Category Archives: Prescription drugs
Antibiotic-resistant Infections on the Rise; Threat Called "Urgent"
Antibiotic-resistant infections sicken more than two million Americans each year, killing more than 23,000 in the process, according to a new study from the U.S. Centers for Disease Control and Prevention (CDC). The report ranked the threats according to seven factors, including health impact, economic impact, how common the infection is and how easily it is spread. It classified carbapenem-resistant Enterobacteriaceae (CRE), drug-resistant gonorrhea, and Clostridium difficile as “urgent." C. difficile alone causes about 250,000 hospitalizations and at least 14,000 deaths each year. Excessive antibiotic use is the number one cause of the increase in antibiotic-resistant infections, with as many as 50 percent of prescriptions either not needed or prescribed inappropriately. “Every time antibiotics are used in any setting, bacteria evolve by developing resistance. This process can happen with alarming speed,” said Steve Solomon, MD, director of CDC’s Office of Antimicrobial Resistance. “These drugs are a precious, limited resource—the more we use antibiotics today, the less likely we are to have effective antibiotics tomorrow.” Antibiotic-resistant infections also add as much as $20 billion in excess direct health care costs and account for as much as $35 billion in lost economic productivity. Read more on prescription drugs.
Survey: Nearly 80 Percent of College Students Oppose Concealed Handguns on Campus
Nearly 80 percent of the students in 15 Midwestern colleges and universities oppose allowing concealed handguns on their campuses, according to a new study in the Journal of American College Health. Ball State University researchers surveyed 1,649 undergraduate students, finding 78 percent were against the handguns and would not apply for a permit if they were legal. “Firearm morbidity and mortality are major public health problems that significantly impact our society,” said study co-author Jagdish Khubchandani, a member of Ball State’s Global Health Institute and a community health education professor in the university's Department of Physiology and Health Science. “The issue of allowing people to carry concealed weapons at universities and colleges around the U.S. has been raised several times in recent years. This is in spite of the fact that almost four of every five students are not in favor of allowing guns on campus.”
The study also found that:
- About 16 percent of undergraduate students own a firearm and 20 percent witnessed a crime on their campus that involved firearms
- About 79 percent of students would not feel safe if faculty, students and visitors carried concealed handguns on campus
- About 66 percent did not feel that carrying a gun would make them less likely to be troubled by others
- Most students also believed that allowing concealed carry guns would increase the rate of fatal suicides and homicides on campus
Read more on violence.
‘Bath Salts’ Drugs Led to 23,000 ER Visits in 2011
The use of “bath salts” drugs accounted for almost 23,000 emergency department visits in the United States in 2011, according to a new report from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). The report is the first national study to analyze the link between the street drugs and emergency department visits. "Although bath salts drugs are sometimes claimed to be 'legal highs' or are promoted with labels to mask their real purpose, they can be extremely dangerous when used," said Elinore McCance-Katz, MD, SAMHSA's chief medical officer. The drugs can cause heart problems, high blood pressure, seizures, addiction, suicidal thoughts, psychosis and even death. About two-thirds of the visits also involved at least one other drug, with 15 percent of the visits also being linked to marijuana or synthetic forms of marijuana. There were approximately 2.5 million U.S. emergency department visits linked to drug misuse or abuse in 2011. Read more on substance abuse.
EHRs Linked to Lower Rates of Hospitalization
The use of electronic health records (EHRs) is linked to lower rates of hospitalization, according to a new study in the Journal of the American Medical Association. Researchers tracked approximately 170,000 people treated for diabetes between 2005 and 2008, finding that changing from paper records to EHRs was associated with a decrease in hospitalizations of between 5 and 6 percent. There was no link to a change in the number of overall doctors’ office visits. The U.S. government has committed about $30 billion for the widespread implementation of EHRs. Rainu Kaushal, MD, director of the Center for Healthcare Informatics and Policy at Weill Cornell Medical College in New York, who was not involved in the study, said while the study shows that investment in EHRs is important, it is also just one piece of what needs to be done to improve overall care. "An EHR is a critical infrastructural tool to change the way in which healthcare is delivered, but it is one of a set of tools that needs to be employed," she said. "It's when you start getting those pieces together…that you really start finding some significant changes in utilization." Read more on technology.
