Pharmacy Industry News: Canada Pharmacy Online Suggests Less Sugar Intake to Avoid Health Concerns
Canada Pharmacy Online Suggests Less Sugar Intake to Avoid Health Concerns
Sugar is the common additive in food, but Canada Pharmacy Online suggests that people should avoid high levels of sugar in their daily diet, as it can trigger weight gain, is capable of accelerating growth of cancer cells, and is directly related to accelerating the process of aging.
One of the cheapest ingredients in food, sugar adds flavor and is often use to replace spices from the food. Along with salt and water, it can be added to desserts, sweets, candies, pastries, cakes, and many other sweetened products freely available in the market.
Sugar has traditionally been used to make cookies and cakes at home. It is usually used to supplement regular food in small quantity. However, marketing and commercialism has allowed manufacturers to brand certain products containing high amounts of sugar to unsuspecting people. Large amounts of cakes and pastries are consumed leading to obesity based on easy lifestyle. Once obesity creeps in, regular exercise is reduced, and people find it difficult to expend higher energy levels induced through excess sugar intake.
The World Health Organization has already published a review establishing that populations of the world with high sugar intake faced a higher risk of getting chronic diseases. Problems related to dental caries and obesity were increasing on a regular basis. Researchers suggested that total dietary intake should not exceed 10% on a regular basis.
People often buy Cymbalta and other drugs from Canada Pharmacy Online to fight depression. However, high intake of sugar is responsible for depression as well as several other diseases such as hyperactivity, mood swings, panic attacks, hypoglycemia, chronic fatigue, high cholesterol, dental problems, obesity, and mineral deficiencies. If neglected, chronic diseases such as diabetes, cancer, and heart disease could strike.
Keeping the right balance in blood sugar levels is vital for maintaining proper health and stamina. Excess sugar is the number one reason why people experience fatigue. Often, refined carbohydrates lead to high sugar levels which can be equally damaging. Soft drinks can contain eight to nine teaspoons of sugar. More importantly, these aerated drinks often contain high salt content which makes people thirstier after consuming the drink.
A safe way to go about avoiding high sugar intake is to begin with avoiding caffeine, alcohol, and do away with bad habits like smoking. Fried and fatty foods, fast foods, candies, and other food material that contains high quantity of sugar must be avoided. Sugar by itself will not indicate symptoms directly, but once obesity and other chronic ailments set in, people will have low resistance levels that will force them to resort to different prescription drugs in order to live a full and active life.
Canada Pharmacy Online suggests that people adopt exercise therapy for cleaning up the lymph and blood supply system. Good circulation helps in strengthening the immune system, builds up endurance power, and rejuvenates tissues of the body. Regular sugar intake may not be damaging, but a busy lifestyle makes it difficult to compensate for several conditions associated with obesity and anxiety, both at the workplace and at home. By reducing sugar intake, people are giving themselves a better chance to fight off chronic illnesses.
Innovative program establishes pharmacist as health coach, partner
Pope illustrated one of its benefits by describing a patient case he recently managed, in which the patient was prescribed metformin. Checking into the online account through which Pope helps her work toward her individual health goals, the patient repeatedly stated that she had not taken her medication properly, so Pope called her to find out what was going on.
She complained of a terrible stomach ache but didn’t want to tell her doctor or Pope that she just couldn’t take the medication. Pope explained that a side effect of the medication was gastrointestinal upset; the good news was that studies showed it appeared to decrease after 2 weeks of treatment. The patient agreed to continue to take the medication for the next 3 weeks; after that, Pope said, if her stomach distress continued, he would help her speak with her physician. Her stomach pains went away and the patient continued her prescription successfully.
“She would not have taken that medicine if she had not checked in with her pharmacist; so that’s the key,” Pope said.
The HealthyHeart.com program that Pope describes is designed to empower pharmacists as health coaches who will help patients at risk for heart disease set and reach health goals, including diet, exercise, and medication adherence, and to improve overall health outcomes.
The new program, which was recently featured on the U.S. Government’s AHRQ.gov site as an innovation in healthcare, provides pharmacists the tools and support they need to attract patients who need to lower blood pressure, cholesterol, or weight for an overall healthier lifestyle that ultimately reduces their chances of cardiovascular events.
