Genetic Testing & Medication Effectiveness – It’s Cool, But Does It Work?

Row of Microscopes on a Table
Image Source: Ousa Chea/Unsplash

In October, the FDA cleared the first DNA test meant to be marketed directly to consumers to help them determine how well certain drugs may work for them.1 The DNA test, conducted by 23andME, provides information on 33 genetic variants that the company say are associated with how patients respond to more than 50 commonly prescribed prescription and over-the-counter medications. While this test is the first consumer directed to be cleared by the FDA, expect to see more in the coming years as pharmacogenetics becomes more mainstream. But the big question is…does it really work?

Background:  What is Pharmacogenetics?

Pharmacogenetics or pharmacogenomics is the study of how genetics impact pharmacology. Pharmacogenetic (PGx) testing is used for determining how an individual will respond to a particular medicine.2 With this type of testing, clinicians would be able to provide a personalized medication plan, rather that prescribing based off the average population. This helps avoid trial and error in finding optimal dosages.

What are the caveats?

The FDA’s marketing authorization came with crucial caveats. The agency cautioned that the test cannot assess whether a drug is appropriate, or gauge a patient’s ability to respond to any specific medication.3 This essentially means that a patient still needs a clinician’s insight in finding the correct medication, but utilizing the results of a DNA test can assist in the dosing process. Pricing can also vary with DNA testing. In many cases, the costs may not outweigh the benefits.

Questions?

If your health plan includes Tria Health, you can talk with a clinically trained pharmacist and review all your current medications (prescription, over the counter and supplements). Tria Health’s pharmacists will help make sure your medications are effectively treating your condition(s) and identify any cost savings opportunities.

Sources:

  1. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm624753.htm  
  2. http://www.rxeconsult.com/healthcare-articles/Overview-Of-Pharmacogenetic-PGx-Testing-Benefits-Costs-And-Role-In-Personalized-Medicine-853/
  3. https://www.statnews.com/2018/10/31/fda-clears-23-and-me-genetics-test-drug-effectiveness/

Is It Time to Stop One of Your Meds?

Pills on Table
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According to a new study released by the journal Annals of Family Medicine, nearly half of people who take certain types of prescription drugs continue taking them for longer than is recommended or safe. The prescription drugs include antidepressants, proton pump inhibitors (PPIs) and bisphosphonates (osteoporosis and bone density treatments).1 Most of these medications are only meant to be taken for a certain period, otherwise they can become less effective, less useful, or can lead to more serious side effects.

How Does This Happen?

The authors of this study attribute some of the results to “legacy prescribing”, a situation that occurs when doctors who start someone on a prescription for a good reason may later renew it without a full assessment of whether or not it’s still needed. Per Nitin S. Damle, M.D., past president of the American College of Physicians and a physician in private practice in Rhode Island, “If there’s no follow-up and [patients’] prescriptions are just renewed electronically, there’s very little thought as to whether they need to be on it or not.”

What’s the Risk?

One of the biggest potential dangers of continuing a prescription for too long is that every on going prescription increases thechances of drugs interacting and causing a harmful reaction.2 There is also an increased risk in side effects and unnecessary costs due to non-optimized medication therapy.

What Should You Do?

If you’re worried about your current medication regime, here are a few tips to help you feel confident in what you’re taking:

  • Discuss all your current medications with your doctor, at least once a year.
    • If you have multiple doctors, it can be difficult to ensure they’re all on the same page. At your annual checkup, talk to your primary doctor about all your current medications.
  • Talk to your doctor about reducing your medications
    • While your doctor will know what dosage is best for you, it never hurts to have a yearly discussion to see if you can lower any of your medication dosages. This helps in combating legacy prescribing.
  • If your health plan includes Tria Health, you can talk with a clinically trained pharmacist and review all your current medications (prescription, over the counter and supplements). Tria Health’s pharmacists will help make sure your medications are effectively treating your condition(s) and identify and cost savings opportunities.

For more tips, click here.

Have any Questions?

Contact the Tria Health Help Desk at 1.888.799.8742

Sources:

  1. https://www.consumerreports.org/drugs/should-you-stop-taking-that-medication/?EXTKEY=AMSNLF01
  2. https://www.msn.com/en-us/health/healthyliving/should-you-still-be-taking-that-medicine/ar-BBPDpo6?li=BBnba9O

New Year, New You?

It’s the time of year for New Year’s resolutions—or, more accurately, the time that most people have given up on those resolutions. You know the kind of resolutions we mean: “I’ll exercise more”, “I’ll start eating better and watch my portion sizes”, “I’ll quit smoking”. To ditch the resolutions by mid-January is par for the course. We understand, change is hard. However, your friends at Tria Health want to help you take back control of your resolutions and your health—and deliver the why behind it.

These lifestyle changes like losing weight, eating well-balanced nutritional meals and exercising can prevent chronic diseases like diabetes, heart disease and some cancers. In fact, these lifestyle changes are part of the recommendations our pharmacists are making to our patients through our Pharmacy Advocate Program.

