The Record Special Sections Health Quarterly 02-16-2020

4 ❚ SUNDAY, FEBRUARY 16, 2020 ❚ THE RECORD HEALTH QUARTERLY / ADVERTISING SECTION PREVENTIVE CARE Healthcare Facilities Break Down Cultural Barriers By JOSEPH RITACCO Health Quarterly Services provided to non- English speaking patients begin when they first walk through the door or pick up the phone Jina Kang, right, Korean patient navigator at the Center for Korean and are greeted Health and Wellness at Englewood Health, assists a patient. by someone speaking their native language who can you’d elevate to the scheduler who assess their needs, schedule the necessary book appointments, then the navigator.” appointments and inquire about insurance. Asian Health Services, relying upon “I came to the United States when I was an interconnected ecosystem that includes two years old,” said Lee. “If you were the roughly 200 physicians, assumes those child in an immigrant family, you were the responsibilities in addition to treatment one going with them to the doctor’s office or social security to be the translator, then See PREVENTIVE CARE Page 18 N avigating the complicated field of healthcare can feel like an insurmountable challenge for non- English speaking patients, one that discourages many from receiving the treat- ment and education they need to maintain healthy lifestyles. North Jersey’s diverse population has prompted hospitals and medical centers in the area to establish programs that break down existing language and culture barriers and create comfortable environments for all patients. Holy Name Medical Center in Teaneck was one of the first in the country to recog- nize and address such barriers, establishing a Korean Medical Program in 2008 that became a go-to resource and national model for culturally-sensitive care. Over the past decade, the program has created similar models for Filipino, Indian, Japanese and Chinese patients, all of which fall under the umbrella of its Asian Health Services Program. Last year, the program added Dae Lee to its leadership team as assistant vice president to further its mission to meet patient demand and community need. “We’re the connectors,” said Lee. “What do our patients need and how do we get it to them? We can be a concierge, navigator or translator — we can be the stand-in son or daughter who holds their hand through- out the process. We’re trying to lower anxi- ety and create a smoother process.” FIT FOR LIFE Managing Medications: Benefits vs. Side Effects CONTINUED FROM PAGE 3 all supplements and over-the-counter drugs, to someone. It is always your best bet to check with a doctor or pharmacist. I do not recommend looking this information up yourself on the internet.” Palamara also notes the importance of keeping this list easily accessible, so that if a patient ends up in the hospital, it is readily available. Common side effects from medications include stomach upset, drowsiness, dizzi- ness, and light-headedness. Patients can discuss management of side effects with doctors and pharmacists. Lupano explains that healthcare professionals and patients must decide, “Does the benefit of the medi- cation outweigh the risk of side effects?” Palamara advises, “It’s important to take medications the exact way that you are directed to take them. For example, if you are told to take them with food or at a cer- tain time, you should do that. Also, patients should know that a lot of side effects will resolve over time; you should give it at least a week.” Both pharmacists note that if the side effects are not tolerable or manageable, the doctor may be able to adjust the dosage strength. Palamara adds, “Healthcare professionals do not like to add another drug to combat side effects, if they do not have to.” Medication costs are another big concern for everyone, a concern that is magnified if multiple medica- tions are involved. Lupano explains, “If a generic ver- Nancy Palamara, sion of the drug is available, take director, Pharmacy the generic drug; Services, HNMC there is no difference in the efficacy; they just cost less. And if you are prescribed a name drug, look online for patient assis- tant discounts; you can print the coupon and bring it to the pharmacy.” He adds, “If you are at one of the four Valley Hospital- held pharmacies, we will look for discounts and coupons for you.” Palamara acknowledges how confusing prescription costs can be: “Your prescrip- tion insurance plan will define what is going to be covered; this makes it harder to navigate the system. If a medication is not covered, it doesn’t mean that you can’t have it. Find out how much it is. Doctors can appeal to the insurance company to get a prescription override, and pharmacists can help with this process.” Palamara notes that generic drugs are used almost exclu- sively in the hospital, when available; she also cautions that whether you are taking a brand name or generic medication, stick with what you are taking or ask a pharma- cist because there can be different formu- lations across brands, even if the active ingredients are the same. As most would acknowledge, it can be difficult to keep track of doses, so how can you keep track and what happens if you miss a dose or double dose? Although old- fashioned plastic boxes labelled with the days of the week are still an option, Lupano speaks highly of electronic boxes: “They are relatively new. The box is on a timer; it beeps when a medication is due, and it automatically resets.” Both pharmacists agree that if you miss a dose or double dose, you should call your pharmacist or prescribing physician. Palamara notes that the usual rule when missing a dose is: “If you remember the missed dose less than halfway to the time your next dose is due, you can take it.” Another issue is that some people, for any number of reasons, cannot swallow pills. Palamara advises, “A fair number of medications are available in liquid form; if they are, only the brand name may be available, not generic. You can always ask the pharmacist. Many tablets can be split or cut, but you have to ask if that can be done with the type of medication.” Lupano explains, “You have to ask if you are allowed to crush a pill — this will not work for an extended release, long-acting dose.” Palamara agrees: “Use caution is you are going to crush a pill — many cannot be crushed. Try taking a pill with something easy to swallow, like applesauce.” Valley Hospital has a Specialty Pharmacy Program for patients with rare conditions. Lupano explains the benefit of this: “The Specialty Pharmacy employs pharmacists who are educated in drugs that are generally infrequently used. The pharmacists have special training, educa- tion and experience in these medications to assure they are used for the exact FDA- approved indication. They are trained to monitor and follow up on assuring that these medications are managed for optimal care to the patient.” Regardless of the reason you are on multiple medications and regardless of the issue that may arise, the prevailing wisdom seems to be: “Ask your pharmacist” — a pharmacist is the most accessible health- care professional there is.

The Record Special Sections Health Quarterly 02-16-2020 | Page 4