Pillbox Beta helps one to identify pills (solid medications)

Pillbox Beta: Rapid Identification, Reliable Information

Need help identifying your medications? Pillbox can recognize over-the-counter and prescription pills by their imprint, shape, color, size, and score marks. This web site is under development by the NLM, NIH, and HHS. (Please note that as of press time, Pillbox is up and running but is still being tested in beta format.)

Related articles

• Tips for Remembering Your Medication (everydayhealth.com)
• Preventing Poisoning: Safety Tips for You, Your Family, and Friends (education.com)

Misleading Statistical Information in Ads: A Drug Ad Analyzed and Related Evaluation Resources

http://psychcentral.com/blog/archives/2011/06/29/an-epidemic-of-bad-infographics-depression/

Do some statistically laden advertisements and Web sites seem misleading? Is there a disconnect between the displayed data in some ads with your gut feelings?  But you just cannot put your finger on why you feel distrustful?

Just plain sloppily represented infographics could be creating some of the confusion. Infographic combines an interesting graphical element with hard data. They are commonly seen in the media, including USA Today.

John Grohol, founder and editor-in-chief of Psych Central, deftly illustrates how to analyze a medical advertisement for misleading information (and downright errors!) in a recent blog item.

Here are some excerpts from An Epidemic of Bad Infograhics: Depression

In an effort to keep trying to get people’s attention in an increasingly attention-deficit world, we get a lot of inquiries for links to websites promoting education programs and other affiliate websites. The latest effort is focused around “infographics,” those graphics made popular by the USA Todaynewspaper that combines an interesting graphical element with hard data. A well done infographic ostensibly makes data more engaging. A fantastic infographic puts data into proper perspective and gives it valuable context.

What these marketing firms send me, however, are not fantastic or even well-done. So in the interests of demonstrating that any infographic can be worse than no infographic, I’m going to critique one of the latest ones to have come across my desk. It’s about depression, one of the most common and serious mental disorders….

….

What about your level of depression? Well, according to the infographic — but not the research or mental health professionals — you can have different “depression levels” ranging from “Normal” (what’s a “Normal” depression?) to “Situational” or even “Major.”

Of course, the Diagnostic and Statistical Manual of Mental Disorders (the DSM-IV) doesn’t divide major depression in this manner. Instead, it specifies that major depression can be Mild, Moderate, Severe without Psychotic Features, Severe with Psychotic Features, In Partial Remission, In Full Remission, or Chronic.

I assume “Situational” refers to a completely different mental disorder — Adjustment Disorder with Depressed Mood. The person designing this graphic was obviously not too familiar with the actual information he was asked to illustrate……

Related Health Information Evaluation Resources

• Evaluating Health Information on the Internet summarizes tips and pointers
• Consumer’s Guide to Taking Charge of Health Information has 10 tips, including how to interpret risk statements, a “reliability chart”,  and where to get more information. Bonus feature: snappy cartoons!
• Evaluating Health Information on the Internet  by the US National Cancer Institute summarizes 10 key points. Links to related federal agencies
• Evaluating Health Information: MedlinePlus provides trusted links to overviews, specific conditions (as cancer and complementary medicine), organizations, and more
• Quackwatch is physician published guide to health fraud including 23 hot topics (as immunization,autism, homeopathy, chiropractic). While the site is a bit controversial, it does have useful information and links.
• National Council Against Health Fraud is a private nonprofit, voluntary health agency that focuses upon health misinformation, fraud, and quackery as public health problems
• patientInform is a collaborative effort of health care related professionals who interpret research articles, in the form of summaries or news items.

• What to look for when reading medical research outlines the different types  of scientific studies and which ones are the best
• Participating organizations  provides links to news items from over 25 publishers and organizations. “The publishers allow readers following links from patientINFORM material on the health organizations’ sites to access the full text of these articles without a subscription, and they provide patients and caregivers with free or reduced-fee access to other articles in participating journals.”

