The American Medical Association (AMA) has outlined five key responsibilities physicians should
adopt when providing care for patients recently discharged from the hospital.  The recommendations
listed in the report were developed to improve safety and reduce hospital readmissions for patients
returning home, according to the AMA Center for Patient Safety. With the new guidelines, The Center
for Patient Care study says it hopes to break a historic trend that left the responsibility for
transition plans almost solely in the hands of the inpatient clinical teams.

Inpatient teams face important limitations in ensuring safe transitions to ambulatory settings,
according to the report. Given the great variability of inpatient and ambulatory care team
resources and capabilities, there can be no 'one-size fits all' model for safe care transitions;
but certain tasks during care transitions are probably best carried out by members of the
ambulatory rather than the inpatient care team, since the ambulatory practice will be responsible
for providing ongoing care to the patient in the ambulatory setting.

The five responsibilities outlined in the report include:

1. Assessment of the patient's health; 
2. Goal-setting to determine desired outcomes; 
3. Supporting self-management to ensure access to resources the patient may need; 
4. Medication management to oversee needed prescriptions; 
5. Care coordination to bring together all members of the health care team. 



The report was issued in February 2013 - shortly after Medicare announced that it will accept the
newly created Current Procedural Terminology codes for care coordination to pay physicians for the
management of patients who have recently been discharged from a hospital or skilled nursing
facility, the AMA said.  The AMA's CPT Editorial Panel built the codes to catalog care management
services, including time spent talking about a care plan, connecting patients to community
services, transitioning them from inpatient settings and preventing read missions.

Improving care coordination and transitions is expected to become more important in the coming
years, the report says, as new models of care delivery, improved methods of communication, and
changes in payment systems will each propel an emphasis on understanding optimal roles for
ambulatory practices in supporting safe care transitions for patients entering and leaving
hospitals and other inpatient facilities. 

The purpose of this guidance is to help prescription drug and biologic product manufacturers
minimize medication errors associated with their products. This guidance focuses on safety aspects
of the container label and carton labeling design, and provides a set of principles and
recommendations for ensuring that critical elements of a product’s container labels and carton
labeling are designed to promote safe dispensing, administration, and use of the product. 

This guidance applies to prescription drug and CDER-regulated biological products, including the
following: 

• Prescription drug products marketed under an approved new drug application (NDA) or
abbreviated new drug application (ANDA); 

• Prescription drugs marketed without an approved NDA or ANDA; and  

• Biological products marketed under an approved biologics licensing application (BLA). 

In this guidance, all such products are jointly referred to as products, and persons responsible
for designing product container labels and carton labeling are referred to as sponsors. References
to end user(s) include, but are not limited to, the patient, patient’s caregiver, the prescribing
physician, nurse, pharmacist, pharmacy technician, and other individuals who are involved in 36
routine procurement, stocking, storage, and administration of medications (e.g., medication
technicians).

One-fourth of teens have misused or abused a prescription drug at least once in their lifetime, a
33 percent increase over the last five years, a new study finds. One in eight teens say they have
taken Ritalin or Adderall when it was not prescribed for them, according to the study by The
Partnership at Drugfree.org and the MetLife Foundation. The Partnership Attitude Tracking Study
(PATS) found parents and caregivers have lax attitudes and beliefs about teen medicine abuse.
Almost one-third of parents say they believe prescription stimulants such as Ritalin or Adderall,
used to treat attention deficit hyperactivity disorder (ADHD), can improve a teen’s academic
performance, even if the young person does not have ADHD.

Of teens who said they abused prescription medications, 20 percent did so before age 14. One-third
of teens say they believe “it’s okay to use prescription drugs that were not prescribed to them to
deal with an injury, illness or physical pain.” The study found 27 percent incorrectly believe that
misusing and abusing prescription drugs is safer than using street drugs.

Teen abuse of prescription painkillers such as OxyContin and Vicodin has remained stable since
2011. The study found 16 percent of teens reported abusing or misusing any prescription pain
relievers at least once in their lifetime, and 10 percent said they did so in the past year.
Parents are much more likely to talk to teens about marijuana or alcohol than prescription drugs.
Teens reported that during the last conversation they had with their parents about substance abuse,
only 16 percent said they discussed the misuse or abuse of prescription painkillers, and 14 percent
discussed any type of prescription drug. In contrast, 81 percent said they have discussed marijuana
and 80 percent have discussed alcohol. 

Did you know acetaminophen is the most common drug ingredient in the U.S., found in more than 600
over-the-counter and prescription medicines? The National Council on Patient Information and
Education (NCPIE) has joined with the National Alliance for Hispanic Health and other members of
the Acetaminophen Awareness Coalition to promote safe use of acetaminophen in Spanish-speaking
communities in both English and Spanish. 

NSAIDs, including prescription drugs and over-the-counter pain relievers like Motrin, Aleve and
ibuprofen, are some of the most commonly used medications in the United States. As a member of the
Alliance for Rational Use of NSAIDs, the National Council on Patient Information and Education
(NCPIE) is working to help patients and healthcare providers better understand the risks and
benefits of using NSAIDs, as well as how to manage those risks. 

Quick NSAID facts:

• More than 23 million Americans use NSAIDs every day.

• Dose and duration are the two biggest factors that influence the risks associated with NSAIDs.

• Heart, kidney and digestive risks are associated with the overuse and misuse of NSAIDs.

• To minimize NSAID risks, take the lowest effective dosage for the shortest period of time.

The Alliance for Rational Use of NSAIDs is a public health coalition dedicated to educating people
about the safe and appropriate use of nonsteroidal anti-inflammatory drugs (NSAIDs).