15 Medical Conditions in Need of New Medications

Americans want more medications to treat obesity and depression, among other conditions.

Obesity, which affects more than one-third of Americans, ranked highest among US physicians who were asked which conditions they wished had more pharmacological remedies.

More than 6000 US physicians participated in the “PatientsMap” survey, which was conducted by the Social Survey Research Information Co, M3 Inc, and M3 Global Research and took place between December 2013 and February 2014.

According to the US survey results, the following are the 15 conditions that most warrant new medications, with some information on how pharmacists can help these patients:

1. Obesity (27.4%)

Yvette C. Terrie, BSPharm, RPh, previously wrote about the role of the pharmacist in helping patients manage their weight. She suggested that pharmacists can monitor patient medication profiles to find out which drugs could be causing weight gain.

Pharmacists can also educate patients on weight-loss programs and encourage long-term weight-management goals instead of “quick fix” products.

The estimated annual medical cost of obesity in the United States was $147 billion in 2008, according to the US Centers for Disease Control and Prevention (CDC). In addition, obese patients have medical costs that are $1429 greater than patients with a healthy weight.

2. Depression (24.7%)

Pharmacists can comfort patients with depression by telling them that it is a common medical disease, not a character flaw, according to Guido R. Zanni, PhD.

Pharmacists should stress the importance of treatment adherence, and remind patients that it may take a while for them to start to feel better. Patients should also be informed about possible adverse effects, and pharmacists should tell patients that they should never discontinue medication without talking with their physician.

3. Diabetes (22.1%)

In the most recent issue of Pharmacy Times, Clarence D. Moore, PharmD, BCPS, stated that skin problems may be the first sign of diabetes. Dr. Moore said pharmacists should stress tight glycemic control and ensure that patients have a good understanding of their condition and how to adhere to their medication regimen.

“More specifically, pharmacists have the ability to assist in the development of a skin and foot care routine that may further decrease possible skin-related complications,” Dr. Moore added.

Pharmacists have also proved that they are key members of the health care team when it comes to diabetes. One study found that a pharmacist-led intervention team can improve patients’ glycemic control.

4. Dementia (20.5%)

One thing pharmacists can do to help patients with dementia is to monitor their drug regimens for possible drug interactions, according to Jeannette Y. Wick, RPh, MBA, FASCP.

Wick also said pharmacists should show empathy toward patients and their caregivers. In addition, patients with dementia would benefit from education related to memory aids and exercise.

5. Migraine (19.5%)

Pharmacists can play a key role in helping patients manage their migraines using OTC products.

Pharmacists can also advise patients to maintain a headache journal to keep track of frequency, triggers, and response to medication, according to George DeMaagd, PharmD, BCPS. He pointed out that pharmacists can monitor patients to make sure they are not overusing prescription analgesics.

6. Anxiety (18.8%)

Dr. Zanni offered the following advice for pharmacists with patients experiencing anxiety: “When patients ask about a product that might ‘calm the nerves,’ pharmacists should use this counseling opportunity to emphasize that anxiety is a real disease in which symptoms can be lessened or alleviated with treatment.”

Pharmacists can also recommend a healthy diet, daily exercise, and relaxing exercises such as yoga or medication. They should also remind patients to not stop taking their medication without speaking with their physician.

7. Hypertension (17.8%)

Through patient counseling, pharmacists can help patients better understand hypertension and their medications, plus increase their awareness of nonpharmacological treatment, according to Thanh Nguyen, PharmD, and Tara L. Muzyk, PharmD.

It may also be helpful for pharmacists to remind patients about the consequences of untreated hypertension, which may include renal failure, stroke, or heart failure.

Pharmacists can catch up on new recommendations for hypertension management by reviewing the latest Joint National Committee (JNC 8) guidelines.

New research also suggests hypertension medications work better when they are taken before bedtime.

8. Chronic pulmonary obstructive disorder (COPD) (16%)

Educate, manage, and collaborate with other health care providers are 3 pieces of advice from Dennis Williams, PharmD, BCPS, AE-C, on helping patients with COPD.

He added that pharmacists can advise patients to avoid exposures like tobacco that lead to COPD and exacerbate the condition. Pharmacists can also take a lead role in helping patients understand appropriate inhaler technique, and they can recommend and provide vaccines.

