1. Home
  2. Drugs

Drugs

HEADSSS Assessment

Author/s: 
Dr Nicola Martin, Dr Louise Ingram, Adam Bonfield

The HEADSSS assessment is an internationally recognised tool used to structure the assessment of an adolescent patient, encompassing Home, Education/Employment, Activities, Drugs, Sex and relationships, Self harm and depression, Safety and abuse. The assessment starts with simple and easy questions about life to allow a rapport to be built, before delving into more personal and embarrassing aspects.

The assessment does not necessarily have to be completed in one sitting, it may take multiple conversations to build up the trust for the young person to disclose such personal information to you. Once a HEADSSS assessment is completed, it is important to document your findings in the notes and communicate appropriate information to other members of the healthcare team. Follow through on any offers of help or support you have made.

If concerns about the young person’s safety have been raised, you must explain to them that you need to pass that information on to the relevant agency. Reassure them that the main priority is their safety and establish what they will do in the meantime to help keep themselves safe.

Keywords 
adolescent Drug abuse Relationships safety abuse Self Harm assessment depression

Strategies to Help Patients Navigate High Prescription Drug Costs

Author/s: 
Hussain S Lalani, Catherine S Hwang, Aaron S Kesselheim, Benjamin N Rome

Importance In the US, many patients struggle to afford prescription drugs, leading to adverse health outcomes. To improve cost-related medication nonadherence, prescribers and clinical staff must understand how to assist patients in overcoming high prescription drug costs.

Observations We reviewed the benefits and limitations of 7 strategies to help patients afford prescription drugs: co-payment cards, patient assistance programs, pharmacy coupons, direct-to-consumer pharmacies, public assistance programs, international online pharmacies, and real-time prescription benefit tools. We created an algorithm to help clinicians identify appropriate strategies based on a patient’s health insurance and the type of drug (brand-name vs generic). For example, co-payment cards can lower out-of-pocket costs for privately insured patients taking brand-name prescription drugs. For uninsured individuals or those with public insurance like Medicare Part D who meet financial eligibility criteria, patient assistance or public assistance programs may be available. All patients, regardless of health insurance, can forgo insurance and purchase drugs directly using pharmacy coupons or direct-to-consumer pharmacies, which sometimes offer lower prices for generic drugs compared to insurance. For insured patients, such purchases do not count toward insurance deductibles or annual out-of-pocket maximums. Online international pharmacies provide a last resort for patients in need of brand-name drugs who lack affordable domestic options. Increasingly, prescribers can use real-time prescription drug benefit tools to estimate patient out-of-pocket costs and identify alternative lower-cost treatments for insured patients, but these tools can be inaccurate or incomplete.

Conclusions and Relevance The current patchwork of strategies to help patients manage high prescription drug costs highlights the structural and policy challenges within the US prescription drug market that impede affordable access for some patients. While these strategies provide tangible solutions for clinicians to help patients access medically appropriate but costly medications, they do not address the root causes of high drug prices.

Keywords 
health care costs costs prescriptions

Strategies to Help Patients Afford Their Medicines in the US

Author/s: 
Kristin L Walter

Many patients in the US struggle to afford their prescription drugs. The inability to take medications as prescribed can lead to worse health outcomes.

Below are 7 strategies that patients can use to respond to high prescription drug costs in the US.

Keywords 
clinical pharmacy and pharmacology Patient Information jama Patient Information Health Care Economics, Insurance, Payment insurance
Subscribe to Drugs