Category Archives: Prescription drugs

Jun 26 2014
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RWJF Scholars in the News: Unemployment and suicide, prescription painkiller abuse, veterans’ care, and more

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

More generous unemployment benefits can lead to lower suicide rates, according to a study co-authored by RWJF Health & Society Scholars program alumna Maria Glymour, MS, ScD. The Huffington Post covers the study, describing it as the first of its kind to reach that conclusion. Glymour and colleagues speculate that higher benefits help mediate some of the stressors that contribute to suicide.

A survey of licensed nurses in Wyoming examines factors involved in their decisions about whether to continue their education. In a Wyoming Business Report story, Mary Burman, PhD, RN, an alumna of the RWJF Executive Nurse Fellows program, notes that the Institute of Medicine’s Future of Nursing: Leading Change, Advancing Health report recommends that 80 percent of nurses have baccalaureate degrees or higher by 2020. She says findings from the new survey point to strategies that might help achieve that goal, noting “the positive role that employers can play by encouraging and supporting nurses to return to school for their baccalaureate degree.” Burman is dean of the University of Wyoming’s Fay W. Whitney School of Nursing, which collaborated on the survey.

Nicholas King, PhD, MA, an RWJF Health & Society Scholars program alumnus, investigates the sharp increase in deaths from prescription painkillers in the United States and Canada over the past 20 years, reports Medical Xpress. King and colleagues analyzed research about the “epidemic,” concluding that Internet sales and errors by doctors and patients have not played a significant role in the increase. Rather, they “found evidence for at least 17 different determinants of increasing opioid-related mortality, mainly, dramatically increased prescription and sales of opioids; increased use of strong, long-acting opioids like OxyContin and methadone; combined use of opioids and other (licit and illicit) drugs and alcohol; and social and demographic factors.” Outlets covering King’s work include the Toronto Sun, Fast Company, and the National Pain Report

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Jun 16 2014
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Should There Be Public Access to Data from Clinical Trials?

Michelle Mello, JD, PhD, is a professor of law and public health at the Harvard School of Public Health, and a fellow with the Edmond J. Safra Center for Ethics at Harvard University. She is a recipient of a Robert Wood Johnson Foundation Investigator Award in Health Policy Research.

Michelle Mello

For years, pharmaceutical companies have been lambasted in the media and government prosecutions for concealing information about the safety and efficacy of their products. In one particularly splashy example, GlaxoSmithKline (GSK) agreed to pay $3 billion in 2012 to settle criminal charges that it failed to report safety data concerning its antidepressant drug, Paxil, and its diabetes drug, Avandia, and engaged in unlawful marketing of these products and one other drug. One mechanism proposed for avoiding such problems is to establish a system through which participant-level data from clinical trials, stripped of identifying information about patients, would be available to the public.

A potential benefit of sharing clinical trial data would be that independent scientists could re-analyze data to verify the accuracy of reports prepared by trial sponsors, which might deter sponsors from mischaracterizing or suppressing findings. Data sharing would also allow analysts both within and outside drug companies to pool data from multiple studies, creating a powerful database for exploring new questions that can’t be addressed within any given trial because the sample is too small to support such analyses. 

The potential value of shared data in improving our understanding of the safety and efficacy of drugs, medical devices, and biologics has sparked considerable discussion about how to make data sharing happen. Earlier this year, the European Medicines Agency—the counterpart to the U.S. Food and Drug Administration (FDA) in the European Union—decided to start making data from trials of approved products available in 2014. This begs the question, should the FDA follow suit?

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Jan 8 2014
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Why Do Deaths from Drugs Like Oxycodone Occur in Different Neighborhoods than Deaths from Heroin?

Magdalena Cerdá, PhD, MPH, is an assistant professor of epidemiology at the Columbia University Mailman School of Public Health and an alumna of the Robert Wood Johnson Foundation Health & Society Scholars program.

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Rates of fatal overdoses caused by analgesic opioids (i.e. opiate-based painkillers) have increased dramatically in the United States over the past five years. The prevalence of nonmedical analgesic drug abuse (i.e. use for recreational or self-treatment purposes without a prescription, or using more medication than prescribed by a physician) is second only to that of marijuana abuse, and currently the number of fatal analgesic overdoses is greater than the number of heroin and cocaine overdoses combined. While research until now has focused on the role of individual characteristics, there is an increasing realization that neighborhoods also play an important role in shaping substance abuse.

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Oct 31 2013
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Human Capital News Roundup: The cost of disposable diapers, toxins in fish, fast food calories, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

WNYC in New York City broadcast an interview with RWJF Community Health Leader Joanne Goldblum about families reusing disposable diapers due to economic hardship. Goldblum, who is founder and executive director of the National Diaper Bank Network, conducted a study that shows how the practice leads to a range of problems for families living in poverty.

When it comes to digital health and new ways to deliver care, the focus should be on the consumer and improving outcomes, not on the technology, according to experts at a recent Connected Health Symposium in Boston, Massachusetts. Mobile Health News reports that Propeller Health (formerly Asthmapolis) CEO David Van Sickle, PhD, MA, an RWJF Health & Society Scholars alumnus, pressed for greater emphasis on outcomes.  Read more about Van Sickle’s work here and here.

