Why It's Important to Get Rid of Unused Medication

The best time to dispose of old meds is Oct. 28: 

National Drug Take Back Day

Consumer Reports /  Ginger Skinner

Last updated: October 26, 2017

When it comes time to dispose of your leftover or expired medicines, you might be tempted to just toss unused pills into the trash—20 percent of people get rid of their meds this way, according to a recent Consumer Reports Best Buy Drugs nationally representative survey of more than 1,000 Americans.

But discarded drugs can contaminate landfill soil and the water supply, according to a study published in 2014 in the journal Environmental Science. And pills can be fished out of the garbage by kids and even pets.

A far better way to dispose of old and unused meds is to drop them off at National Prescription Drug Take Back Day, this Saturday, Oct. 28.

Throughout the U.S., from 10 a.m. to 2 p.m., you can drop off unused pills and liquid medications at designated police departments, fire stations, health clinics, and other facilities in your community for proper disposal. (This doesn’t include inhalers or syringes; see below for how to dispose of those.)

To find a collection site near you, visit TakeBackDay.DEA.gov or call 800-882-9539. Drop-off is free and anonymous.

A Safer Way to Clear Out Old Opioids

To help reduce prescription drug abuse, the Drug Enforcement Administration, in conjunction with the Secure and Responsible Drug Disposal Act of 2010, launched Take Back Day seven years ago. Since then, this twice-yearly event has collected more than 900,000 pounds of medications.

Take Back Day goes a long way toward “eliminating the possibility of a family member or stranger removing your drugs from a medicine cabinet with the intent to misuse or abuse them,” says DEA spokesman Melvin S. Patterson.Many people keep old or unused pills such as opioids in their cabinets because they don’t know how to dispose of them, Patterson says.

Recent research bears that out: According to a survey published last June in JAMA Internal Medicine, 60 percent of people who had been recently prescribed an opioid—Vicodin, Percocet, and others—reported holding on to the drugs for future use. Almost half said that they weren’t aware of how to properly store or dispose of the drugs.Meanwhile, deaths from the use of these drugs have reached epidemic levels—91 people die every day from an opioid overdose, according to the Centers for Disease Control and Prevention.

“Anyone participating in Take Back Day is a welcome part of the solution to a significant problem,” Patterson adds. “It gives everyone an opportunity to take part in ridding our communities of old, unwanted, and potentially harmful drugs.”

The drugs you turn in on Take Back Day are all incinerated—never redispensed or put into landfills, Patterson says.

Other Ways to Dispose

If you can’t participate in Take Back Day this Saturday but still have unused meds to get rid of, follow these steps:

Buy an envelope and mail back your meds. Costco, CVS, and Rite Aid pharmacies sell postage-paid envelopes for a few dollars that allow you to mail any prescription pills or liquids, including opioids and over-the-counter medications, to a disposal facility to be incinerated. (Do not send inhalers or syringes.)

Drop off at a free kiosk in CVS or Walgreens. As part of its initiative to address opioid misuse, CVS this week announced that it plans to offer free, anonymous, secure drug disposal kiosks at 750 pharmacy locations across the U.S. Walgreens already also offers safe drop-off at in-store kiosks. (Medications are incinerated.) To use one, remove your personal information from the bottle or packaging and drop your unwanted or expired medication, including controlled substances, in the slot.

Toss meds in the trash (only if you can’t purchase a mail-back envelope or get to a CVS or Walgreens kiosk). Doing so can contaminate the soil and water supply, so this is not an ideal solution. If you must throw drugs away, first conceal pills (from kids and pets) by mixing them in a bag or another container and mix them with an unappealing substance, like used coffee grounds or kitty litter. Then seal up the container and toss the item into the trash.

Last resort: flushing. This is not ideal because trace amounts of flushed meds can end up in drinking water and possibly harm aquatic life. Our survey found that 17 percent of people said this was their typical disposal method.

The Food and Drug Administration suggests flushing certain drugs, like dangerous opioids, when they are no longer needed, because they could be deadly if accidentally taken by someone else, particularly children.

Disposing of Syringes and Inhalers

You won’t be able to dispose of needles, syringes, or inhalers at National Take Back Day. And it’s not recommended that you throw these items into the trash.

For inhalers, contact your local trash and recycling facility for proper disposal instructions.

