Search

Background Drug take-back programs (TBPs) provide the opportunity to safely dispose of unused or expired medications (UEMs), potentially reducing the risk of environmental harm and morbidity. Data on patient perceptions and participation are limited, especially in underserved Asian populations. Objective This study aimed to evaluate medication disposal perceptions and behaviors through a free mail-in medication disposal program among patients in a Chinatown community pharmacy. Methods An institutional review board–approved Web-based survey was developed in English and Mandarin. Student pharmacists tabled at a Chinatown community pharmacy in Boston, Massachusetts. The patients were educated about safe medication disposal practices and invited to take the anonymous survey assessing medication disposal needs, practices, and beliefs accessed in person by using a quick response code. On survey completion, the patients were offered a disposal envelope. Envelope tracking numbers were used to evaluate medication disposal over a 9-month follow-up period. Results Sixty-two patients of Asian descent completed the survey, and 42 (67.7%) accepted an envelope. Forty-seven patients (75.8%) reported having access to UEMs. More than half indicated that TBPs were important to alleviate the risk of medication and environmental consequences despite low previous use (6.5%). Most patients felt more aware of TBPs (72.6%), an increased sense of the importance of TBPs (74.2%), and intent to participate in TBPs (69.4%), including using the envelope (75.8%). Three (4.8%) patients disposed of medications using the study-provided envelope during the 9-month follow-up. Conclusion Patient education about TBPs and their importance may be effective in increasing TBP awareness in a population with low TBP use. Free disposal envelopes did not seem to be highly used within 9 months of receipt despite interest and access to UEMs. Future research should continue offering programs at no charge, evaluating barriers to free TBP use, and implementing follow-up procedures to increase envelope use.

Background: Previous studies linked metformin use to vitamin B12 deficiency and demonstrated that the prevalence of vitamin B12 monitoring remains low. Objective: This study aimed to assess the occurrence of monitoring vitamin B12 levels in a diverse population. Methods: This was a retrospective chart review of adult patients with type 2 diabetes on metformin doses ≥ 1000 mg for ≥ 6 months at five Federally Qualified Health Centers (FQHC) and one Program of All-Inclusive Care for the Elderly (PACE). Charts were reviewed for occurrence of monitoring vitamin B12 levels in the past 5 years. Data collected included patient demographics, laboratory data, other potential vitamin B12 level lowering agents, active prescription for vitamin B12 supplementation, concomitant diabetes medications and metformin total daily dose. Results: Of the 322 patients included, 25% had a vitamin B12 level measured in the previous five years. Among the patients with a vitamin B12 level, 87.7% were within the normal range (>350 pg/mL), 11.1% were low (200-300 pg/mL), and only one patient (1.2%) was deficient (

Objective Glucagon-like peptide-1 (GLP-1) receptor agonists are preferred injectable therapies for type 2 diabetes, but their high cost is an area of concern. This study evaluated monthly glucose-lowering medication cost and clinical impact after initiating a GLP-1 receptor agonist. Design A retrospective, pre-post cohort study evaluated monthly glucose-lowering medication cost, glycated hemoglobin (HbA1c), weight, and polytherapy impact (name, dose, and number of daily doses or injections) when a GLP-1 receptor agonist was initiated (baseline) and after 6-12 months (follow-up). The population was analyzed overall and as subgroups, based on baseline medication regimen and demographics. Setting and participants The study was performed at 8 ambulatory care sites (7 federally qualified health centers and a Program of All-Inclusive Care for the Elderly) in the greater Boston, MA, area. Patients were included in the analyses (n = 120) if they had a documented diagnosis of type 2 diabetes, were 18 years of age or older, had an HbA1c ≥ 7.5% measured within 3 months prior to the initiation of a GLP-1 receptor agonist, and an HbA1c measured 6 to 12 months following the initiation of a GLP-1 receptor agonist. Outcome measures Primary outomes were changes in glucose-lowering medication cost, HbA1c, and weight. Secondary outcome analyses included the impact to the glucose-lowering medication regimen in terms of dose, number of medications, and number of daily doses or injections. Results The study population was largely female, aged 55.8 ± 11.7 years, obese, 76% non-Caucasian, equally English and non-English speaking, had a high tablet and injection burden, and had an average baseline HbA1c of 10%. After the addition of a GLP-1 receptor agonist, monthly glucose-lowering medication cost increased $586.86 (overall), $741.69 (oral only baseline regimen), and $530.55 (insulin ± oral baseline regimen) (all P Conclusion Although a positive impact was observed in glycemic control, weight, and reduced polytherapy 6-12 months after initiating a GLP-1 receptor agonist, the increase in monthly glucose-lowering medication cost was significant and may serve as a barrier to treatment.