FDA Proposes Stronger Safety Labels of Opioids
In response to the growing public health problem of opioid-related overdose and death, the U.S. Food and Drug Administration (FDA) is calling for stronger safety labeling for long-acting and extended-release opioids. New labeling will emphasize both the dangers of abuse and possible death—there were 16,651 in 2010, according to FDA—and the risk for women who are pregnant. "The FDA is invoking its authority to require safety labeling changes and postmarket studies to combat the misuse, abuse, addiction, overdose and death from these potent drugs that have harmed too many patients and devastated too many families and communities," said FDA Commissioner Margaret Hamburg in a release. “Today’s action demonstrates the FDA’s resolve to reduce the serious risks of long-acting and extended release opioids while still seeking to preserve appropriate access for those patients who rely on these medications to manage their pain.” Read more on prescription drugs.
IOM: Nation Faces Looming ‘Cancer Crisis’
An aging population, rising health care costs, the complexity of care and other issues are leading the United States toward a future cancer crisis, according to a new report from the Institute of Medicine (IOM). Current estimates predict as many as 2.3 million new cancer diagnoses per year by 2030, with the total cost of cancer care expected to climb to $173 billion by 2020. The report concluded that what’s needed is a shift toward patient-centered, evidence-focused care. "Most clinicians caring for cancer patients are trying to provide optimal care, but they're finding it increasingly difficult because of a range of barriers," said Patricia Ganz, chairwoman of the committee that wrote the report and a professor at the School of Medicine and School of Public Health at the University of California, Los Angeles. "As a nation, we need to chart a new course for cancer care. Changes are needed across the board, from how we communicate with patients to how we translate research into practice to how we coordinate care and measure its quality." Read more on cancer.
CDC: 200,000 Lives Lost Each Year to Preventable Heart Disease, Stroke
Healthier living and improved preventative efforts could help save more than 200,000 U.S. lives lost each year to preventable heart disease and stroke, according to a new report from the U.S. Centers for Disease Control and Prevention. That’s approximately one in four of heart disease deaths. More than half of those deaths were people younger than 65, with blacks twice as likely as whites to die of the preventable conditions and men more likely than women. Still, the overall rate fell approximately 30 percent from 2001 to 2010. To further improve these rates, health care providers should encourage healthy habits such as not smoking, increasing physical activity, eating a healthy diet, maintaining a healthy weight and taking medicines as directed. At the community level, health departments can promote healthier living spaces, including tobacco-free areas and safe walking areas, as well as access to healthy food options. Read more on heart health.
Patients More Likely to Take Multiple Medications When Combined in Single Pill
Patients are more likely to take multiple medications if they are combined into a single pill—or “polypill”—according to a new study in the Journal of the American Medical Association. This finding could be especially important for people dealing with chronic conditions such as heart disease, who are often prescribed a combination of blood pressure medication, cholesterol medication and aspirin to break up blood clots. Only about half the patients in prosperous countries take all three prescribed pills and as few as 5 percent of patients in developing countries do so. One of the obstacles is simply remembering to take the many medications on time. "The simplification of the delivery of care we provide to our patients is a significant part of the improvement we can gain by this type of strategy," said David May, MD, chair of the board of governors for the American College of Cardiology. "Oftentimes we become enamored with the idea of how much improvement we get with this or that medication, on top of the other drugs a patient has been prescribed. The short answer is, if they don't take it, you don't get any improvement." Read more on prescription drugs.
Common Hospital Infections Cost $10B Annually
In addition endangering patients’ health and lives, the five most common hospital-acquired infections cost the U.S. health care system an estimated $10 billion annually, according to a new study in the journal JAMA Internal Medicine. About one in 20 patients contract an infection after being admitted to a hospital, according to the U.S. Centers for Disease Control and Prevention, and studies indicate that as many as half may be preventable. The found that central line-associated bloodstream infections averaged about $45,000 per case, pneumonia infections that lead to ventilators cost about $40,000 per case and surgical site infections—a result of about one in 50 operations—cost about $21,000 per case. In a previous study, Trish Perl, MD, a professor of medicine and pathology at the Johns Hopkins School of Public Health in Baltimore, found that eliminating surgical site infections alone would save the four hospitals in the Johns Hopkins Health System approximately $2 million in revenue each year. Perl was not involved in the new study. Read more on infectious diseases.