For needle disposal, go to safeneedledisposal.org or call 800-643-1643 to find drop-off locations near you. You’ll also find information on pharmaceutical company mail-back programs.

Do Expiration Dates Matter?

Drug manufacturers are required by law to stamp an expiration date on medication bottles, cartons, and tubes; it’s the date the manufacturer can guarantee maximum safety and potency based on testing.

Our medical experts say you can keep most prescription and over-the-counter drugs for about 12 months past the expiration date, with critical exceptions. The antibiotic tetracycline should never be taken after that date, because as tablets break down they can become toxic and cause kidney damage. It’s especially important to keep nitroglycerin and other liquid meds, like insulin and epinephrine (i.e., EpiPens) up-to-date. They lose potency after the expiration date, so they might not work as well or at all in an emergency.

Editor’s Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

National Clean Out Your Medicine Cabinet Day

Easy Steps for Getting Rid of Unused Medication

The risks for misuse and abuse increase with every bottle of pills you keep. 

Here’s how to safely dispose them.

Consumer Reports / Ginger Skinner / March 20, 2017

Today is National Clean Out Your Medicine Cabinet Day, and chances are you haven't given much thought to the unused medications taking up space in your medicine cabinet.

A new Consumer Reports Best Buy Drugs nationally representative survey of 1,006 American adults found that about one-third of Americans haven't cleaned out their medicine cabinets in a year or more; and nearly a fifth (19 percent) haven't done so in three years.

But those leftover pills are far from harmless.

Taking a drug not intended for you (or one taken by your child accidentally) could mean a trip to the emergency room—and can even prove deadly. Of particular concern are leftover opioids—narcotic painkillers such as Oxycontin, Percocet, and Vicodin.

A survey last June published in JAMA Internal Medicine suggests that there are a lot of opioids in people's medicine cabinets: 60 percent of respondents who had been recently prescribed an opioid reported holding on to the drugs for future use. Almost half said that they weren’t aware of how to properly store or dispose of opioids.

Don’t Hang on to Your Meds

Dan Budnitz, M.D., M.P.H., director of the Centers for Disease Control and Prevention's Medication Safety Program, suggests doing a yearly inventory of what’s in your medicine cabinet and discarding unused meds. Doing so will cut down on the risk of someone misusing a medication in your home—and not just young children, but teenagers, too.

When it comes time to clean out the cabinet or drawer, you might be tempted to just toss pills or other drugs into the trash. But because pills can easily be fished out of the garbage by a kid, you’ll want to take safer precautions instead:

1. Return unused medication to your pharmacy. (Or you can return it to a hospital, clinic, long-term-care facility, or narcotic treatment program.) New rules in 2014 from the Drug Enforcement Administration allow pharmacies to voluntarily take back your medications. This is an especially good option for opioids, ADHD drugs, and benzodiazepines (think: Xanax). Places that accept your unused medications are usually part of take-back programs, such as DisposeMyMeds, that collect and destroy (usually by incineration) unused drugs.

If you’re not sure what pharmacies accept meds, you can search for an authorized collector near you at DisposeMyMeds.org or DEAdiversion.usdoj.gov and search for "drug disposal." Or call the DEA’s Registration Call Center at 800-882-9539. It can also point you to fire and police departments, community hospitals, independent pharmacies, and other collection sites.

2. Drop off unused meds during National Prescription Take-Back Day on Saturday, April 29. Twice a year, the Drug Enforcement Agency holds National Prescription Take-Back Day, where you can drop off all your leftover medications at designated police departments, fire stations, and other specially designated facilities in your community for proper disposal. Drop-off is completely free and anonymous. If you miss this one, the DEA hosts a second one in the Fall.

3. Mail medication to a collection site. Costco, CVS, and Rite-Aid pharmacies sell postage-paid envelopes for customers to mail any prescription, including opioids, and over-the-counter medications to a disposal facility.

4. Use a self-service disposal kiosk. Walgreens offers free, anonymous, and secure kiosks in almost all states, and you can drop off any medication. To use one, remove your personal information from the bottle or packaging and drop your unwanted or expired medication, including controlled substances, in the slot.