Related Statistics Resources

• Guide to Biostatistics (MedPage Today) is a bit technical, but a good introduction to biostatistical terms used in medical research 
  

Related articles

• Misleading Statistical Information in Ads: A Drug Ad Analyzed and Related Evaluation Resources (jflahiff.wordpress.com)
• Misleading information on health social sites (and tips on how to evaluate health/medical information) (jflahiff.wordpress.com)
• Women And Prescription Drugs: One In Four Takes Mental Health Meds (worldwright.wordpress.com)
• 1 in 5 of U.S. adults on behavioral meds (worldwright.wordpress.com)
• Ethical Implications of the Use of Data and Statistics (lynnmunoz.wordpress.com)
• Information Designers (fusionfinds.wordpress.com)
• 1 in 5 Adults on Behavioral Meds (abcnews.go.com)
• How our society breeds anxiety, depression and dysfunction (salon.com)

 

Information Overload in Drug Side Effect Labeling

From the 24 May 2011 ScienceDaily In the study, appearing in the May 23, 2011 issue of the Archives of Internal Medicine

ScienceDaily (May 24, 2011) — The lists of potential side effects that accompany prescription drugs have ballooned in size, averaging 70 reactions per drug, a number that can overwhelm physicians trying to select suitable treatments for their patients, according to a new study of drug labels.

In the study, appearing in the May 23, 2011 issue of the Archives of Internal Medicine, the researchers found that the average label contains 70 different side effects, with more commonly prescribed drugs averaging around 100 side effects. The upper range was remarkably high, with a single label containing as many as 525 reactions. The study involved analysis of more than 5,600 drug labels and more than half a million labeled effects.

“Having a high number of side effects on a drug’s label should not suggest that the drug is unsafe. In fact, much of this labeling has less to do with true toxicity than with protecting manufacturers from potential lawsuits,” said lead author Jon Duke, M.D., Regenstrief Institute investigator and assistant professor of medicine at the IU School of Medicine.

“But having all these labeled side effects can overwhelm doctors who must weigh the risks and benefits when prescribing a medication. The Food and Drug Administration has taken steps to discourage such ‘overwarning,’ but at present information overload is the rule rather than the exception,” Dr. Duke said….

Journal Reference:

1. J. Duke, J. Friedlin, P. Ryan. A Quantitative Analysis of Adverse Events and ‘Overwarning’ in Drug Labeling.Archives of Internal Medicine, 2011; 171 (10): 944 DOI:10.1001/archinternmed.2011.182

[For suggestions on how to get this article for free or at low cost, click here]

Related articles

• Drug Information Product DailyMed Mobile Version Launched (jflahiff.wordpress.com)
• Public confused about ingredients in pain relievers, study finds (jflahiff.wordpress.com)

National Council on Patient Information and Education

The National Council on Patient Information and Education is a long time patient safety coalition and has been working to advance the safe, appropriate use of medicines through enhanced communication since 1982.

Currently about two of every three doctor visits results in a prescription, and about 3.5 billion of these prescriptions are filled yearly. However, most prescription information is not written in easy to understand language. This National Council provides information about the use of medicines: why we need them, how to take them, and when to take them.  They believe that if one understands medications, both prescription and over the counter, they will be used effectively to treat conditions and diseases.

 The NCPIE website provides information for consumers, special populations of consumers, and those health care workers who work with patients directly.

Information for medicine users includes

• How to talk about prescriptions
• Wise Use of Dietary and Herbal Supplements
• Using Antibiotics Appropriately
• Safe Storage and Disposal of Medication – New
• Reducing Medication Errors

• Special Population Topics as Older Adults, Women , and Safeguarding Your Medicines

