December 2, 2015

Responsibilities Not Taken Seriously

I am very concerned about the lack of caring by those in the business of providing education to people new to injecting medications for diabetes. I admit that I don't like to see Victoza being used, but it is and there are several other medications that are not insulins that are injected.

I am seeing more and more Disasters Averted, Near Miss Case Studies reported in Diabetes-in-Control weekly newsletters that involve people either using equipment the wrong way or injecting a medication in the same spot day after day and wonder why they are having problems.

This makes me wonder what professional people missed giving out information to have these things happen. Some are even reported anonymously which means someone has to be ashamed of what they did not teach correctly. Most have been CDEs reporting these incidents.

Just reading these, makes me wonder about the competency of the people doing the prescriptions or the people the patients have been referred to for education.

Common themes include:
  • Injecting medications in the same area day after day.
  • Not having operation of insulin pens explained properly.
  • Over prescribing of same medication because patient sees several doctors.

The first should be taught to all people using injectable medications to prevent the build up of scar tissue just below the skin. When this happens, the medications are prevented from being used by the body as they become trapped in the scar tissue.

The second applies to many pieces of equipment because patients beg for equipment and no one teaches the patient the proper use of the equipment. I have seen pharmacists spend a lot of time explaining equipment when patients ask and even contact patients using the equipment when they are busy and can't take the time to explain everything.

The last point above happens over and over. Several of our support group have had doctors try to do this to them and refused the prescription after explaining they were already taking a medication, which the doctor's office had not requested any information to know what was being taken. Blood pressure drugs and statins seem to be the favorites in our area and most doctors push these without determining what the patients is already taking.

Some doctors are requiring patients to bring in all supplements and prescription medicines and making a record of each. When a patient does not bring in any supplements, they are warned that no more prescriptions can be issued so that conflicts with prescription medications can be prevented. When a patient says they are natural and don't need to be considered the doctors are becoming even more insistent on getting all supplements.

Barry said he had a friend that would not tell his doctor what supplements he is taking, as it is none of the doctor's business. Both Ben and Barry have warned him that some medications have conflicts with some supplements and can even cause death if this information is ignored. Yet he held fast to this belief and just tells the doctor he is not taking any supplements. The only thing that might have saved him was when he had one prescription filled, the pharmacist noticed the supplements he was purchasing and advised him of the conflict and what could happen if he took the supplement with the new prescription. Barry was with him and advised him to follow the pharmacist's advice.

We know what happened as Barry's friend ended in the hospital two days later and died the next day.

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