Women with Midwives Less Likely to Have Complicated, Premature Births
Pregnant women cared for by midwives are less likely to have complicated or premature births, according to a new review of 13 studies by The Cochrane Library. The analysis found that women with midwives were 23 percent less likely have premature births and 19 percent less likely to lose the fetus before 24 weeks. Such pregnancies are also linked to fewer epidurals, episiotomies and the use of instruments such as forceps or vacuums during delivery. Lead author Jane Sandall, professor of social science and women's health in the Division of Women's Health of King's College London, said the next step is to determine exactly why this is the case. "For example, whether it is the model of care itself where midwives are in a position to pick up problems and get the right specialist input as early as possible, or whether a relationship where a women knows and trusts her midwife leads to a better outcome," said Sandall, according to Reuters. Read more on maternal and infant health.
Survey: Large U.S. Employers to Pay 7 Percent More on Health Benefits in 2014
Large U.S. employers estimated the cost of providing health care benefits to their employees will rise 7 percent in 2014, according to a new survey from the National Business Group on Health. The organization is a non-profit association of more than 265 large employers. The survey also found that some employers are interested in the possibility of health insurance exchanges for certain populations, as well as that more companies intend to offer consumer-directed health plans as their only options. This would be the third consecutive year that employers have budgeted for an increase of 7 percent. While this means rates have been kept “stable,” employers are still looking at ways to engage workers in health management and healthy lifestyles that would also help lower costs. “Rising health care costs remain a serious concern for U.S. employers,” said Helen Darling, President and CEO of the National Business Group on Health. Read more on access to health care.
More than 8.5 Million U.S. Adults Use Prescription Sleep Aids
More than 8.5 million U.S. adults took a prescription sleep aid in the past month, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC). As many as 70 million U.S. adults suffer from a sleeping disorder. The report found that the rates of use increases with age, that about 5 percent of women over the age of 20 utilized the medications, that about 3.1 percent of men over the age of 20 utilized the medications and that the higher a person’s level of education, the less likely they were to take the drugs. Report coauthor Yinong Chong, an epidemiologist at the CDC's National Center for Health Statistics, said the rate of usage climbed only about 1 percent from 1999 to 2010. Jordan Josephson, MD, a nasal and endoscopic sinus surgeon at Lenox Hill Hospital in New York City, said the report findings were not surprising. "More accurate diagnosis and better education has led more people to seek treatment for these disorders, which affect them in every aspect of their lives," he said. "For those people who suffer from fatigue and/or daytime somnolence—being tired and feeling sleepy—it is important for them to seek treatment from a board-certified sleep specialist.” However, the U.S. Food and Drug Administration has also lately been taking a closer look at the effects of sleep aids—which recent evidence shows can last into the following day—and plans to have manufacturers perform more extensive tests on the drugs. Read more on prescription drugs.
Malpractice Worries Mean More Tests, Higher Costs for Patients
Concern over malpractice suits increases the number of diagnostic tests ordered by physicians and referrals to emergency rooms, which in turns adds significantly to the costs of health care, according to a new study in the journal Health Affairs. This problem of “defensive medicine” cost the nation approximately $55.6 billion in 2008, or 2.4 percent of all U.S. health care spending. "It's an area where we can chip away at healthcare costs without causing pain to the patient, since these are services ordered not primarily because doctors think they're medically necessary," said Michelle Mello, senior author and professor of law and public health at the Harvard School of Public Health in Boston. Researchers examined the records of approximately 29,000 people who experienced chest pain, lower back pain or headache, but were not later diagnosed with a serious illness related to the complaint. The found that physicians with high levels of concern over malpractice suits ordered additional testing for people with headaches about 11 percent of the time (compared to 6 percent for doctors with low levels of concern) and for patients with lower back pain ordered additional tests about 30 percent of the time (compared to 18 percent). Read more on access to health care.