Tria Health’s Pharmacy Advocate program helps people with Chronic Conditions

In addition to lifestyle changes, most chronic conditions require medication to effectively treat and manage. Tria Health’s pharmacists make sure patients are receiving the best benefits from their medications. They work with patients and their physicians to identify, prevent and resolve drug therapy problem’s related to a patient’s medications.

Tria Health’s pharmacists provide one-on-one telephonic counseling for members to discuss how lifestyle and medication impact chronic conditions. They provide valuable, clinically based information on how to improve your health. And, they will coordinate any recommendations with the members’ physician and/or pharmacy.

You Have the Power to Prevent Chronic Disease  

The CDC reports that, “chronic diseases and conditions—such as heart disease, stroke, cancer, type 2 diabetes, obesity, and arthritis—are among the most common, costly, and preventable of all health problems.” This year, and always, we encourage you to resolve to live a healthy lifestyle. These lifestyle changes will help you feel better today—and for many tomorrow’s:

  • Get to and stay at a healthy weight.
  • Eat a nutritious diet of whole foods.
  • Watch your portion sizes.
  • Be active.
  • Quit smoking (and other tobacco products).
  • Limit your alcohol use.

Change IS hard, but if you consider the possibility of preventing chronic disease, it’s an easy decision to attempt to make these lifestyle changes. Your friends at Tria Health hope you will resolve to commit to living a healthy lifestyle to prevent chronic conditions.

 

For more information on CCM, please visit our website at www.triahealth.com or call our help desk at 1.888.799.8742

 

 

Are you or your loved ones at risk of harmful drug interactions?

Close up of assorted pills and prescriptions
Image Source: iStock.com/klenova

An average Tria Health patient takes 8 prescription medications. Most older Americans take multiple medications each day for a variety of conditions. Typically, when people have multiple chronic conditions, they see multiple prescribing physicians.

Do you think those prescribing physicians talk to one another?

In many cases, the answer is, unfortunately, no.

A new study, called “Improving Health and the Bottom Line: The Case for Health Literacy,” showed how greater health literacy can improve community health, reduce health costs, enhance the quality of care and improve patient and provider experiences.  The lead author of the report, Stan Hudson, said “the relationship between health literacy and health outcomes is very important. We found that low health literacy is a contributing factor for readmission for chronic conditions such as diabetes, heart disease and cancer. Hudson also made a point that “health literacy helps ensure the best quality of care for everyone.”

The CDC reports that about half of the adults in the United States have inadequate skills when it comes to understanding their health care options.

In another study, National Poll on Healthy Aging found that 1 in 3 who take at least one prescription drug had talked to a health care professional about possible drug interactions. Among those taking six or more medications, less than half had discussed possible drug interactions.

Drug interactions could, best case scenario, prevent medicine from absorbing properly. Worst case scenarios put people at risk of blood sugar issues, kidney damage or even death. Due to the variety of prescription and over-the-counter drugs available, even medical professionals are challenged with identifying potential drug interactions.

Additionally, 1 in 5 respondents said they had used more than one pharmacy in the past two years (including mail order pharmacies), and 3 in 5 see more than one doctor for their care. While 63% of the respondents said their doctor and pharmacists are responsible for identifying potential drug interactions, only 36% said their pharmacist definitely knew about all their medications when they fill a prescription.

Knowledge is Power

This is our focus and expertise at Tria Health. Our team works diligently to improve health literacy among our patients. We have found that identifying drug therapy problems, drug interactions and discovering non-adherence issues are only possible by physically speaking with patients. We empower our patients by educating them on all their chronic conditions, their medications and we make recommendations to prescribing physicians to avoid harmful drug interactions and drug therapy problems. This educational approach has proven to reduce hospital readmissions and improve clinical outcomes for chronic conditions. This helps our patients live healthier lives and helps their employers save on their healthcare costs.

Tria Health encourages you to be an advocate for your own healthcare and take the time to learn more about all your prescriptions and over-the-counter medications. Knowledge is power.

 

 

FDA Warns Consumers About Kratom, Citing 36 Deaths

The FDA has issued a public health advisory warning “consumers to stay away from the herbal supplement kratom, saying regulators are aware of 36 deaths linked to products containing the substance.” The use of the supplement has increased in recent years as a treatment for anxiety, depression, pain, and opioid withdrawal. FDA Commissioner Scott Gottlieb said that kratom is not approved by the FDA for any use, and that there is no “reliable evidence” to support the claim that kratom is a safe treatment for opioid abuse or addiction. Gottlieb also said that the substance can have similar effects as opioids, “and carries similar risks of abuse, addiction and, in some cases, death.”

At Tria Health, our pharmacists counsel patients on all their prescription medications AND over-the-counter vitamins and herbal supplements. It’s imperative to understand exactly what each item is supposed to accomplish for your health, AND whether there are any potential drug interactions.

If you are taking kratom, please talk to your doctor or pharmacist about this potentially dangerous herbal supplement.

For more information, visit the FDA website here.