Educational Resources (some are free, others are available for purchase) include

• “Make Notes & Take Notes” to Avoid Medication Errors (B&W)
• Prescription Pain Medicines: What You Need to Know
• Your Medicine: Play It Safe

http://www.talkaboutrx.org/

Since 1982, the National Council on Patient Information and Education (NCPIE) has been working to “Educate Before You Medicate”. Over 3.5 billion prescriptions are dispensed yearly, yet easy to understand information about prescription drugs is hard to find. The NCPIE website provides information for consumers, special populations of consumers, and those health care workers who work with patients directly. The “Educational Resources” link has both free and pay publications. The free pamphlets, such as “Priorities & Approaches for Improving Prescription Medicine Use by Older Adults” and “Children and America’s Other Drug Problem: Guidelines for Improving Prescription Medicine Use Among Children and Teenagers” can be downloaded, and even previewed before downloading. The pay pamphlets have to be ordered, and some of them are in both English and Spanish. The “For Medicine Users” section is dedicated to the issues that represent a majority of inquiries to NCPIE. This section includes links to resources on talking about prescriptions, information about specific medicines, use of non-prescription medicines, and much more. [KMG]

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Related articles

• Public confused about ingredients in pain relievers, study finds (jflahiff.wordpress.com)
• Doctor’s Office Is Usually First Stop In Medication Mishaps (jflahiff.wordpress.com)
• Prescription meds misuse rampant, deadly: report (cbsnews.com)

Ten Tips to Prevent an Accidental Overdose

Always use the cup, syringe, or other dosage device that comes with a medicine. A different device, or a kitchen spoon, could hold the wrong amount.

From a May 4, 2011 FDA (US Food and Drug Administration) consumer update

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For a medicine to work for you—and not against you—you’ve got to take the right dose.
Many over-the-counter liquid medicines—such as pain relievers, cold medicine, cough syrups, and digestion aids—come with spoons, cups, oral droppers, or syringes designed to help consumers measure the proper dose. These “dosage delivery devices” usually have measurement markings on them—such as teaspoons (tsp), tablespoons (tbsp), or milliliters (mL).
But the markings aren’t always clear or consistent with the directions on the medicine’s package. The Food and Drug Administration (FDA) has received numerous reports of accidental overdoses—especially in young children—that were attributed, in part, to the use of dosage delivery devices that were unclear or incompatible with the medicine’s labeled directions for use.
On May 4, 2011, FDA issued a guidance to firms that manufacture, market, or distribute over-the-counter liquid medicines. The guidance calls for them to provide dosage delivery devices with markings that are easy to use and understand.
Parents and caregivers can do their part, too, to avoid giving too much or too little of an over-the-counter medicine. Here are 10 tips:
1.Always follow the directions on the Drug Facts label of your medicine. Read the label every time before you give the medicine.
2.Know the “active ingredient” in the medicine. This is what makes the medicine work and it is always listed at the top of the Drug Facts label. Many medicines used to treat different symptoms have the same active ingredient. So if you’re treating a cold and a headache with two different medicines but both have the same active ingredient, you could be giving two times the normal dose. If you’re confused, check with a doctor, nurse, or pharmacist.
3.Give the right medicine, in the right amount. Medicines with the same brand name can be sold in different strengths, such as infant, children, and adult formulas. The dose and directions also vary for children of different ages or weights. Always use the right strength and follow the directions exactly. Never use more medicine than directed unless your doctor tells you to do so.
4.Talk to your doctor, pharmacist, or nurse to find out what mixes well and what doesn’t. Medicines, vitamins, supplements, foods, and beverages aren’t always compatible.
5.Use the dosage delivery device that comes with the medicine, such as a dropper or a dosing cup. A different device, or a kitchen spoon, could hold the wrong amount of medicine. And never drink liquid medicine from the bottle.
6.Know the difference between a tablespoon (tbsp) and a teaspoon (tsp). A tablespoon holds three times as much medicine as a teaspoon. On measuring tools, a teaspoon (tsp) is equal to “5 mL.”
7.Know your child’s weight. Dosage amounts for some medicines are based on weight. Never guess how much to give your child or try to figure it out from the adult dose instructions. If a dose is not listed for your child’s weight, call your health care professional.
8.Prevent a poison emergency by always using a child-resistant cap. Relock the cap after each use. Be especially careful with any medicines that contain iron; they are the leading cause of poisoning deaths in young children.
9.Store all medicines in a safe place. Some are tasty, colorful, and many can be chewed. Kids may think they’re candy. Store all medicines and vitamins out of your child’s (and your pet’s) sight and reach. If your child takes too much, call the Poison Center Hotline at 800-222-1222 (open 24 hours a day, 7 days a week) or call 9-1-1.
10.Check the medicine three times before using. For any medicine, it is always good practice to first, check the outside packaging for such things as cuts, slices, or tears. Second, once you’re at home, check the label on the inside package to be sure you have the right medicine and that the lid and seal are not broken. Third, check the color, shape, size, and smell. If you notice anything unusual, talk to a pharmacist or other health care professional before using.
This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