An American Thoracic Society panel of experts, including RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) grantee Richard Mularski, MD, is calling for better care for those who suffer severe shortness of breath due to advanced lung and heart disease. The Annals of the American Thoracic Society reports that the panel recommends patients and providers develop individualized actions plans to keep episodes from becoming emergencies, Medical Xpress reports.

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Sep 19 2013
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Human Capital News Roundup: Suicide prevention, psychotropic medication, Las Vegas buffets, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Jennifer Stuber, PhD, an alumna of the RWJF Health & Society Scholars program, was a guest on KING’s New Day (Seattle, Wash.) to discuss Forefront, an organization she co-founded to advance suicide prevention through policy change, professional training, campus and school-based interventions, media outreach and ongoing evaluation. Stuber has been an advocate for suicide prevention since her husband took his own life in 2011, and supports suicide-assessment training for medical professionals as part of continuing education. Read a post Stuber wrote for the RWJF Human Capital Blog about that legislation.

Nearly 60 percent of the 5.1 million patients who were prescribed a psychotropic medication in 2009 had received no psychiatric diagnosis, according to a study led by RWJF/U.S. Department of Veterans Affairs Clinical Scholar Ilse Wiechers, MD, MPP. The study also finds that 67 percent of those prescriptions were given to patients who did not receive any specialized mental health care, Medscape reports, meaning the medications were prescribed in primary care, general medical, or surgical settings.

Minnesota Public Radio and MinnPost.com report on a study co-authored by Health & Society Scholars alumni Sarah Gollust, PhD, and Jeff Niederdeppe, PhD, MA, examining how different messages about the consequences of childhood obesity could affect public attitudes about obesity-prevention policy. The researchers found that tapping into core values beyond health—like the need for a strong and ready military—appealed to conservatives, sometimes causing them to revise their views on how the problem should be addressed and which public and private entities should play a role.

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Sep 5 2013
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Human Capital News Roundup: How adverse working conditions affect health, the impact of the “trophy culture” on kids, antibiotic development, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Adverse working conditions contribute substantially to the risk of depression for working-age adults, according to new research from a team led by RWJF Health & Society Scholars alumna Sarah A. Burgard, PhD. The study is the first of its kind to show the impact of the sum total of negative working conditions, rather than focusing on only one particular risk factor, Science Daily reports.

A study led by RWJF/U.S. Department of Veterans Affairs Clinical Scholars alumnus Michael Hochman, MD, finds that the philosophy behind patient-centered medical homes supports improved patient care and better physician and staff morale, Bio-Medicine reports. Hochman and his colleagues studied Galaxy Health, a program jointly operated by the University of California, Los Angeles, and the University of Southern California. "We all know that fewer and fewer young physicians are choosing careers in primary care because of the difficult work schedules, lack of support and lower salaries," Hochman said. "What we did here was to move in the direction of a team-based approach and it resulted in improved satisfaction for physicians in training with their primary care experiences."

RWJF Scholars in Health Policy Research alumna Hilary Levey Friedman, PhD, wrote a column for the Time Magazine Ideas blog, reflecting on a trend in organized children’s activities that she calls “the carving up of honor.” It consists of devising smaller categories that offer more opportunities for prizes. Giving children rewards for doing an activity lowers intrinsic motivation, she writes, which bodes poorly for long-term success and for pride in hard-earned achievement. “The carving up of honor and the trophy culture that accompanies it has clearly gone too far: carving up honor probably doesn’t improve children’s performance or motivation—but it may mean a bigger payday for those who run childhood tournaments.” Friedman identified the trend while researching her new book, Playing to Win.

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Jan 10 2013
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Human Capital News Roundup: Study partners for Alzheimer's patients, medication color changes, the 'bystander effect,' and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

The Chronicle of Philanthropy named RWJF President and CEO Risa Lavizzo-Mourey, MD, MBA, one of the “Five from the Nonprofit World Who Will Influence Public Policy in 2013.” She was also featured in a profile in the Newark, New Jersey, Star-Ledger, as part of a series profiling “some of the people who make the Garden State special.”

RWJF Senior Communications Officer Linda Wright Moore wrote a piece for Ebony.com about the work of Debbie Chatman Bryant and Ifeanyi Anne Nwabukwu, who were honored last year as RWJF Community Health Leaders for their work to fight cancer. Bryant cares for the underserved in the Low Country of South Carolina, and Nwabukwu helps African immigrant women in the Washington, D.C. area.

John R. Lumpkin, MD, MPH, senior vice president and director of the Health Care Group at RWJF, and Susan Bakewell-Sachs, PhD, RN, program director of the New Jersey Nursing Initiative (NJNI) and interim provost of the College of New Jersey, published a guest editorial in the Newark Star Ledger about NJNI’s work to solve the state’s nurse faculty shortage. Since its launch in 2009, NJNI has supported 61 New Jersey Nursing Scholars, providing tuition and other support while they pursue master’s or doctoral degrees that qualify them for faculty positions. NJNI is a program of RWJF and the New Jersey Chamber of Commerce Foundation.