Poll: 10% of Americans Take Drugs Prescribed for Someone Else
Approximately 1 in 10 Americans has taken prescription drugs prescribed to somebody else, according to a new Reuters/Ipsos poll. About 6 in 10 say they did it for pain relief, while 1 in 5 said it was to sleep or manage stress and anxiety. The poll also found that it was generally not difficult to for people to get their hands on non-prescribed medications, with two-thirds of users saying they were given the drugs by a family member, friend or acquaintance. With prescription drug misuse already the second most abused category of drugs in the United States, this ease of access and casual approach to taking major narcotics is a serious public health issue with severe potential problems. Wilson Compton, MD, a division director at the National Institute on Drug Abuse, said that because prescription drugs are tailored to a person’s particular needs, it can be dangerous for someone else to take them. "Simply because it's a medicine that comes from a pharmacy does not mean it is without risk," he said. "There's a reason they require a prescription." Read more on prescription drugs.
Drug for Enlarged Prostate, Baldness Improves Ability to Identify Prostate Cancer Early
A recently completed study on the effects of a drug used to treat enlarged prostates and male pattern baldness also reduces the risk of prostate cancer by making it easier to identify and treat early, according to a new study in the New England Journal of Medicine. It also refutes concerns that finasteride, found in the prostate drug Proscar and the hair-loss drug Propecia, promotes more virulent prostate cancers."You take Proscar for six months to a year and it halves the size of your prostate, but the cancer inside your prostate does not shrink," said Otis Brawley, MD, chief medical officer for the American Cancer Society. "If I'm performing a biopsy on a smaller prostate, I'm more likely to hit that cancer than if I am sticking into a larger prostate. This drug wasn't causing more prostate cancer. It's causing more prostate cancer to be diagnosed." Approximately 1 in 6 men will be diagnosed with prostate cancer in their lifetime, with 3 to 5 percent dying from the disease. Read more on cancer.
While men are more likely to die of a prescription painkiller overdose, since 1999 the percentage increase in deaths has been greater among women than among men, according to the Vital Signs monthly health indicator report released today by the Centers for Disease Control and Prevention (CDC). The increase in deaths between 1999 and 2010 has been 400 percent in women compared to 265 percent in men, according to the new report. The overdoses killed nearly 48,000 women during that time period.
“Prescription painkiller deaths have skyrocketed in women…” says CDC Director Tom Frieden, MD, MPH. “Stopping this epidemic in women – and men – is everyone’s business. Doctors need to be cautious about prescribing and patients about using these drugs.”
Key findings include:
- About 42 women die every day from a drug overdose.
- Since 2007, more women have died from drug overdoses than from motor vehicle crashes.
- Drug overdose suicide deaths accounted for 34 percent of all suicides among women compared with 8 percent among men in 2010.
- More than 940,000 women were seen in emergency departments for drug misuse or abuse in 2010.
For the Vital Signs report, CDC analyzed data from the National Vital Statistics System (1999-2010) and the Drug Abuse Warning Network public use file (2004-2010).
According to the CDC, studies have shown that women may become dependent on prescription painkillers more quickly than men and may be more likely than men to engage in “doctor shopping” (obtaining prescriptions from multiple prescribers).
Federal Agencies Issue Final Rules on Workplace Wellness Programs Under the Affordable Care Act
The U.S. Departments of Health and Human Services, Labor and the Treasury have issued final rules on employment-based wellness programs under the Affordable Care Act. Starting in 2014, the rules will allow companies to reward employees who participate in the programs by reducing their health insurance premiums up to 30 percent—up ten percent from current rules. Incentives for smoking cessation can be even higher. And employers can increase premiums for employees who don’t participate in workplace programs or don’t meet certain benchmarks. However, the rules require companies to provide "reasonable alternatives" to employees who can’t meet health benchmarks but still want the discounts. They also allow workers to involve their physicians to help tailor programs with their employers. "These rules will help ensure that wellness programs are designed to actually promote wellness, and that they are not just used as a back-door way to shift health-care costs to those struggling with health problems," said Ron Pollack, executive director of Families USA, a health advocacy group. Read more on prevention.
CDC: 20 Percent of U.S. Adults Visited ERs in a Year
Approximately one in five U.S. adults took at least one trip to an emergency department over the past year, according to a new comprehensive government report based on a survey conducted in 2011. Health, United States, 2012 compiled health data from federal health agencies, state health agencies and the private sector and includes a wide array of U.S. health data. Among the other findings are the fact that 7 percent of people reported at least two emergency department visits, cold symptoms were the most common reason for emergency visits by children and people up to age 64 with Medicaid coverage were the most likely to visit emergency department. The full U.S. Centers for Disease Control and Prevention report is available here. Read more on access to health care.