Related Resources (from the University of Toledo Consumer Health Library Guide)

• Familydoctor.org -health information for the whole family
  Web pages include Conditions A-Z, Health Information for Seniors, Men, and Women, Healthy Living Topics, pages geared to Parents & Kids, and videos.  Numerous health tools in the left column (as health trackers, health assessments, and a Search by Symptom page. Written and reviewed by physicians and patient education professionals at the American Academy of Family Physicians.
• Mayo Clinic
  Trusted information on diseases and conditions (including a symptom checker), drugs and supplements, tests and procedures, and healthy lifestyle information. By a team of Mayo physicians, scientists, writers, and educators. 
  
• Drugs, Supplements, and Herbal Information (from a MedlinePlus page)
  Prescription and over-the-counter medication information contains answers to many general questions including topics as what a drug is used for, precautions, side effects, dietary instructions, and overdoses. From the American Society of Health System Pharmacists
• Drug Information Portal
  A good central source of drug information by the US government (the National Institutes of Health). It links you to information on over 12,000 drugs from trusted consumer drug information sources, the US Food and Drug Information, and LactMed (summary of effects on breastfeeding), It also gives any summaries from medical and toxicological articles (however, the whole article may not be for free on the Internet)

Related Articles

• Over-the-Counter Medicine: Kids Aren’t Just Small Adults (education.com)
• FDA 101: Medication Errors (everydayhealth.com)
• Painkillers need clearer warnings to prevent liver damage (newscientist.com)
• Drugmakers Eliminate Infant Drops of Key Medicine (foxnews.com)
• Overdose Risk for Young Children on Prescription Pain Drugs (webmd.com)
• Opioid prescription overdose and abuse – Staying safe while reducing pain (psychologytoday.com)
• High Dose Painkillers Up Risk of OD Deaths (abcnews.go.com)
• Parents – Dosing Tips for Kids and Cough and Cold Remedies (education.com)

Public confused about ingredients in pain relievers, study finds

Image via Wikipedia

From a 2 May 2011 Science News Daily article

ScienceDaily (May 2, 2011) — People take billions of doses of over-the-counter pain relievers like Tylenol every year, but many do not pay attention to the active ingredients they contain, such as acetaminophen, according to a new Northwestern Medicine study. That lack of knowledge about popular pain relievers plus particular ignorance of acetaminophen’s presence in more than 600 over-the-counter and prescription medicines could be a key reason acetaminophen overdose has become the leading cause of acute liver failure in the U.S.

The study reported only 31 percent of participants knew Tylenol contained acetaminophen. In addition, 75 percent of participants knew Bayer contained aspirin; 47 percent knew Motrin contained ibuprofen; 19 percent knew Aleve contained naproxen sodium; and 19 percent knew Advil contained ibuprofen.

The solution proposed by the researchers is to develop a universal icon for acetaminophen that would appear on all medicine labels….

…”People may unintentionally misuse these medicines to a point where they cause severe liver damage,” Wolf said. “It’s easy to exceed the safe limit if people don’t realize how much acetaminophen they are taking. Unlike prescription products, there is no gatekeeper, no one monitoring how you take it.”

Individuals don’t understand they may be taking the drug simultaneously in multiple medications, said Jennifer King, lead author of the paper and project leader for medication safety research in Feinberg’s Health Literacy and Learning Program.

The study found only 41 percent of participants read the ingredients on drug labels….