5. Be responsible if you put pills in the trash—hide them in coffee grounds, sawdust, or kitty litter, then seal both in a plastic bag. If your local pharmacy won't accept your medication and drop-off at an authorized location is not an option, you can toss most pills in your household trash—just be sure to mix them with a substance that makes them less recognizable. (Don’t do this with opioids or other dangerous meds—it’s too easy for kids to fish these out of the trash and ingest them.)

6. For dangerous drugs, the FDA says flushing is an option. But trace amounts of drugs can end up in the water supply and possibly harm aquatic life. Flush dangerous drugs such as opioids only if there is absolutely no other choice.

What About Needles?

Most collection sites won’t accept asthma inhalers, needles, insulin syringes or any other syringes, marijuana, mercury thermometers, and medications containing iodine.

In some areas you can put asthma inhalers in the trash or recycling, but in other municipalities they’re considered hazardous waste and can’t be tossed in the regular trash. Check with your local sanitation company, recycling facility, or the health department for the rules where you live.

For disposal information and drop-off locations for syringes, needles, and other injectables—for example, expired EpiPens—go to Safe Needle Disposal or call 800-643-1643.

When in doubt about how to safely dispose of a medication or medical device, check with your pharmacist.

Editor's Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

What You Need to Know About Expired EpiPens

Consumer Reports / Ginger Skinner / August 26, 2016

Are they safe? And will they be effective in an emergency?

Anne McMaster, a retired nurse in Seattle with a serious allergy to bees, used to buy a new EpiPen every year when her current one expired. That stopped about three years ago when her out-of-pocket costs for the potentially life-saving medication spiked and she couldn't afford the higher price. Instead, she just kept her old injector, figuring an expired EpiPen is better than no EpiPen at all.

"I would never tell anyone else to do it because of the risks of it not working," McMaster says. "But for me, it was a risk I had to take."

Although there are some lower-cost alternative injectors on the market, and Mylan, the maker of EpiPen, says it is introducing programs to make the device more affordable for consumers, many Americans are wondering whether it is indeed okay to use expired EpiPens.

It's important to replace your epinephrine injector before the expiration date stamped on the pen. That’s because epinephrine deteriorates over time and relying on an outdated one (past the standard 12- to 18-month expiration date) can leave you with an auto-injector that's less effective, or not effective at all, when you most need it.

But what should you do if you are having an allergic emergency and the only injector you have is an expired one? It's probably better to use it than not, some experts say.

"If a patient were to experience an allergic emergency that required use of epinephrine and the only injector available was an outdated one, I would use it," says Andrew Murphy, M.D., a board-certified allergist at the Asthma, Allergy and Sinus Center in West Chester, Pa. "The risk would be that the epinephrine would have degraded and you may not get an optimal dose."

An April 2015 study in the Annals of Allergy, Asthma & Immunology looked at 35 expired EpiPens and found that injectors that were up to two years past their expiration date could retain 90 percent or more of the initial dose listed on labeling.

Murphy stresses that you shouldn't use any injector, even if it's technically not expired, if the medicine is pink or brown (instead of colorless), cloudy, or contains solid particles. In that case, "the medicine clearly has decayed and the injector should not be used at all," Murphy says.

Murphy also says that anytime you use an auto-injector—expired or not—you should call 911 or go to the emergency room, even if the shot seems to be working. That's because severe allergic reactions can require more than just a shot of epinephrine.

Storing and Disposing EpiPens
Be sure to store epinephrine auto-injector properly. And that doesn't mean in the refrigerator: Extremes of heat or cold can degrade the medicine, as can exposure to light and humidity. So while you might need to carry one around with you, when you are at home or work store it at room temperature in a dry, dark place. And while it might be tempting to keep a spare in the glove compartment of your car, that's probably not a good idea because it can get too hot or cold, in there. If your child needs one while at school, ask the nurse to keep it. Many schools have special lockers for such medicines.

It's also important to properly dispose of expired EpiPens or used injectors, says Barbara Young, Pharm.D., of the American Society of Health-System Pharmacists.

Auto-injectors thrown into in your household trash could prick or injure people or pets in your home. Instead, if you've used the injector, give the device to the healthcare professional you saw afterward. Take expired EpiPens to a doctor’s office, hospital, or pharmacy for disposal, Young says.

You can find a drop-off location near you at SafeNeedleDisposal.org.

