health-related information on an individual that can be created, gathered, managed, and 
consulted by authorized clinicians and staff within one health care organization," have the potential to provide 
substantial benefits to physicians, clinic practices, and health care organizations and improve the quality of patient 
care and safety.  Nevertheless, despite these myriad benefits, the possibility of medical error or misinformation 
Most recently, researchers from Boston University School of Medicine have explored the ways in which EMR 
discrepancies may affect glaucoma medication adherence. According to the research team, patients with glaucoma 
typically have ever-changing drug therapy regimens involving multiple eye drop products; in addition to these 
complex regimens, inconsistent documentation in glaucoma patients' electronic medical records (EMRs) can also 
play a role in their medication adherence."  The research, entitled Electronic Medical Records and Glaucoma 
Medications: Connecting the Medication Reconciliation with Adherence, is published in the Volume 10, 2016 edition 
of Clinical Ophthalmology.
The authors conclude that "with the growing prevalence and incidence of glaucoma nationwide and the increasing 
presence of EMRs, inconsistent documentation in the EMR may be a contributing factor in patient [glaucoma] 
medication adherence. However, when inconsistencies are present, patients are more likely to follow their 
physician's verbal directions than the EMR handout. Even so, clinicians should be diligent in providing consistent 
medication documentation throughout the EMR to reduce non-adherence due to clinician error (Source:  Maureen 
Duffy, VisonAware™ - posted originally 4/25/16)