E-prescribing

E-prescribing allows me to electronically send an accurate, error-free and understandable prescription directly to the pharmacy. I can send the prescription to local as well a mail-order pharmacies and I can verify that that the prescription was actually received. In many cases, the software will query the patient’s insurance company and I will be able to see if a less expensive option is possible.

Another advantage of e-prescribing is that I will alerted to potential drug interactions to medication prescriber by other practitioner as well as to potential drug allergies. Patients don’t always remember adverse effects from medications taken long ago but if someone entered that data the software will pull it forward.

In New York, all controlled substance must be electronically prescribed; paper, fax and telephone prescriptions will not be accepted. In contrast, prescriptions for controlled substances in Connecticut must be printed onto tamper-proof paper and presented to the pharmacy along with appropriate identification. Before prescribing any controlled substance the practitioner must check the centralized database that lists all controlled substances dispensed to patient.

From the Connecticut Department of Consumer protection: The purpose of the CPMRS is to present a complete picture of a patient’s controlled substance use, including prescriptions by other providers, so that the provider can properly manage the patient’s treatment, including the referral of a patient to services offering treatment for drug abuse or addiction when appropriate.

It has been years since I have written a paper prescription. I still have a few (locked up) which I will use for travel immunizations from the health department. E-prescribing makes for better patient care. Even though the new narcotic laws may be irritating to patients they too lead to better patient care.

The Department of Consumer Protection has useful information. 

Cataracts

A cataract clouds the lens of the eye and this blocks or changes the way light passes through the eye. If not enough light gets through the person will be blind. A commonly performed surgery can restore better sight.

Risk factors for developing cataracts including aging, overexposure to ultraviolet rays from the sun, smoking, diabetes and long-term steroid use.

Symptoms of a cataract:

·      light seems to be too dim for reading or close-up work or overwhelmingly bright

·      blurred vision, double vision or  a sense of a film over the eyes

·      eyeglass prescriptions change often without improvement in vision.

As part of a comprehensive examination, an ophthalmologist will test vision, eye pressures and assess the density of a cataract. Everyone over the age of 65 should have an eye exam every two years, even if there doesn’t appear to be any problem seeing.

Don't let a cataract limit your life: more information. 

Malaria

Malaria was eliminated form the United States in 1951 but is still deadly around the world. There were 214 million cases and 438,000 deaths in 2015, mostly young children in sub-Saharan Africa. Each year approximately 1,500 travelers become infected abroad and return to the United States.

 

Anyone can get malaria. Usually people get malaria after being bitten by an infective Anopheles mosquito but malaria is also transmitted by shared needles or syringes. It is not sexually transmitted. Symptoms start ten days to four weeks after infection.

Many effective anti-malaria medications are available. It is best to buy the medications in the United States since there is a risk of counterfeit medications and/or the medications may not be safe. There is no vaccine available yet.

A comprehensive review from the CDC answers almost all questions. 

Pain

There are aches and pain of daily life and then there is pain: post-operative, orthopedic or associated with cancer. In the acute situation pain relief will lead to less stress on the body and the mind with the hopes of accelerating recovery. This type of acute pain is an appropriate use of narcotics. In the unfortunate situation the pain becomes chronic. In the past one learned to live with the pain but then the tide turned and the goal was to make everyone ‘pain free.’ The unintended consequence of a ‘pain free’ existence has been an epidemic of drug abuse.

The use of narcotics may be entirely appropriate in acute and self-limited situations but the long-term goal now is to maintain functionality even the face of pain. Complementary medicine, such as acupuncture, plays an important role in the management of pain. Health care practitioners are embracing a new paradigm, some more enthusiastically than others.

The Department of Consumer Protection in Connecticut monitors all dispensing of controlled substances. These include sleeping pills, tranquilizers, codeine cough medicine and most pain medications. From the website: The prescription monitoring program collects prescription data for Schedule II through Schedule V drugs into a central database, the Connecticut Prescription Monitoring and Reporting System (CPMRS), which can then be used by providers and pharmacists in the active treatment of their patients. The purpose of the CPMRS is to present a complete picture of a patient’s controlled substance use, including prescriptions by other providers, so that the provider can properly manage the patient’s treatment, including the referral of a patient to services offering treatment for drug abuse or addiction when appropriate.

Prescriptions for controlled substances cannot be called into a pharmacy but must be written on special paper. The prescriber is mandated to check the database for any prescription for a more than seventy-two hour supply of medication. Prescriptions for chronic pain are typically written for a twenty-eight day supply with the ultimate goal of weaning the patient from narcotics to other modes of pain management.