“As pharmacists, we do disease-state management really well; we know that whenever pharmacists get involved, outcomes improve,” Pope said. “At the same time, we know that the secondary windfall benefit of attracting that chronic care patient to the store means a great deal to the pharmacy, because, for instance, a diabetic patient is going to spend between $6,000 and $12,000 a year. The top 1% spends $28,000.”
Program cornerstones
The program, which was designed through collaboration with pharmacists and feedback provided by physicians and patients, uses the power of the pharmacist to support the physician by providing education, accountability, and encouragement to patients at risk for chronic illness.
The program consists of an initial in-person consultation between the pharmacist and the patient to discuss health-related goals; weekly e-mail check-ins, through which the pharmacist can keep track of the patient’s progress toward goals and offer additional support or guidance; and a monthly group class in which the pharmacist meets with all the members of the program to answer questions and to offer educational presentations on general wellness topics. The Healthy Heart Club team supplies the scripted presentations, and a user-friendly website provides easy-to-understand information on healthy eating and exercise, as well as a variety of tools for both the patient and pharmacist to track progress and to keep the patient’s physician updated.
The time commitment is essentially 1 hour per month for the educational classes and an additional 15-30 minutes a week, during which the pharmacist checks on patients through his or her HealthHeartClub.com account, which Pope says can be integrated into the morning routine. “I check mine while I’m checking in my morning order,” he said.
Pharmacist support
Support for pharmacists is provided by business coaches who explain how to use the tools and how to set up a profile and account within the system; there are also blogs about new ideas or new services in the pipeline, Pope said. Additional support and marketing services are available through the company’s Market Pharm service. And Cardinal Health, which has developed a Specialized Care Center program around the Healthy Heart Club platform, is offering a 9-hour continuing education course on cardiovascular risk reduction at the upcoming Retail Business Conference in Las Vegas.
Most pharmacists charge patients a minimal fee of $15-$20 per month. According to Pope, they have found that patients are more than willing to pay, even in the type of population served by as his pharmacy, which includes many Medicare/Medicaid patients. The company is currently holding discussions with insurance companies and pharmacy benefit managers who are interested in the program.
The company is currently in the middle of a year-long pilot study in collaboration with Cardinal Health, monitoring return on investment and medication adherence, among other things. The company also has just finished designing a study with University of South Carolina that will look more closely at patient outcomes and overall healthcare costs. Pope said the initiative is actively seeking funding; he expects the study to begin within the year.
According to Pope, pharmacists are stepping outside their comfort zones a little, but the effort is paying off in big ways. The demand is out there and the response has been overwhelming, he said.
Drug shortages forcing late treatments in Ore.
Tom Childers drove up the hill to Oregon Health & Science University one morning last January for his monthly chemotherapy — only to be told to come back tomorrow. The drug his life depended on was in short supply.
His doctor, Michael Mauro, assured Childers the clinic was doing all it could to get more leukemia medicine. “I accepted that at face value,” recalls Childers, 67.
Mauro, however, was frustrated that a lifesaving treatment relied on a drug shipment for which there was no guarantee. “If we didn’t get the drug for this gentleman — as days passed, or maybe if it went longer than that, if weeks passed — he would relapse,” says Mauro. “What are we, a Third World country?”
Childers, from Dufur, stayed at a friend’s house in Portland that night. He returned to the clinic in the morning only to be told more supplies had not arrived. He returned home. After a week of worry for his family, Childers received a call to return for his medicine. In April, after three more chemotherapy sessions, his leukemia was declared in remission.
While things worked out for Childers, the incident jolted Mauro.
He hadn’t realized the extent to which OHSU pharmacists wrestled with shortages. The last-minute decision to delay treatment for Childers and several other relatively healthy patients reflects a national problem.
The number of individual drugs in short supply nationwide has climbed from 70 in 2006 to a record 211 last year — and more than 150 already this year.
Shortages are hitting every aspect of health care in rural and urban areas alike. As a result, patients are getting late treatments, substitute medications or decreased drug doses for illnesses in which survival rests on getting the best medicine available.
“It was pretty bad to have to look someone in the eye and say, ‘Look, we can’t treat you right now,'<” Mauro says. “In the United States in 2011, that seemed like a pretty ridiculous thing.”
The problem boils down to profits, quality, and supply and demand.