A final tip: When filling an EpiPen prescription, ask the pharmacist to give you auto-injectors with the latest expiration date.


Editor's Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

4 Ways to Get Insurance to Cover Your Prescription Drugs

Reprinted from Consumer Reports / Ginger Skinner / February 12, 2016

If your medication costs have shot up, ask your doctor for help

If your medication prices seem higher than last year, one culprit might be changes to your insurance company’s “formulary”—the list of drugs covered by your health plan.

During the year, insurance plans may change which prescription treatments they cover, and that’s true especially when it’s time to re-enroll.

Formularies are often developed to encourage people to use the least expensive medications whenever possible. But that list can change if an insurer negotiates a better deal with a drug company, if new research shows the medication isn’t as safe or effective as thought, or a less expensive generic version of the drug hits the market.

Even if your drug is covered on an insurance company’s formulary, the full cost of it may not be. Where an insurance company places a drug on its formulary, the list of drugs is further divided into what is called a ”tier”—and it’s essentially a way to determine how much you’ll pay out of pocket for it, through your co-pay. The higher the tier the higher your share of the costs.

"Consumers need to be on guard because drugs can be taken off a formulary at any time, or moved to a higher tier, which could make a big difference in your share of the costs," says Betsy Imholz, Consumers Union's director of special projects.

Most plans have about four levels, or tiers, of coverage, but in the last few years, more insurers have added a fifth tier by splitting the "generics" tier into two: "preferred" and "nonpreferred." Insurance companies do this to encourage people to choose less expensive medications.

Your copay for a drug in the non-preferred generic tier, for example, may be $15, compared to a preferred generic in the lowest tier, where your copay could be $5 or less. 

Diligently checking your plan's formulary (you can find it on your insurer’s website) can help you avoid getting stuck with paying the full costs of your prescriptions. But if it turns out a drug you're taking is dropped or moved to a higher tier, you have several options:

1. Switch Drugs. Ask your doctor to prescribe a drug on your formulary that may be just as effective and safe for your condition. Most plans will offer one or more alternatives to a medication they no longer cover.

2. Ask for an Exception. "Many people don't realize that just because a drug is not on your plan's formulary does not mean it's unavailable for coverage," says Imholz, "Work with your doctor."

If a drug alternative is not possible, your doctor can file an exception, or "prior authorization," through your health plan, requesting that the drug be covered because it’s medically necessary. If that happens, your plan should approve or deny your request within a few days.

3. Try Step Therapy. Depending on what medication it is, after your doctor files an exception, some plans may require that you agree to “step therapy” first, which is a type of prior authorization. It means trying other lower-cost medications that are appropriate for your condition first. If the lower-cost drug doesn’t work for you, your doctor can ask your insurer to cover the more expensive drug. 

4. File an Appeal. If your insurer still denies your request to cover a drug you need, you can file an appeal. You and your doctor can either complete and file an appeals form provided by your insurer, or write a letter that includes the name of the drug, why you need it covered, and any other supporting documents from your doctor. Your insurer's website will provide more details on the appeals process.

If your plan denies your appeal, you can file for an external, or independent, review with your state’s insurance regulator, which will make the final decision.

If your state doesn’t have an external review mechanism, the Department of Health and Human Services (HHS) or an independent review organization will oversee the process. A decision can take up to 60 days and is free if handled by the HHS, but may cost you to $25 if it’s handled by your state or an independent review organization.


When All Else Fails, Shop Around
Filing an appeal can be a lengthy process, and there’s still no guarantee that your insurer will agree to cover your medication. If you end up having to pay more for your medications out-of-pocket, shop around.

Our secret shoppers have found that prescription prices can vary widely from one pharmacy to the next, even in the same zip code. Costco often offers low prices (you don’t have to be a member) and independent pharmacies may be able to negotiate. And ask your pharmacist if you can save more by not using your insurance; many chains and big-box stores, such as Target, Walgreens, and Walmart, offer hundreds of generics for as low as $4 for a 30-day supply and $10 for a 90-day supply.

When it's time to re-enroll or change insurance plans, before choosing coverage, Imholz recommends checking the formulary to make sure the drugs you need are covered and under which tier.


