The Unmentionable: HIV and the Older Adult, Are they at Risk?

By: Kandace L. West, Pharm.D.

I came across this recent statistic: by 2015, 50% of people with HIV will be 50 years or older

In case you may not realize it, it is now 2013 and 2015 is a year and a half away! So what does this mean?

This means: (1) not only are people living longer with HIV due to an increase in antiviral therapies (which is an amazing accomplishment), but (2) unfortunately many older adults are unaware of their risk of HIV and are becoming newly infected as adults in their 40s, 50s, 60s and sometimes 70s as well. So, why is this?

Well let’s think about the numbers. Currently, according to the CDC, there are 1.1 million people living with HIV/AIDS in the U.S. and roughly a quarter are 50 years and older: 275,000 people. Again, when I talk about the numbers, does anyone imagine an older adult, mother, father, grandmother, aunt or uncle being at risk for this disease? No, no one does and most people still believe it is a disease that only affects people in their teenage years or early twenties, the LGBT community or non-married people. It is precisely this lack of awareness that leads to an attitude lacking in precaution. The reality is that a growing number of people age 50 and older represent 25% of the population of people with HIV/AIDS in the U.S. and this segment will continue to grow so long as the pervasiveness attitude of unawareness is allowed to persist.

June 27th is National HIV TESTING DAY and an excellent opportunity to take the time to learn more about HIV testing and how to keep individuals, especially our older adults safe and healthy from this disease.  Below is the link to find more information for testing and to increase awareness for the unmentionable risk group, the older adult.

Medicine Cabinets Must-Have, NOTs: The Simple Sixes

By: Kandace L. West, Pharm.D.

People are very nostalgic over what is in their medicine cabinets, and despite that many of the items are old, faded and more often than not expired, people feel such great emotional relief that a particular item resides on the same shelf in the medicine cabinet for years. The medicine cabinet houses prescription medications, over-the-counter products, and home remedies for the most common aches, pains, and illnesses, but unfortunately a number of items in there may not even be necessary, are well past their shelf-life, or have the potential to cause harm if taken. As a Medication Care Pharmacist, along with checking prescription medications, over-the-counter products, herbals and supplements for safety in the comfort of the individual’s home, I am always astonished at the number of items that any one person manages to gather in their medicine cabinet. When I ask the question “Why do you still have this?” the overwhelming response is, “I bought it and it’s mine and I will keep it because I might need it in the future.”

My Commitment as a Medication Care Pharmacist is to ensure medication care and safety. And fulfilling this commitment usually means explaining why a medication may or may not be necessary. In this scenario, when people are holding onto what they believe are “medicine cabinet must-haves” I find this an opportunity to explain the reasons why many times a medicine cabinet can harbor dangerous items, especially in the Older Adult Population.

And so I’ve developed some basic rules for the Medicine Cabinet Must-Have Nots called: ‘The Simple Sixes’ to guide anyone through a Medicine Cabinet Clearing Session!

(1)    If the medicine cabinet is in the bathroom, where the shower is located and is subject to moisture and steam from a shower . . . guess what? Everything being stored in there is not as good quality as it should be because most medications (prescription and over-the-counter) should be stored in a cool dry place, otherwise they degrade faster and may not be as effective. The best place to store medications is in a cool dry place such as a bedroom closet or cabinet in the kitchen. The cabinet should be within arm’s reach for an adult but if there are small kids around it should be stored up and away.

(2)    Check expiration dates! All prescription medications, over-the-counter herbals, and supplements should be labeled with an expiration date. Medications used after their expiration date are not guaranteed to work the same as non-expired products, and sometimes individuals can suffer undesired side effects from expired medications.

(3)    Before storing medications, keep all medications in their original containers. Never combine medications, or refill bottles. Each bottle has an individual lot or batch number and this is helpful in case there is a drug recall. The FDA places information on their website that is often relayed in our local news regarding specific drug recalls, and if the medications are not in their original containers, who is to know if it has been recalled?

(4)    Please do not flush medications down the toilet! The medication, active ingredient and bi-products end up in our drinking water!  Disposal of expired, unwanted, unnecessary medications can be done by getting more information from the DEA (Drug Enforcement Administration). They host an annual take back day, where they collect medications for disposal locally. It’s a great opportunity to set National Take Back Day as your annual medicine cabinet cleaning day.

You can also check if local pharmacies in your area collect medications for disposal.

(5)    Over-the-counter products for acid reflux, sleep-aid, weight loss, and combination cold-flu products should not be used unless you have sought professional advice from a medical doctor or pharmacist who knows all the medications you are currently taking. Many over-the-counter products are just as strong as prescription medications and can interact with other medications, so it is necessary that they are recommended by a professional. So, if you have not sought professional advice prior to using, I recommend discarding these items; refer to Step (4) for disposal methods.

(6)    Prescription medication that was prescribed for a limited time period, such as antibiotics, pain medications and steroids (prednisone) should not be stored for another illness, unless instructed to do so by a medical doctor. Many of these medications if used by an individual based up their personal judgment of an illness may cause harm. These medications should properly be disposed of. Please refer to Step (4) for disposal methods.

It’s hard to develop a hard and fast list of everything, but I hope that the Simple Sixes will help many of you start an annual medicine cabinet cleaning session!