Supplies of Childers’ drug dwindled when several manufacturers shut down production of cytarabine — a popular chemotherapy drug that is irreplaceable in fighting certain types of leukemia — due to quality problems or a shortage of raw materials.
Overall, about half of pharmaceutical shortages stem from quality problems, according to the nonprofit Institute for Safe Medication Practices. Other shortages concern production issues, such as when companies consolidate and close factories.
Many common generic medications also can be hard to find. When drug patents expire, it opens the door to other manufacturers but lower profits.
That’s why supplies of generic leucovorin, a B vitamin proven to make cancer treatments more successful, have been short since late 2008. A patented, more expensive version remains plentiful. Many observers say shortages are exacerbated by hoarding and speculation by third parties who purchase large quantities of drugs and sell them at a premium like scalpers outside a concert.
“In the industry, we call them the pirates,” says Mike Brownlee, OHSU pharmacy director.
Cancer doctors like Gerald Segal have become vocal critics. Segal, who works at Northwest Cancer Specialists in Northeast Portland, has had to tell patients that because of shortages, they’re receiving reduced doses of leucovorin that may not be as effective.
“I never in my life thought something like this would happen in the United States,” he says.
Perhaps most disturbing to him is that even though the medical establishment has sounded alarms, no one sees a way out.
“The shortages are growing worse at such an exponential rate,” says Erin Fox of the University of Utah’s Drug Information Service. She works with the American Society of Health System Pharmacists to document shortages. “I feel that we’re at a tipping point of a health care crisis.”
Besides shortages of key cancer drugs, sedatives crucial to emergency rooms and intravenous nutrients have been crimped. So have certain antibiotics, ADHD drugs and even drugs to put inmates to death.
In the United States, no deaths have been directly attributed to lack of medicine. However, surveys of pharmacists and other health care professionals attribute hundreds of near misses and treatment errors to drug shortages, and that’s probably underestimated, according to the ISMP.
Two bills in Congress would require manufacturers to give more notice of impending shortages so health care providers and the government can adjust. When the Food and Drug Administration learns of the shortages in advance, it often is able to boost foreign imports, according to FDA spokeswoman Tamara Ward.
However, the bills’ fates are unclear, and even some senators with a strong reputation in health care, such as Oregon Sen. Ron Wyden, are not signing on. Wyden “has questions as to whether or not the legislation as introduced gets at the root problem of why there are shortages to begin with,” says his spokesman, Tom Caiazza.
With no solutions on the horizon, doctors and pharmacists are adjusting.
OHSU’s Mauro pushed for a cancer-drug shortage committee to improve shortage response times.
“Usually, it’s a mad scramble,” says Majid Tanas, an OHSU pharmacy manager. He says the committee evaluates each patient to determine minimum drug dose or a possible substitution.
“It’s day-to-day micromanaging of a precious stock to make sure our patients are well taken care of,” he says.
OHSU drug buyers use social media to soak up the latest scuttlebutt, and the pharmacy has a “clean room” where a remote-controlled robot divides large vials of drugs when smaller doses are unavailable.
Like most of the health care community, OHSU frowns on hoarding scarce drugs. But pharmacists there are considering increasing reserves of certain medications.
Most doctors and hospitals try not to buy from third-party suppliers because the drugs’ origin and quality are unknown. But, in some cases, shortages can mean choosing between denying necessary treatment or buying drugs of unknown quality.
“You don’t know where the product is coming from,” said Kathy Stoner, pharmacy director of Legacy Health Systems. In an email, she added, “We have, very rarely, used them when in dire need.”
Other times, providers make difficult choices on rationing, as with the long-running leucovorin shortage.
Dr. Samuel Taylor, an oncologist with Celilo Cancer Center in The Dalles, says his group has rationed leucovorin. Colon cancer patients considered curable receive full doses. Patients considered terminal, but who could have years to live with full treatment, instead receive a partial dose, he says.
“I’m not sure that there would be a measurable detriment to patients with that, but it is a modification that is not recommended,”
Taylor says. “These are issues that at least do compromise our standard of treatment.”
Segal, the Portland oncologist, says the free market is no longer taking care of patients’ needs. He thinks the country may need a drug czar to ensure supplies.
“Somebody’s got to grab this situation,” he says, “and do something about it.”