Editor's Note: These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

When Nasal Decongestant Sprays Make You Sicker

Consumer Reports / Ginger Skinner / Feb 2 2016

Overusing Vicks Sinex and other OTC sprays can cause rebound congestion

If you’re battling congestion from a cold or sinus trouble, the good news is that easier breathing might be just a spray or a drop away.

Over-the-counter, 12-hour nasal decongestant sprays like Afrin, Dristan, and Vicks Sinex contain the active ingredient oxymetazoline. That drug shrinks swollen nasal tissues quickly, and usually causes fewer side effects than oral decongestant pills because very little gets absorbed into the bloodstream.

But there is a downside: These sprays are a temporary fix, and come with instructions to stop using after three days. Using them longer than that increases your risk for one very troubling side effect: rebound nasal congestion, also known as rhinitis medicamentosa.

Rebound congestion happens when nasal tissue can’t shrink back to its normal size, and instead stays swollen or becomes even further inflamed, says Zara Patel, M.D., assistant professor of otolaryngology at Stanford University and chair of the Education Committee for the American Rhinologic Society.

“Using these sprays long term—months to years—can even lead to something more dangerous called atrophic rhinitis,” warns Patel. “It’s a rare but difficult-to-treat condition marked by uncomfortably dry, nasal passages, sometimes with chronic crusting, and in some cases, loss of smell.”

What to Do After Three Days

If you’re using an OTC nasal decongestant spray and still feel stuffy after three days, switch to pseudoephedrine pills (Sudafed and generic) to lower your rebound congestion risk. Those are available behind the counter at pharmacies.

Some people are sensitive to pseudoephedrine, which is known to cause nervousness, dizziness, or sleeplessness. Side effects, some of which can be life-threatening, are increased when too much of the drug is taken, so don't exceed the recommended dosage.

Also, don’t bother with decongestants sold on open store shelves, such as those containing phenylephrine (Sudafed PE and generic). Research shows that phenylephrine doesn’t work that well, if at all.

It’s important to note that if you have glaucoma, heart disease, high blood pressure, an enlarged prostate, or thyroid disease, check with your doctor or pharmacist before using any type of decongestant, even sprays, because they sometimes make those conditions worse.

Try Nondrug Treatments

For a safer route to relief that won’t cause rebound symptoms, consider trying nondrug options, such as a saline (salt-based) rinse before reaching for nasal decongestant sprays and pills.

"Saline rinsing acts in two ways to relieve nasal congestion: It draws out excessive water trapped in your tissues, thereby acting as a natural decongestant, and it rinses away allergens that would otherwise stick to the lining,” says Patel.

Saline wash is safe to use long term, but since some tap water contains low levels of organisms, such as bacteria and protozoa, it’s best to rinse with bottled, filtered, or distilled water. You can pick up an already-sterilized saline rinse, such as Ayr Allergy & Sinus Simply Saline, and generic versions, at your drugstore.

Editor's Note: These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

Outraged over Rx drug prices?

Join us w/ @CRBestBuyDrugs and get answers to your questions on avoiding #RxStickerShock

Are you paying more for #meds? 

Join our #RxStickerShock Twitter chat 

on Nov 4 at 2pm ET and discuss!

Is it OK to Use Expired Neosporin?

It can be, but there are other good reasons to skip this first-aid remedy

Consumer Reports

By Ginger Skinner

Last updated: September 20, 2015

If you’re treating a wound that’s infected—it’s red, painful, and oozing pus—or if the wound still looks dirty after washing it, our experts say it’s fine to use Neosporin topical ointment within a year after it’s expired. That’s because some research suggests many medicines are still effective even several years after the expiration date. The date you see stamped on your medicine is the time until which the drug manufacturer can guarantee its maximum safety and potency based on product testing.

“To assure that medicines stay effective after their expiration dates, don’t store them in bathroom medicine cabinet,” suggests Marvin Lipman, chief medical consultant, Consumer Reports. “Heat and humidity accelerate how fast a drug deteriorates, so store drugs in a cool, dry place and well out of the reach of children.”

But there are situations when you shouldn’t use antibiotics creams at all, which have nothing to do with whether the drug is expired or not. That’s because overusing those creams, like overusing any antibiotic, and others like it—Bacitracin Plus, Curad, Mycitracin, Polysporin, and generic versions, for example—can contribute to the spread of resistant bacteria, making these drugs less likely to work when you really need them. A 2011 study found a link between using Neosporin and other over-the-counter antibiotic ointments and the spread of a resistant MRSA (methicillin-resistant staphylococcus aureus) strain of bacteria called USA300, which is now being found more commonly.

