Pneumonia Warning Siren

During the late 80’s and early 90’s, my wife, young family and I lived and worked in the mountains of Northern California.  Even though an interstate highway went directly through town, we were still considered a relatively small community that looked out for and cared for one another.  At times, winter weather could be quite heavy and the town had a warning system in place to alert the community when we were on the crest of a heavy winter storm. 

Infrequently, the snow would be falling at such a rate that the town’s snow plow system could not keep up with the storm.  This snow fall would create a dangerous environment on the roads due to significant accumulation and, unless you had a snowmobile or a four-wheel-drive with snow tires and chains on all four wheels, you would be stuck. 

This little mountain town had a crude, yet effective, warning system to alert the town that the storm was heavy, the roads were closed to all but emergency vehicles, and stay at home until further notice.  From town central a piercing siren would scream from the top of a building.  I can only imagine that it sounded like an air-raid siren from WWII.  The sound could be heard for miles.  The siren would ring clear for about 60 seconds, and then again, hours later, when the immediate danger was clear.

Pneumonia is an infection of one or both of the lungs caused by either a bacterial, viral or fungal infection.  The infection will inflame the alveoli (the sacs that transfer oxygen to the blood) in your lungs and may cause the alveoli to fill up with fluid causing severe symptoms such as a severe cough, chills, fever and difficulty breathing.

Patients at high risk for developing pneumonia include:

·         Children 2 years of age or younger because their immune systems are not fully developed.
·         Adults 65 years of age or older.
·         Patients with co-existing disease states such as asthma, COPD, heart disease, diabetes, cancer or some other immuno-compromising disease state.

If not treated soon enough or appropriately, pneumonia may lead to severe complications including:

·         Pleural effusion; this occurs with a fluid buildup in the space between the lining of the lungs and chest cavity.  If the fluid becomes infected it may need to be drained through a chest tube or removed.
·         Bacteremia; this may occur when bacteria enter the bloodstream from the lungs.  This may carry the bacteria and spread infection to other organs in the body.
·         Breathing Difficulty; severe pneumonia, coupled with other existing lung disease, may make it difficult to breath in enough oxygen to oxygenate the tissues.
·         Lung abscess; this may occur if pus forms in a cavity of the lung.  This may then need to be drained with a long needle in order to clear the fluid.

Fortunately, we have an internal warning system that lets us know we may be in danger of developing pneumonia.  Initially, a pneumonia patient may experience some chills, fever and a little difficulty breathing.  As the air-raid siren begins to increase in volume, the individual will be experiencing chest pain when coughing, a cough with phlegm, shortness of breath, and possibly some nausea, vomiting and diarrhea.

Learn the warning signs and listen to them carefully, especially if you are at “high-risk” for developing pneumonia.  Listening to the warning signs and seeking medical attention as soon as possible will help decrease the chance a pneumonia infection will develop into a more complicated situation.

You may also be interested in reviewing the following information:


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Community Involvement

Community involvement is the process of engaging in communication and collaboration with members of your community.  Not only is community involvement valuable to the recipients of whatever services are being provided; the simple process of being involved provides a sense of meaning and fulfillment to those offering the services.

This past weekend, my wife and daughter joined me in presenting AudibleRx at the local community hospital health fair.  I know it seems like a small thing; however, many useful, mostly unexpected, consequences arose from the planning of and presenting at this community event.  Time will reveal what consequences will present as a result of us presenting at this fair.

·         The preparation time required me to prepare and organize exactly what it is I wanted to share with the community.

·         I was given the opportunity of sharing AudibleRx in much greater detail with my wife and daughter so they would be prepared to answer questions at the fair.

·         Through the process of preparation, I designed and put together two poster boards that describe what AudibleRx is and how it works.

·         The time that I spent at the fair with my wife and daughter was Really Fun!

·         Visiting with the 200+ individuals that worked their way through the fair allowed me the opportunity to fine tune my AudibleRx pitch.  This process really helped me refine how I can describe what AudibleRx is and how it works in a short, interesting pitch.

·         I had the opportunity to meet a number of care givers and other health fair presenters that were quite interested in AudibleRx which may lead to further collaboration.

·         The feeling of being involved in our community, communicating with individuals and collaborating with other health care workers is priceless.

At AudibleRx, we are all about medication information.  Take the time to increase your Health Literacy by understanding what you do and don't know about your medications.  After you have developed a few educated questions about your medications and health condition, contact your pharmacist, doctor or other health care provider and engage them in a conversation.

The country is in a state of health care transition.  No one really has a clear idea of how the Affordable Care Act will change our access to health care coverage over the next one, five or even ten years.  One point we can be sure of; as individuals, we all need to take more responsibility for our own health.  

Sometimes it really is brain surgery; however, more often, it comes down to simple questions:   

·         Will this food affect my heath?

·         When do I fit exercise into the day?

·         How much sleep do I need?

·         Do I understand my diagnosis?

·         Do I understand why I am taking my medications and the consequences of not taking them?

·         Where do I get my health care questions answered?

AudibleRx, educating and motivating individuals to participate in their pharmaceutical care.

Copyright AudibleRx (TM), all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx (TM).

After the Heart Attack

I have a friend whose heart stopped beating due to a massive heart attack over ten years ago.  His wife found him unresponsive, called 911 and performed CPR on him until the paramedics arrived.  He was taken to the hospital for an extended stay in the intensive care unit where doctors and nurses performed multiple procedures, infused him with many different medications and monitored him constantly in an effort to stabilize his now beating heart.  When discharged from the hospital, my grateful friend did one important thing; he followed his doctor's directions. 

·         First of all, he quit smoking.  He had smoked daily and regularly for many years.  This gentleman has not smoked a cigarette since he left the hospital.

