SOS Rx Update

 

SOS Rx is a new collaborative coalition dedicated to promoting outpatient medication safety. The National Consumers League is convening SOS Rx with support from Express Scripts as founding sponsor.  Express Scripts is supporting the creation of SOS Rx because of its mission to make the use prescription drugs safer as well as more affordable. More than 40 organizations have officially joined the coalition, attended one or both SOS Rx meetings on July 30th and October 1, or participated in a work group meeting as reflected in appendix B. This document details the coalition’s purpose and plans.

 

 

The Challenge:

Interest and concern is growing about the safe use of prescription drugs, as demonstrated by the recent publication of research articles in the Annals of Internal Medicine, the New England Journal of Medicine and the Journal of the American Medical Association.  

 

A special focus has been on senior citizens and Express Scripts’ own research has found that senior citizen prescription claims generate twice as many safety warnings as for those who are younger.  The debate over a senior prescription benefit in Medicare will also focus attention on the overall issue of senior medication safety and more specific challenges within this issue, such as prescribing errors, lack of physician connectivity, potentially hazardous interactions, therapy duplication, patient non compliance, and unheeded safety alerts or signs of side effects. 

 

While there appears to be great concern over the problem, even a sense of urgency, there does not appear to be a concrete, broad-based, collaborative effort to address it.  This provides an extraordinary opportunity – in fact, a great need – to build an alliance of concerned partners who can search for answers and create actionable plans for improvement that ultimately can positively affect many consumers and the system as a whole. 

 

 

Meetings

 

Held respectively at the National Farmers Union and AFL-CIO, both meetings featured presentations by nationally recognized experts.  In July, Dr. David Classen reviewed recent research and reported on initiatives underway at the Institute of Medicine and the Leapfrog Group.  Dr. Classen is a vice president at First Consulting Group, where he leads the quality of health care initiatives practice area.  He is also an associate professor of medicine at the University of Utah. 

 

In October, Dr. Tejal K. Gandhi, one of the nation’s leading authorities on outpatient medication safety issues, reviewed the results of studies conducted at Boston’s Brigham and Women’s Hospital where she is director of patient safety.  She also maintains an active outpatient practice.  Also speaking was Barbara Rudolph, director of leaps and measures for the Leapfrog Group.  She briefed the group on expansion of Leapfrog’s focus beyond inpatient care to include physicians’ offices.

 

Consensus was reached during the first meeting on the following purpose statement for SOS Rx: 

 

The purpose of SOS Rx is to make the outpatient use of medicines safer.  Our voice is national and our actions evidence-based.  SOS Rx will focus on campaign-style education/information initiatives aimed at securing consumer actions and system changes that enhance the safe outpatient use of medications.  Participating organizations signify support and commitment to work together to assure the safe outpatient use of medications for all consumers and patients, with initial focus on safe use by senior citizens.

 

At the second meeting, coalition members reported on work group sessions held during September regarding the an education campaign, which will kick-off in 2004, and an action agenda consensus retreat scheduled for November 9-11 at the Aspen Institute, Wye Mills. 

    

During the retreat a small group of about 35 experts will identify the consumer actions and system changes with the greatest potential for enhancing the safe outpatient use of medications.  Facilitator for the consensus retreat will be Hugh Tilson, steering committee chair of the Centers   for Education and Research on Therapeutics (CERTS).  Keynoting the retreat will be George Lundberg, currently editor-in-chief emeritus of Medscape (WebMd) and formerly editor of the Journal of the American Medical Association.  Joining the session at its conclusion to hear the results will be the director of the Agency for Healthcare Research and Quality, Dr. Carolyn Clancy, as well as senior representatives from the Food and Drug Administration, Department of Veterans Affairs and the Centers for Medicare and Medicaid Services. 

 

The prioritized consumer actions and system changes emerging from the consensus retreat will then serve as targets for the campaign-style education and communication initiatives undertaken by SOS Rx.  In preparation for that campaign, media and resource audits have been performed and were presented during the report of the education work group.