Related Resources (from the University of Toledo Consumer Health Library Guide)

• Familydoctor.org -health information for the whole family
  Web pages include Conditions A-Z, Health Information for Seniors, Men, and Women, Healthy Living Topics, pages geared to Parents & Kids, and videos.  Numerous health tools in the left column (as health trackers, health assessments, and a Search by Symptom page. Written and reviewed by physicians and patient education professionals at the American Academy of Family Physicians.
• Mayo Clinic
  Trusted information on diseases and conditions (including a symptom checker), drugs and supplements, tests and procedures, and healthy lifestyle information. By a team of Mayo physicians, scientists, writers, and educators. 
  
• Drugs, Supplements, and Herbal Information (from a MedlinePlus page)
  Prescription and over-the-counter medication information contains answers to many general questions including topics as what a drug is used for, precautions, side effects, dietary instructions, and overdoses. From the American Society of Health System Pharmacists
• Drug Information Portal
  A good central source of drug information by the US government (the National Institutes of Health). It links you to information on over 12,000 drugs from trusted consumer drug information sources, the US Food and Drug Information, and LactMed (summary of effects on breastfeeding), It also gives any summaries from medical and toxicological articles (however, the whole article may not be for free on the Internet)

Related Articles

• Alarm over ignorance-based OTC meds misuse (cbsnews.com)
• Acetaminophen and Liver Injury: Q&A for Consumers (everydayhealth.com)
• FDA 101: Medication Errors (everydayhealth.com)

Drug Information Product DailyMed Mobile Version Launched

DailyMed Mobile Version Launched

From the National Library of Medicine (NLM)  March 4 announcement

NLM® released DailyMed® Mobile on January 31, 2011. DailyMed provides access to over 20,000 structured product labels (SPL) from the Food and Drug Administration. DailyMed mobile features a simplified design enabling easy search, retrieval and display of SPLs from any Web-enabled mobile device (see Figure 1). Users can also e-mail SPLs to themselves or colleagues for later viewing on other platforms.

Editor Flahiff’s note:  You also cannot go wrong with these nonmobile(at least for now!)  resources (via a Consumer Health Library Guide

Dietary Supplements Labels Database

Information about ingredients in more than three thousand selected brands of dietary supplements. It enables users to determine what ingredients are in specific brands and to compare ingredients in different brands. Information is also provided on the health benefits claimed by manufacturers. These claims by manufacturers have not been evaluated by the Food and Drug Administration. Check out the Help section for tips on how to browse and search this site.

Drug Digest

This noncommercial consumer health and drug information site provides information about drugs and treatment options to be discussed with your primary health care provider or a pharmacist.  Information about over 1,500 drugsas well as common herbs and supplements. The check interactions tab (potential interactions between drugs)  and conditions/treatments area provide easy-to-read overviews. Information provided by Drawing pharmacy experts, licensed doctors of pharmacy, and physicians. From ExpressScripts.

Drugs and Supplements (sponsored by the Mayo Clinic)

Somewhat lengthy drug and over-the-counter medicationinformation with these sections: description, before using, proper use, precautions and side effects. From Micromedex, a trusted source of healthcare information for health professionals. 

Herb and supplement information includes information on uses based on scientific evidence as well as safety and potential interactions with drugs, herbs, and supplements. From Natural Standard, an independent group of researchers and clinicians.

Drug Information Portal

A good central source of drug information by the US government (the National Institutes of Health). It links you to information on over 12,000 drugs from trusted consumer drug information sources, the US Food and Drug Information, and LactMed*** (summary of effects on breastfeeding i), It also gives any summaries from medical and toxicological articles (however, some whole articles may not be for free on the Internet).

PillBox Beta

Aids  in the identification of unknown solid dosage pharmaceuticals using images to identify pills (color, shape, etc) as well as a separate advanced search (imprint, drug manufacture, ingredients, etc)

Related Articles

			Announcements Beware of Fraudulent Weight Loss “Dietary Supplements” The Food and Drug Administration warns that false claims and tainted products can cause serious harm to consumers. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm246742.htm Consumer Update: Dietary Supplements The Food and Drug Administration has found nearly 300 fraudulent products—promoted mainly for weight loss, sexual enhancement, and bodybuilding—that contain hidden or deceptively labeled ingredients. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm246744.htm

• Drug Information Product DailyMed Mobile Version Launched (jflahiff.wordpress.com)
• PubMed Health Provides Disease and Treatment Information for Consumers (jflahiff.wordpress.com)

***As of July 2011…The National Library of Medicine Drugs and Lactation Database (LactMed)
has added complementary and alternative medicine (CAM) products. CAM
products generally consist of dietary supplements derived from botanicals
(herbals), “nutraceuticals” (natural and synthetic nonherbals, such as
coenzyme Q10), and related products.
http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT

What Is Comparative Effectiveness Research?