“I have a lot of experience when patients of mine come and say, ‘I was taking a green pill and now it’s pink. What's going on?’” Aaron Kesselheim, MD, JD, MPH, an RWJF Investigator Award in Health Policy Research recipient, told Reuters. Kesselheim’s new research finds that patients are less likely to take their medication if the color changes, which often happens when they switch from a brand-name to a generic drug. The findings were also covered by the New York Times Well blog, CBS News, and Health Canal, among others. Read more about Kesselheim’s work here and here.

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Dec 20 2012
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Human Capital News Roundup: Promoting health professions, generic drug manufacturers, traumatic brain injuries, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

The Baltimore Times reports on the Tour for Diversity in Medicine, founded in part by RWJF Summer Medical and Dental Education Program (SMDEP) alumnus Alden Landry, MD, MPH. Several weeks each year, the Tour visits college campuses across the country to promote careers in the health professions to students from groups underrepresented in higher education. Read more about the Tour for Diversity here and here.

Jason Karlawish, MD, recipient of an RWJF Investigator Award in Health Policy Research, spoke to the Philadelphia Inquirer about tests for Alzheimer’s disease. Read posts Karlawish wrote for the RWJF Human Capital Blog about the disease and the challenges associated with early diagnosis.

Pharmacy Times reports on a perspective piece in the New England Journal of Medicine, co-authored by Investigator Award recipient Aaron Kesselheim, MD, JD, MPH. It addresses concerns about a proposal to increase liability for generic drug manufacturers for adverse reactions. Read a post Kesselheim wrote for the RWJF Human Capital Blog about pharmaceutical industry marketing to medical students.

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Aug 30 2012
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Human Capital News Roundup: 'Superbugs,' doctor rating systems, drug safety, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

Forbes named RWJF President and CEO Risa Lavizzo-Mourey, MD, MBA, to its annual list of the “World’s 100 Most Powerful Women.” The list includes political leaders, corporate executives, NGO heads, top government officials and a first lady.

The Academic Progression in Nursing (APIN) program has announced grants to nine states, Nurse.com reports. California, Hawaii, Massachusetts, Montana, New Mexico, New York, North Carolina, Texas, and Washington state will receive two-year, $300,000 grants to advance state and regional strategies aimed at creating a more highly educated, diverse nursing workforce. Read more about the APIN grants.

City Biz List Baltimore reports on the selection of Jason E. Farley, PhD, MPH, CRNP, to be a 2012 RWJF Nurse Faculty Scholar. He is among the 12 talented junior nurse faculty members chosen for the highly competitive program. Read more about the new cohort of Nurse Faculty Scholars.

RWJF Physician Faculty Scholars alumnus Deverick J. Anderson, MD, MPH, spoke to the Associated Press about hospital infection control and “superbugs,” or antibiotic-resistant germs. The story was picked up by USA Today, U.S. News & World Report, and CBS News, among other outlets.

The University of California, Los Angeles (UCLA) School of Nursing honored the Future of Nursing: Campaign for Action with one of its “Nurse 21 Awards” at its second annual gala, Nurse.com reports.

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Jun 28 2011
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Does Pharmaceutical Industry Marketing to Medical Students Affect Their Prescribing Choices as Physicians?

Aaron Kesselheim, M.D., J.D., M.P.H., is an assistant professor of medicine at Harvard Medical School and a primary care physician based in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital. He is a 2009 recipient of the Robert Wood Johnson Foundation Investigator Award in Health Policy Research.

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As a physician who studies trends in drug prescribing and seeks to promote evidence-based medicine, I have always been intrigued by the paradox related to the impact of pharmaceutical marketing on physicians’ behavior. Physicians are highly educated, and that preparation is intended to impart special insight when it comes to the medical literature and evaluating the data underlying potential treatment decisions. It is perhaps not surprising, therefore, that when physicians are surveyed, most report that pharmaceutical marketing does not sway their individual prescribing choices. Yet most objective studies show that marketing does indeed drive prescribing in non-evidence-based ways. And physicians, when polled, will generally not deny this effect, although they usually point fingers at their colleagues, believing them to be influenced by marketing, while claiming that they personally are not.

What’s going on? In numerous cases, pharmaceutical industry marketing has been shown to rely on distorted presentations of the medical literature, and many advertising campaigns improperly favor use of the particular drug being promoted in order to sell more product. Yet most physicians take seriously their professional ethical requirements, and I don’t doubt that all physicians try to apply their years of training to offer the best care they can to their patients. If so, why are physicians as susceptible to marketing messages from the pharmaceutical industry as ordinary consumers are susceptible to marketing messages they see on television?

One possible contributing factor is the perspectives and practices formed early in physicians’ careers. The socialization effect of professional schooling can be strong, exerting a powerful influence on how students behave after graduation. It is well known that medical students are frequently exposed to pharmaceutical marketing, even in their preclinical years. Some policymakers dismiss the relevance of these interactions; after all, medical students cannot prescribe drugs, so the potential for direct harm is limited. And medical students are often deeply in debt, and thus many sorely need the free supplies and books that might be distributed to them by pharmaceutical manufacturers.

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