9. Lower back pain (15.7%)

Pharmacists can make recommendations on OTC remedies such as pain relievers, topical creams, ointments, gels, and patches for their patients with low back pain. However, it is important to check the patient’s medical and allergy history for interactions and contraindications, according to Kathleen Kenny, PharmD, RPh.

Dr. Kenny noted that there are other steps patients can take to relieve pain, including exercising core muscles, losing weight, and maintaining good posture.

10. Dyslipidemia (15.6%)

Wick and Dr. Zanni maintain that lipid-lowering strategies, including pharmacotherapy, can help reduce coronary events, procedures, hospitalization for cardiovascular events, and stroke.

Pharmacists can emphasize to patients with dyslipidemia that they should focus on lowering cholesterol levels, especially low-density lipoprotein cholesterol (LDLC) levels, as these reductions can lead to a decrease in heart disease incidence by around 20% to 30%.

11. Osteoarthritis (15.1%)

Pharmacists can help patients with osteoarthritis, which is the most common form of arthritis. In addition to making this list, osteoarthritis has been named one of the top 10 disabling diseases in developed countries.

“Pharmacists are well positioned to review medication histories, evaluate risks and benefits of therapy options, and follow up on symptoms,” Caroline Howard, PharmD, BCACP, CPP, wrote in Pharmacy Times Health-System Edition.

Acetaminophen can provide relief for mild pain, while nonsteroidal anti-inflammatory drugs (NSAIDs) may be needed for more severe pain.

12. Fibromyalgia (14.8%)

Fibromyalgia is the second most common disorder seen by rheumatologists, following osteoarthritis.

Pharmacists can help patients with this condition find the right vitamin supplements, according to Wick, who noted that many patients with fibromyalgia have vitamin D deficiencies.

Treatment may target symptoms such as fatigue, pain, and physical disabilities.

13. Headache (14.8%)

Headaches are a common condition that will attract patients to pharmacies.

One way pharmacists can help these patients is by educating them on recommended duration for analgesics and possible adverse effects. They can also suggest eating food or drinking milk if they experience an upset stomach when taking headache medication, according to Terrie.

Pharmacists can also educate patients on some triggers for headaches and migraines, including stress, fatigue, changes in sleeping or eating patterns, and environmental factors.

14. Gastroesophageal reflux disease/nonerosive reflux disease (GERD/NERD) (14.3%)

Dr. Zanni suggested that pharmacists can recommend antacids or H2-receptor antagonists for patients with GERD who are seeking help without a prescription.

Some other counseling points include emphasizing dietary and lifestyle changes, chewing gum to increase saliva production, and identifying whether the patient has kidney disease, in which case the patient should not take antacids.

NERD may affect up to 70% of patients who have GERD. One way that the 2 conditions differ is that NERD patients tend to be resistant to proton pump inhibitors.

15. Diabetic neuropathy (13.9%)

The most common treatments for diabetic neuropathy are antidepressants, anticonvulsants, prescription pain medications, and topical agents, according to Dr. Zanni.

He noted that antidepressants and anticonvulsants are typically used as first-line treatments for diabetic neuropathy. He also stated that medications typically reduce pain by only 30% to 50%.

Some research suggests that L-carnitine and alphalipoic acid can help reduce pain.

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The PatientsMap survey was also conducted in Japan, where dementia landed the top spot, followed by seasonal allergic rhinitis, sepsis, perennial allergic rhinitis, and diabetes.

The researchers behind the survey discovered that the US survey respondents showed a greater desire for psychiatric disorder drug therapies, while the Japanese survey respondents wanted more treatments for conditions like allergic rhinitis, gastric cancer, and atopic dermatitis, which are more prevalent in Japan, but were not listed in the top 15 of the US survey results.

The researchers also noted that the United States showed more interest in new products, with the overall percentages higher among the US survey takers than their Japanese counterparts.

Not surprisingly, the researchers noted that the need for new products was greater when the survey respondents considered those in the realm of their own specialty.

“[W]hen viewed by individual specialties, the needs for new products were generally higher for rare diseases and/or cancers within their respective area of specialty,” the researchers concluded. “We are planning to conduct further comparative analysis on this aspect in the future.”

PatientsMap was launched in 2009 and is used by more than 20 pharmaceutical companies.