What Is Comparative Effectiveness Research?

From the US AHRQ (Agency for Healthcare Research and Quality) Web page

Comparative effectiveness research is designed to inform health-care decisions by providing evidence on the effectiveness, benefits, and harms of different treatment options. The evidence is generated from research studies that compare drugs, medical devices, tests, surgeries, or ways to deliver health care.

There are two ways that this evidence is found:

• Researchers look at all of the available evidence about the benefits and harms of each choice for different groups of people from existing clinical trials, clinical studies, and other research. These are called research reviews, because they are systematic reviews of existing evidence.
• Researchers conduct studies that generate new evidence of effectiveness or comparative effectiveness of a test, treatment, procedure, or health-care service.

Comparative effectiveness research requires the development, expansion, and use of a variety of data sources and methods to conduct timely and relevant research and disseminate the results in a form that is quickly usable by clinicians, patients, policymakers, and health plans and other payers. Seven steps are involved in conducting this research and in ensuring continued development of the research infrastructure to sustain and advance these efforts:

1. Identify new and emerging clinical interventions.
2. Review and synthesize current medical research.
3. Identify gaps between existing medical research and the needs of clinical practice.
4. Promote and generate new scientific evidence and analytic tools.
5. Train and develop clinical researchers.
6. Translate and disseminate research findings to diverse stakeholders.
7. Reach out to stakeholders via a citizens forum.

Common questions about comparative effectiveness research

Q: Why is comparative effectiveness research needed? What problem is it trying to solve?

• If you don’t get the best possible information about your treatment choices, you might not make an informed decision on what treatment is best for you.
• When you shop for a new car, phone or camera, you have lots of information about your choices. But when it comes to choosing the right medicine or the best health-care treatment, clear and dependable information can be very hard to find.
• It’s true that some treatments may not work for everyone, and that some treatments may work better for some people than others. This research can help identify the treatments that may work best for you.

Q: What are the practical benefits of comparative effectiveness research?

• You deserve the best and most objective information about treating your sickness or condition. With this research in hand, you and your doctor can work together to make the best possible treatment choices.
• For example, someone with high blood pressure might have more than a dozen medicines to choose from. Someone with heart disease might need to choose between having heart surgery or taking medicine to open a clogged artery. Reports on these topics and others include the pros and cons of all the options so that you and your doctor can make the best possible treatment decision for you or someone in your family.
• Every patient is different — different circumstances, different medical history, different values. These reports don’t tell you and your doctor which treatment to choose. Instead, they offer an important tool to help you and your doctor understand the facts about different treatments.

Related Content

Can I Trust This Information?

What Is the Research Process?

How are Comparative Effectiveness Reviews Conducted?

…and AHRQ Effective Health Care Program Links

Guides for Patients and Consumers include research reviews, research reports, and summary guides

Glossary of Terms

Personalization and Social Media Tools – These tools (as an email list)allow you to personalize your experience with the EHC Program Web site and share it with colleagues, family, and friends.

Related Articles

• Many new drugs did not have comparative effectiveness information available at time of FDA approval (eurekalert.org)
• The differences between comparative and clinical effectiveness (kevinmd.com)
• The Role of Data Mining in Cost Effectiveness Research (medicineandtechnology.com)
• The Newspeak of comparative effectiveness research (CER) (doctorrw.blogspot.com)
• CDISC Standards at Core of FDA Cross-study Clinical Trial Repository Project (prweb.com)
• National Library of Medicine Updates (aa47.wordpress.com)
• Shall I compare thee to another drug? (blogs.nature.com)