 

Materials from both meetings are available at http://www.nclnet.org/sosrx.

 

Moving Forward:

In addition to the November 9-11 consensus retreat, the action agenda work group will meet on December 2 to review the results of the retreat and the education campaign work group will meet on December 12 to work on plans for the 2004 education campaign.  The next full meeting of the coalition will occur on January 7, at AFL-CIO headquarters.  All meetings will be held in Washington, DC, and accessible via telephone conference call. 

 

 

Appendix A

Defining and Differentiating SOS Rx

 

The initial focus of the coalition is on senior outpatient medication safety, however, because all populations are affected by adverse drug events, it is reasonable to expect that SOS Rx could decide to expand the effort beyond seniors. The following details provide definition of the key focus areas of SOS Rx:

 

Focus:              Outpatient

                        (Not Inpatient)

 

Emphasis:         Most at risk populations -- initially, seniors.

                        (Not low risk populations)

 

Objective:         Increase safe use of medicines/reduce harm from unsafe use

                        (Not surgical, radiological, laboratory, diagnostic, etc. errors)

 

Scope:              Includes over the counter, supplements and prescriptions

                        (Not prescription drugs alone)

 

Target:              Consumer actions and system changes for safer use

                        (Not discovery, approval, formulation, manufacture or counterfeit)  

 

Activity:            Education and communication initiatives

                        (Not research, standard, protocols, measures, monitoring, etc.)

 

Strategy:           Campaigns

                        (Not another brochure)

 

Members:         “Everyone around the table”

                        (Not just consumers, industry, or health professionals, etc.)

 

Appendix B

SOS Rx Participation

 

Legend:

1)         Attended July 30 meeting

2)         Attended October 1 meeting

C1)       Attended September 23 consensus group meeting

E1)       Attended September 16 education group meeting

 

Officially Signed On:

·        Academy of Managed Care Pharmacy (1, 2)

·        Agency for Healthcare Research & Quality (1, 2, C1)

·        Alliance for Aging Research (1, E1)

·        American Academy of Nurse Practitioners 

·        American Academy of Physicians Assistants (2)

·        American Association of Colleges of Pharmacy (1, 2, C1)

·        American Medical Women’s Association (2)

·        American Pharmacists Association Foundation (1)

·        American Society of Consultant Pharmacists (2, C1, E1)

·        American Society of Health System Pharmacists (1, 2)

·        Center for Information Therapy (2, C1)

·        Department of Defense

·        Express Scripts (1, 2, E1, C1)

·        Generic Pharmaceuticals Association (1, 2, E1, C1)

·        Institute for Safe Medication Practices (1)

·        Joint Commission on Accreditation of Healthcare Organizations (2)

·        Massachusetts Group Insurance Commission (1)

·        Medical Records Institute (2)

·        National Consumers League (1, 2, E1, C1)

·        National Family Caregivers Association (1, 2, E1)

·        National Health Council (1, 2)

·        National Quality Forum (C1)

·        Visiting Nurses Association of America (VNAA) (2, E1, C1)

 

 

Participated in Meetings

·        American Academy of Family Physicians (1, 2)

·        American Benefits Council (2)

·        American College of Law and Medicine (2)

·        American Geriatrics Society (1)

·        American Hospital Association (2)

·        American Medical Association (1)

·        American Nurses Association (2)

·        Families USA (2)

·        Healthcare Information and Management Systems Society (2)

·        Johnson & Johnson (2)

·        Laborer Health & Safety Fund of North America (2)

·        Leapfrog Group (2)

·        Massachusetts Coalition for the Prevention of Medical Errors (1, 2)

·        National Alliance for Hispanic Health (2)

·        National Council on the Aging (C1)

·        National Patient Safety Foundation (1, E1)

·        NCPIE (on own and on behalf of NCCMERP) (2, E1)

·        Older Women's League (1)

·        Rite Aid (2)

·        UnitedHealth Group (Ovations) (1, 2, E1)