Instead of using an antibiotic ointment, a safer way to treat a minor cut, scrape, or burn is to wash it with soap and warm water to clear out any visible dirt. Then cover it with a non-stick bandage and keep an eye on it. Your wound should heal on its own in 7 to 10 days; if it doesn’t, see your doctor.

Another reason to go easy on topical antibiotics: the risk of skin reactions. Both bacitracin and neomycin carry a small risk of skin irritation and allergic reactions, such as contact dermatitis. The risk is slightly less for bacitracin.

Good to know for all your medication: Cases where you should stick closely to the expiration date include certain liquid medications such as nitroglycerin, insulin, and epinephrine, and especially the antibiotic tetracycline—which, past it expiration date can become toxic and cause kidney problems—should not be used past the expiration date.

Still to be on the safe side and be sure you’re getting a medicine’s full potency, experts advise replacing medicines that have expired years ago with a new supply. Although take-back programs are a good way to get rid of expired medications, it’s OK to toss your old tube of Neosporin in the household garbage. But you’ll want to be sure to take precautions so that children or pets don’t get their hands (or paws) on it, says Barbara Young, Pharm.D., editor of consumer-medication information for the American Society of Health-System Pharmacists. When in doubt, ask your pharmacist about proper disposal.  

These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

Should you get vaccinated at a pharmacy?

Consumer Reports

Here’s what to know before you go
Published: July 14, 2015 06:00 AM

You’re picking up a few household items at the pharmacy and spot a sign for on-site vaccinations. Would getting vaccinated at a pharmacy be a reasonable move? Yes. It’s a safe, convenient way to keep up to date on your immunizations, and may save you a trip to the doctor. What’s more, pharmacists are trained in immunization technique and practice giving shots regularly.

CVS, Rite Aid, Walgreens, and other chains, as well as some independents, offer more than the flu shot – they also administer Centers for Disease Control and Prevention-approved vaccines, including hepatitis A and B, pneumonia, polio, shingles, Tdap (tetanus, diphtheria and pertussis), and varicella (chickenpox). And many also offer travel immunizations for meningitis, typhoid, yellow fever, and other diseases.

While many pharmacies require no appointment and only ask that you complete a consent form (which includes questions about your medical history and authorizes the release of your health care provider and insurers), rules and vaccine availability vary by state—so call ahead before you drop in.

As at your doctor’s office, most pharmacies will file with your insurance, and under the Affordable Care Act, insurers are required to cover most immunizations for adults and children, so you probably won’t be charged. When in doubt, you or your pharmacist should check first with your insurer. Note, too, that your insurance plan may have age limitations, for example, most plans will not cover the shingles vaccines for adults under age 60. If you’re paying out-of-pocket, know that prices vary depending on the pharmacy, just as they do at your doctor’s office. For example, you’ll pay $85 for the pneumonia vaccine at CVS and Target, but just $73 at Costco pharmacies. And the dual Hepatitis A and B vaccine costs $169 at Target, and $114 at Walmart. Ask your pharmacist to forward information about your vaccinations to your doctor's office so that it can be added to your medical record.

An added perk for getting vaccinated at the pharmacy: CVS, Walgreens, and other chains offer loyalty programs (it’s free to sign up) that earn you rewards for each vaccination you get, and those reward points add up to discounts on other store purchases. Sign up online or at the pharmacy counter.

If you are uninsured or paying out-of-pocket, many of the same statewide free health clinics and community health centers that provide preventative care offer free or low-cost vaccinations. Find a clinic near you.

—Ginger Skinner

Understand the threat of antibiotic resistance

Almost half of Americans don't understand threat of antibiotic resistance
Published: Consumer Reports, July 05, 2015

When it comes to the growing threat of superbugs, far too many Americans just don’t get it. That’s according to a poll in June of 1,006 adults by Consumer Reports National Research Center that showed 41 percent of people hadn’t even heard of antibiotic resistance.

