A Q&A with Colin Banas, MD, chief medical officer at health care software company DrFirst.
Summer travel season is in full swing. Earlier this year, industry experts predicted a significant increase in summer travel bookings—even in the face of record inflation and reduced airline routes.1 But after end of the COVID-19 public health emergency in May, Americans aren’t letting much of anything get in the way of their summer vacation.
Drug Topics spoke with Colin Banas, MD, chief medical officer at DrFirst, who provided tips that pharmacists can share with their patients around medication storage, medication adherence, and what to do if your medication gets lost.
Drug Topics: Summer is one of the busiest travel seasons, what are some some things people who take daily prescriptions should do before they even start packing for a trip?
Colin Banas, MD: I think one of the most important things [for patients] is to have a complete list [of medications]. In this day and age, you can do these things digitally. So, there are plenty of ways to compile and keep track of your medications, but a complete list is going to be super helpful—especially if something goes awry on your trip and you need to go to an emergency services. The first thing they're going to ask you is what medications you’re taking.
In the old days, when I would work in the emergency department, people or family members would bring in a folded piece of paper and it was useful; it was helpful because a lot of times people really can't remember. And even though there's this perception that it's all in my [electronic] record, the interoperability between records still really isn't at the level that it should be in 2023.
Aside from that, there's also practical things that [patients] can do. When traveling by air, you [may be] separated from your luggage. Don't put your medications in your luggage; your luggage can get lost [and] you can be without your supply of medications until that gets resolved. You also have to be pretty aware of the physical conditions that you're storing the medications in. Don't leave them in a hot car when you park to go to the beach. It seems like common sense, but you know, you're excited for your vacation. These are not things you're going to think of right offhand. It's important to take a moment and reflect and get these things right.
Drug Topics: You touched on this a bit, but what some other tips when it comes to packing that people should be aware of?
Banas: I would say, bring enough medications, and then some. Over pack on your medications. If it's a 5 day trip, maybe take 7 or 8 days’ worth of medications, just in case. It gets tricky trying to get meds refilled or get emergency supply when you're away from the home base.
Drug Topics: What are the first steps someone should take if, once they get off the plane at their destination, they realize that they don’t have their prescriptions with them?
Banas: Thank goodness that we're in an era of increased connectivity. I think if you could say one positive thing about the pandemic, it's probably the fact that it promoted a lot this connectivity, whether it's patient portals or televisits. We really got an acceleration in the digital connectedness that we have between patients and [health care providers]. I would say the very first thing is contact your [physician] or your provider.
There are lots of good ways to do this now. It doesn't always have to be a phone call through an answering service. There's the patient portal, there's secure messaging, things like that. There's even televisit options that you most likely have with your trusted provider. Getting in touch with them and letting them know the situation is probably the most important thing. Some of these medications are really time sensitive. It might be one thing to skip a day or 2 of your atorvastatin (Lipitor), but for someone who's on blood thinners or immunosuppressants, [those medications are] critical. You really can't afford to miss doses. So, getting in touch with a provider or a representative from your provider's group is probably the critical first step.
Drug Topics: DrFirst developed an app called iPrescribe. Can you talk about how that was developed and how people can use it?
Banas: So, to understand DrFirst, you have to go back to the genesis of the company. It was literally a pioneer in the e-prescribing world. In the year 2000, our founder wanted to be the first company in the millennium. At midnight of January 1, he founded DrFirst to be the first company of the new millennium. They started doing e-prescribing before e-prescribing was even a thing.
You go back 23 years, we were still writing paper prescriptions and handing them to patients. Maybe every once in a while, for a really advanced organization, you might have a computer, but you would still print the prescription and hand it to the patient. Fast forward 20 something years, we've come a long way since then.
There are times when you are away from your computer, from your electronic medical records, where this care still needs to occur. The idea behind iPrescribe was “How can I empower the provider to be able to write any prescription from anywhere that they are, and do it with all of the benefits of decision support, allergy checking, dose interactions, and make sure that it's still being securely transmitted?”
If you don't have iPrescribe, or you don't have mobile ways to do this, you actually still get on the phone and call the pharmacy. You go through a phone tree or you leave a message for the pharmacist and the pharmacist calls you back. It's terribly inefficient. Whereas with iPrescribe, I can literally rewrite that prescription or write you a new prescription within a matter of seconds, transmit it securely, and then the application will notify the patient.
So, we're really trying to close the loop, letting the provider write this prescription from anywhere they are, but also engaging the patient at the time the prescription is written so that they know where it went. You can set reminders to go get it, you can see copay assist programs. We've actually been able to show that the combination of the two together actually increases the adherence rate for our patients. That's really one of the ultimate goals of DrFirst, to get patients on therapy and then through technology, keep them on therapy for better outcomes.
Drug Topics: Do you have any advice around medication adherence individuals who are traveling?
Banas: Just because you're on vacation and out of your normal routine doesn't mean you get to deviate from the routine of your medications. I think it's about awareness; whether it’s a list, or keeping the pills with you, or making sure you have extra.
Going on vacation is exciting, you can definitely see people forgetting their prescriptions, it happens all the time. Just take a beat and run your checklist to make sure you have the swimsuit, you have the toothbrush, you have the medications. And remember that you need to store them appropriately, have extra, and keep them on you.