Study: ADHD Drugs Don’t Increase the Risk of Adulthood Addiction
Taking medication for attention-deficit/hyperactivity disorder (ADHD) during youth does not increase the risk of adulthood addiction to substances such as alcohol, cocaine, marijuana and nicotine, according to a new study in JAMA Psychiatry. There has been debate over the issue for years in the medical community, with studies reaching different conclusions. "Our study provides an important update to clinicians," said study author Kathryn Humphreys, a doctoral student in psychology at University of California, Los Angeles. "Particularly for those who are concerned that stimulant medication is a 'gateway' drug or increases the risk for later substance use, there is no evidence at the group level for this hypothesis." Stimulants such as Ritalin and Adderall are commonly used to treat ADHD. Read more on prescription drugs.
Drug Patent Expirations Helped Lower Patient Spending for First Time in 55 Years
Per patient spending on medicine dropped 3.5 percent from 2012 to 2011, the first such drop since 1957, according to the IMS Institute of Healthcare Informatics. Spending was $325.8 billion overall and $898 per person in 2012. The main contributor to the decline was the expiration of patents on major drugs such as Lipitor and Plavix, allowing people to instead opt for cheaper generic versions. Michael Kleinrock, director of research development at IMS, said this is likely the first of several years in which spending on prescriptions won’t grow as quickly as overall health care spending. Read more on prescription drugs.
CDC Releases New Resources on Lyme Disease Prevention, Treatment
As across the country the weather is gradually getting warmer and kids are spending more time outdoors, the U.S. Centers for Disease Control and Prevention (CDC) has released new resources to help kids prevent tick bites that can lead to Lyme disease and a reference guide for health care providers. The kid-targeted comic strip includes tips for both kids and their parents. Tickborne Diseases of the United States includes information on types of ticks and the various diseases they can transmit. There were more than 24,000 confirmed cases of Lyme disease in 2011, according to the CDC. Read more on infectious diseases.
Study: Everyday Noises Can Effect Heart Health
Even basic, everyday background noises can affect heart function, according to a new study in the journal Environmental Health Perspectives. That includes increased heart rate as noises become louder than normal conversation levels and a decrease in natural, healthy heart beat variability. A decrease in heart bear variability, such as when someone is stressed, has been linked to a greater risk for heart attack. While these noise effects to individuals is minimal, they could provide greater insight into the health effects of community noise on the broader population level, according to Charlotta Eriksson, a researcher at the Karolinska Institute, in Stockholm, Sweden, who was not involved in the study. Read more on heart health.
CDC: Only 20 Percent of U.S. Adults Meet Aerobic, Muscle-strengthening Requirements
Only about one in five U.S. adults meet the aerobic and muscle strengthening components of the federal government's Physical Activity Guidelines for Americans, according to a new report in the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report. The guidelines call for a minimum of 2.5 hours of moderate-intensity aerobic activity each week, or 1.25 hours of vigorous-intensity aerobic activity, as well as at least two days of muscle-strengthening activities. About half of adults meet the aerobic minimums and 30 percent meet the muscle-strengthening requirements, which Carmen D. Harris, MPH, epidemiologist in CDC's physical activity and health branch, called “encouraging.” "This is a great foundation to build upon, but there is still much work to do,” she said. “Improving access to safe and convenient places where people can be physically active can help make the active choice the easy choice." Read more on physical activity.
Hospital Programs Find Success in Cutting Antibiotic Prescriptions, Drug-resistant Bacteria
Hospital programs designed to decrease the number of prescriptions for antibiotics also successfully cut the number of drug-resistant bacteria, according to a new study in the Cochrane Library. Such bacteria, as well as the possibility of secondary infections, can leave patients especially at risk. "Antibiotic resistance is recognized worldwide as a public health problem that's just getting worse. Really around the world people are worried that we'll end up with bacteria that are resistant to the antibiotics we've got," said Peter Davey, MD, of the University of Dundee in Scotland. Researchers found that while persuasion/education programs were effective, actually restricting prescriptions saw more improved outcomes early on, which persuasion/education’s effectiveness catching up later. "We got good evidence that restrictive interventions work faster in terms of changing prescribing and microbial outcomes," he said. Read more on preventing antibiotic resistance.