When asked pointed questions about the risks and benefits of using antibiotics, responses were mixed. While a majority of Americans strongly agreed that taking an antibiotic unnecessarily can make that drug less effective for you in the future, fewer people appear to understand the bigger picture. Roughly just half (52 percent) strongly agreed that bacteria that are resistant to multiple antibiotics, so-called “superbugs,” are a major public health problem today. Forty-nine percent strongly agreed that taking an antibiotic you don’t need makes that drug less effective at treating illnesses in other members of the community in the future. Overall, less than half (45 percent) said they’re somewhat or very concerned that this problem might affect their family.

An equally worrisome finding: More than a quarter (27 percent) of people said they think antibiotics are effective in treating colds and the flu (they aren’t—colds and flu are infections from viruses, not bacteria).

In fact, a second poll we conducted in June of 223 people who received a new antibiotic prescription in the past year showed Americans are being prescribed antibiotics inappropriately for illnesses against which the drugs either don't work or may not be the best treatment, such as sinus infections (12 percent), as a precaution after medical or dental surgery (11 percent), coughs or colds (8 percent), and abnormal urinary symptoms (7 percent).

http://www.consumerreports.org/cro/magazine/2015/06/the-rise-of-superbugs/index.htm

Misconceptions about antibiotics can lead to misuse. And misuse can result in antibiotic-resistant bacteria, which now sicken at least 2.25 million people each year—and kill 37,000. One way you can help the overall problem of bacterial resistance is by not insisting on antibiotics from your doctor for viral infections. And even when you do have a bacterial infection, if it’s mild, ask your doctor about fighting it off on your own without resorting to the use of an antibiotic. Case in point: sinusitis and bronchitis are usually viral. And even when bacteria are the cause, mild sinus and bronchial infections often clear up in about a week on their own. Also many older people are routinely given antibiotics for findings of urinary bacteria, even though they are lacking symptoms of a urinary tract infection. Such inappropriate use of antibiotics can do more harm than good.

http://www.consumerreports.org/cro/2014/03/when-you-think-you-need-antibiotics-but-really-don-t/index.htm

Other steps you can take to help keep you, your family, and everyone else safe from superbugs include: 

• Requesting targeted drugs. If your doctor determines you need an antibiotic, ask for a culture to be done to identify which bacteria is causing the infection. That should lead to prescription of an antibiotic that can specifically treat the identified bacteria, rather than a broad spectrum drug that kills more types of bacterial, unnecessarily, as well. 
• Avoiding antibiotic topical creams, unless advised by your doctor. Even antibiotics applied to the skin can lead to resistant bacteria. So use over-the-counter ointments containing bacitracin and neomycin only if dirt remains after cleaning with soap and water. 
• Preventing infections in the first place. That means staying up to date on vaccinations. And it means washing your hands thoroughly and regularly, especially before preparing or eating food, before and after treating a cut or wound, and after using the bathroom, sneezing, coughing, and handling garbage. Plain soap and water are best. Avoid antibacterial hand soaps and cleaners, which may promote resistance. 
• Getting rid of leftover antibiotics. More than one out of four people (28 percent) in our poll this past June said they have leftover antibiotics at home. To avoid misuse, dispose of unused antibiotics safely, either by returning them to the pharmacy or mixing them with coffee grounds or cat litter and tossing the mixture in the trash. 

— Ginger Skinner

Click on link to video for more information from Consumer Reports regarding antibiotic myths

http://www.consumerreports.org/cro/video-hub/4285970453001/

Editor's Note: These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

BBD's Digital Health Finds from Ginger

It has been awhile since I posted Ginger's Friday updates. Here is today's information that you may find of interest. 

Tweets about migraines provide data on pain [Health Central]
Social media outlets like Twitter may help doctors better understand causes and potential treatments for people who have migraines, according to new research. Scientists from the University of Michigan examined approximately 22,000 tweets that included the word “migraine” that were posted over a one-week period. They found that globally, the migraine tweets spiked at 10 a.m. on Monday. In the United States, about 74 percent of the migraine tweets came from women, and the majority of the tweets occurred between 9 a.m. and 9 p.m., Monday through Friday.