·         He signed up with a health club, and began a regular course of aerobic and resistance training.

·         He followed his doctor's orders about taking his new medications.

Here we are, more than ten years later, and my friend leads a happy and healthy life.  He is somewhere over 70 years old; however, he still exercises daily, travels, hunts, fishes, and is alive to be present for his wife, children and grandchildren.

A study that was just published in the October, 2013 issue of the American Heart Journal reviewed the importance of medication adherence for patients post Myocardial Infarction (heart attack-MI). Unlike most adherence studies, which attempt to answer the question as to why a patient is not taking their medications, this study focused specifically on the clinical outcome of post-heart attack patients compared to how often they took their prescribed medications.

"The results indicated that patients who achieved adherence of 80% or greater to each of their prescribed medications were significantly less likely to experience a major vascular event or undergo revascularization when compared with controls, while non-adherent and partially adherent patients had event rates similar to control patients. Adherent patients were 24% less likely to experience an event compared with control patients."

"The researchers conclude that all recommended therapies are necessary in patients after heart attack and that improved adherence to each drug reduces the risk of subsequent major cardiovascular events. The results of the study highlight the importance of adherence and the need for more interventions to improve adherence among these patients."

After a heart attack patients are sent home with a handful of new medications that they have never taken before.  Many heart attack survivors have never needed to take medications on a daily basis.  Here they are, faced with the task arranging their schedule so they remember to take four or more new medications on a daily basis, sometimes up to three times daily.

Many tools are available to help patients remember to take their medications on a scheduled basis.  Walk into your local community pharmacy and ask them to show you their pill box section, most likely you will see a rack that has over 10-15 different choices of daily or weekly pill containers.  These help patients keep their medications organized in a nice manner.

How do people remember to take their doses?  Like the article we reviewed said, even if you obtain at least 80% adherence to your heart medication you will be increasing your chance for the most favorable outcome of therapy.  I recently reviewed a smart phone app called Medisafe that provides a great dosing reminder tool.  If you have difficulty remembering to take your medications, this is a worthwhile tool.

Lastly, I feel that one area that may be overlooked at times with regards to adherence is medication education.  When a patient receives upwards of four new prescriptions, they need some level of current and ongoing education to help them understand their medications.  Quite often, just the doctor, nurse and pharmacist telling them they need to take their medications is not enough.

This is the section I like to call Motivational Adherence.  Educating a patient about their medications may help a patient to become motivated to participate in their own pharmaceutical care.  When a patient understands what the medication is doing and what effects to look out for, they are then becoming an active participant in their own care, rather than just following directions. 
·         Medication education you LISTEN to
·         Where do you get your Medication Education
·         What is Health Literacy
·         Blood Pressure Medication Treatment Options
·         Acute Coronary Syndrome

Please comment and let us know what tools you use to remember to take your medications.


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Medication Information you LISTEN to

"Pharmacy based, Medication Specific Counseling SessionsTM, provided in audio format, with the intent of educating individuals to better understand their pharmaceutical care, increase adherence and decrease adverse events.  AudibleRxTM objectively bridges the medication-education-gap between the patient, their pharmacist and their doctor."

Daily, patients receive prescriptions in the mail or pick up prescriptions from busy pharmacy counters.  Current barriers to effective medication counseling do not regularly allow time for the pharmacist to sit with the patient and discuss their medications for 10-15 minutes at the counter.
Pharmacists are under tremendous pressure to meet their performance metrics and will regularly cover the counseling points of three or four medications in fewer than two minutes. Furthermore, the patient may be in a hurry to get their medication and leave and may not fully pay attention to what the pharmacist does say.  The patient is sent home with stacks of pamphlets that may be difficult to read.

Patient medication education is only one aspect of medication adherence; however, as stated in a recent report from the Agency for Healthcare Research and Quality, “Our findings suggest that educational interventions and case management approaches offer the most consistent and voluminous evidence of improvements in medication adherence across varied clinical conditions.”

“The pharmacy profession has accepted responsibility for providing patient education and counseling in the context of pharmaceutical care to improve patient adherence and reduce medication related problems.”

Patients log on to the AudibleRx website, navigate to the medication they want to learn about, click on the link, then listen to a 6-8 minute Medication Specific Counseling SessionTM describing all the important counseling information for that specific medication.  After listening to a session a patient or caregiver will have a clear idea of what they know and don’t know about their medication and will be able to take educated questions back to their own health care provider.
It is important to understand that the digital recordings provided through AudibleRxTM are meant to supplement a patient’s education and understanding of their medication and are not a legal replacement for a face-to-face counseling session with their own pharmacist; however, patients may appreciate the simple manner in which they may access and listen to a medication education session.

AudibleRxTM is free for individual users; however, a licensee agreement is necessary when a provider wants to promote its use as a patient education tool such as may be used by an institution, hospital, pharmacy, clinic, insurance company, or any other group, are available.

AudibleRxTM has also released a smart phone and tablet application complete with all the 200+ Medication Specific Counseling SessionsTM currently available.  These apps are being offered for free to individual users and are for personal use only. They are not to be used for institutional education purposes without the institution first obtaining a licensing agreement from AudibleRxTM for such use.

For more information please contact:
Steve Leuck, Pharm.D.
Owner/President, AudibleRx
or visit

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Top 10 Reasons for Medication Non-Adherence

1.  Forgetfulness

2.  Motivation*

3.  Cost

4.  Lifestyle*

5.  Communication*

6.  Patient-Practitioner relationship

7.  Beliefs*

8.  Side effects

9.  Patient experiences

10.    Access

* = related to Health Literacy

Health Literacy

"The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions."

When you get a chance, visit and read about all they are doing to advance the process of medication adherence. 


Copyright AudibleRx (TM), all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx (TM).