Suicide Rate Up Significantly for Middle-aged Americans
Attempts to explain the dramatic increase in suicides by middle-aged Americans over the past decade have left many public health experts “dumfounded,” according to Lanny Berman, executive director of the American Association of Suicidology. "The best we can come up with is maybe this is the group most likely to be affected by the recession and unemployment and [home] foreclosure," he said. "It affected suicide rates both nationally and internationally." A new report from the U.S. Centers for Disease Control and Prevention reveals that suicides for people aged 35-64 rose by 28 percent from 1999 to 2010. For comparison’s sake, more Americans died by suicide in 2010 (38,364) than in car crashes (33,687). According to an agency news release: "Suicide is a tragedy that is far too common. The stories we hear of those who are impacted by suicide are very difficult. This report highlights the need to expand our knowledge of risk factors so we can build on prevention programs that prevent suicide,” said CDC Director Tom Frieden, MD. Read more on mental health.
Supreme Court Lets FDA Move Forward with Graphic Cigarette Warnings and Other Tobacco Regulations
The Supreme Court yesterday announced that it will not hear the tobacco industry's appeal of a March 2012 ruling by the U.S. Court of Appeals for the Sixth Circuit on graphic cigarette warnings and several other tobacco regulations. That decision allows the U.S. Food and Drug Administration (FDA) to move forward in developing graphic cigarette warnings allowed by a 2009 law that gave the FDA sweeping new authority over tobacco, and other recent court rulings.
The 2009 law requires graphic warnings that cover the top half of the front and back of cigarette packs and 20 percent of cigarette ads. According to the Campaign for Tobacco-Free Kids (CTFK), a tobacco control advocacy group based in Washington, D.C., the graphic warnings are needed to better inform Americans about the deadly consequences of smoking. According to CTFK, the current, text-only warnings which are printed on the side of cigarette packs haven’t been updated since 1984 and often go unnoticed.
The appeals court ruling also upheld other key provisions of the law that:
- Tobacco companies are prohibited from making health claims about tobacco products without FDA review
- Several forms of tobacco marketing that appeal to children would be banned, including brand name sponsorships; tobacco-branded merchandise such as caps and t-shirts; and free samples of tobacco products
- Tobacco companies are prohibited from making statements implying that a tobacco product is safer because it is regulated by the FDA.
In a statement released yesterday, CTFK Executive Director Susan Liss said: “The FDA should move forward aggressively to reduce the death and disease caused by tobacco use, which is the nation's number one cause of preventable death.” Read more on tobacco.
Task Force Finds Insufficient Evidence for Universal Suicide Risk Screenings
While the U.S. Preventive Services Task Force’s latest draft guidelines stated that there is not enough evidence to support universal screening to identify people at risk of suicide, it’s still critical for health care professionals to be wary of certain signs, said David Grossman, MD, MPH, a member of the Task Force. "Although we did not find enough evidence to say ‘here are the right questions and tools to find the people who may be at risk for suicide,' doctors should be screening for depression and alcohol abuse disorders in their primary care population," he said. Top risk factors include depression and alcohol abuse. There are approximately 37,000 cases of suicide in the United States each year. Read more on mental health.
Poll: Nearly 1 in 4 High School Students Have Abused Prescription Meds
Approximately 24 percent of high school students have abused prescription drugs, according to a new poll from by Partnership at Drugfree.org. With about 5 million kids admitting to the medication abuse, the rate is up 33 percent since 2008. About 13 percent say they’ve experimented with Ritalin or Adderall, both of which are used to treat attention-deficit/hyperactivity disorder. At the heart of the problem is the misconception by both kids and parents that misusing prescription drugs is not as dangerous as taking other drugs. "The key here is that kids and often their parents are buying into the myth and misunderstanding that prescription drug abuse is a safer way to get high, a safer alternative to street drugs, and that they can control it," said said Steve Pasierb, president and CEO at the Partnership organization. "And it's very important to note that, on this, kids and parents are in the same place. Kids say that they don't think that their parents are going to be upset if they know about this, and parents are essentially saying the same thing." Read more on prescription drugs.