Mail order medication lessens need for emergency treatment

by Barbara Hewitt on November 26, 2013

Patients with diabetes who received prescribed heart medications by mail order are less likely to need emergency health treatment than those who picked up prescriptions in person, a new study has found.

A study by the Kaiser Permanente Division of Research in the United States looked at 17,217 adults with diabetes who were first prescribed heart medications in 2006 and followed them for three years.


Patients aged under 65 who used mail order pharmacies had significantly fewer visits to hospital emergency departments

It found that diabetes patients aged under 65 who used mail order pharmacies had significantly fewer visits to hospital emergency departments for any cause than those who picked up prescriptions, at 33.8% compared with 40.2% respectively.

This study is the first to examine the potential impacts of mail order pharmacies on patient safety and utilization, and explores the concern of patients experiencing adverse outcomes because they do not meet face to- ace with a pharmacist.

‘Overall, we didn’t see any safety concerns. For the vast majority of people the mail order pharmacy works well,’ said Julie Schmittdiel, a research scientist with the Kaiser Permanente Division of Research and the study’s lead author.

Kaiser Permanente offers members the options of using its mail order pharmacy or picking up prescriptions at walk in pharmacies located in Kaiser Permanente hospitals and outpatient medical buildings. Medication can be delivered by mail with free shipping and mail order requests can be made by phone or online. Mail order costs are often lower.

The study did not look at possible reasons why the use of mail order pharmacies was associated with fewer emergency visits, but researchers noted that further investigation may involve exploring factors such as patients having disabilities, time constraints or limited transportation.

This study is part of Kaiser Permanente’s ongoing efforts to understand how mail order pharmacies can improve care. Schmittdiel’s previous studies have shown that patients who use mail order pharmacies have significantly better medication adherence and cholesterol management.

Meanwhile, the US Food and Drug Administration is lifting restrictions on a once widely prescribed diabetes drug. It says that GlaxoSmithKline’s Avandia does not increase the risk of heart attacks.

Avandia, which had been one of Glaxo’s top selling medicines with sales of $3.2 billion in 2006, was pulled from the market in Europe and had severe restrictions placed on its use in the United States in 2010 due in part to ambiguity about a possible increased risk of heart attack and stroke seen in a large clinical trial aimed at determining the drug’s safety called Record, as well as a review of other studies.

Now after a further review of the Record trial, the health regulator says there is no elevated risk of heart attack or death in patients being treated with Avandia when compared with standard of care diabetes drugs.

‘GSK welcomes the decision of the FDA and appreciates the agency’s robust review of the science with regard to Avandia. GSK maintains its view that Avandia is a safe and effective treatment for type 2 diabetes when used appropriately,’ the company said in a statement.

‘Our decision reflects the most current scientific knowledge about the risks and benefits of this drug,’ said Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research. ‘Given these new results, our level of concern is considerably reduced, thus, we are requiring the removal of certain prescribing restrictions,’ she added.

The FDA said it will order changes to the Avandia label to reflect its updated position on cardiovascular safety and that diabetes patients will again be able to receive Avandia through regular retail pharmacies and mail order pharmacies.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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