On-screen doctor visits are the new house call [Star Tribune]
Three times a week, Dr. Joseph Olson dons his white coat, but he doesn’t leave his home in Storden, Minn. Instead, he fires up his tablet, peers into the camera and starts “seeing” patients via real-time video chat. On the other end of the Internet connection are people who have logged on for the virtual visit through their smartphones or tablets. One by one, Olson examines them — diagnosing mostly minor ailments such as sinus infections, skin rashes and sprains. Olson works for “Doctor on Demand,” a mobile app that started four months ago and is now in 40 states, with 1,000 doctors on staff. A 15-minute video session costs $40.

Beth Israel uses Glass and EHR data in the ED to make time-sensitive treatment decisions faster, smarter [MedCity News]
I'm now able to publicly write about the work that Beth Israel Deaconess Medical Center has been doing with stealthy start up, Wearable Intelligence. We’ve been working over the past 4 months on pilots that I believe will improve the  safety, quality  and efficiency of patient care through the integration of wearable technology such as Google Glass in the hospital environment. I believe that wearable tech enables providers  to deliver better clinical care by supporting them with contextually-relevant data and decision support wisdom.

Veterans say appointment reminders are most useful feature in health app study [MobiHealth News]
More than half of providers that used mCare, a secure messaging app for soldiers, saw an improvement in health appointment attendance and 85 percent would recommend that their patients use the app, according to a study, published in Telemedicine and e-health, that looked at the effects of mCare on 497 veterans. All soldiers who participated in the program were part of a U.S. Army Community-Based Warrior Transition Unit (CBWTU), which provides support to wounded, ill and injured soldiers who require at least six months of rehab and complicated health management. These units are in five locations: Florida, Massachusetts, Illinois, Virginia, and Alabama.

PatientsLikeMe signs five-year data access deal with Genentech [MobiHealth News]
Boston-based PatientsLikeMe, a hub for crowd-sourced patient data and an open research platform, has announced its most wide-reaching pharma partnership yet, a five-year agreement to share data with Genentech, a division of Roche. “They are a forward-looking company in the health IT space, and … I think they’re really looking at new forms of evidence and how that can improve their business and impact their products and services,” PatientsLikeMe President and Co-founder Ben Heywood told MobiHealthNews. “They are a patient-centered business and they’re really trying to improve their leadership in that arena.”

Eight (no, nine!) problems with big  [New York Times]
Big data is suddenly everywhere. Everyone seems to be collecting it, analyzing it, making money from it and celebrating (or fearing) its powers. Whether we’re talking about analyzing zillions of Google search queries to predict flu outbreaks, or zillions of phone records to detect signs of terrorist activity, or zillions of airline stats to find the best time to buy plane tickets, big data is on the case. By combining the power of modern computing with the plentiful data of the digital era, it promises to solve virtually any problem — crime, public health, the evolution of grammar, the perils of dating — just by crunching the numbers.Or so its champions allege.

IOM: Put social, behavioral data in EHRs [Fierce Health IT]
Social and behavioral health information should be included in electronic health records to give care providers the most complete patient data about the patient, the Institute of Medicine says in a new report. A 13-member committee compiled a proposed list of 17 social and behavioral "domains" to be included as a guide for federal officials developing criteria for Meaningful Use Stage 3, reports Family Practice News.

Five cool medical innovations we saw last week [Vector blog]
Last week, Boston Children’s Hospital’s Innovation Acceleration Program hosted a jam-packed Innovators’ Showcase where teams from around the hospital networked, traded ideas and showed off their projects. Here are a few Vector thinks are worth watching.

Digital drugs will transform healthcare [Wired UK]
Andrew Thompson is CEO and co-founder of Proteus Digital Health, a California-based company building tiny ingestible sensors that can be incorporated into pills to let doctors know when patients take them. This is one of several connected products the company has in the pipeline that should help improve current diagnosis and treatment methods. Andrew will be speaking at Wired Health on 29 April.

What if medical records worked like Wikipedia? [KevinMD.com]
I’ve been thinking about EMRs, electronic medical records, lately. It’s a subject, despite some professional experience, I don’t feel particularly close to. In fact, if anything, they are a source of consternation. As an industry insider, I see them as an expensive albatross around our collective neck. As a human centered design adviser, I see them as an encumbrance for both providers and patients. And, as a patient I see them largely as an opaque blob of data about me with a placating window in the form of a portal. Which makes me wonder, am I obsessed with EMRs lately?