Category Archives: Prescription drugs
BSR: More and More, Private Sector Being Asked to Improve Population Health
Traditionally, health efforts fall under the purview of human resources—not corporate social responsibility (CSR)—in the business world. However, companies are playing an increasingly important role in not only health improvement efforts for their own employees, but also in population health for their larger communities. Increasingly, consumers are demanding this from companies to support their CSR work, as reported by Fast Company. That's also the subject of a BSR report, A New CSR Frontier: Business and Population Health. The report looked at the role of businesses in overall public health for more than 350 major companies, including Coca-Cola, Walmart, Microsoft, Chevron, and General Mills. The report found three major trends:
- Society expects companies to play a bigger role in population health
- Companies are responding to those expectations, but primarily with employees and customers
- Health and wellness are still largely the domain of human resources, even though departments such as philanthropy, marketing and research & development should be involved
"The pullback of government as an influence for population health has created gaps and stakeholders are expecting more from the private sector," said Mark Little, director of health care advisory services at BSR. "The overarching single headline is that business now has new responsibilities that are recognized by stakeholders. We do believe there is a new frontier for CSR."
Support for this report was provided by a grant from the Robert Wood Johnson Foundation. Read more on business.
AAP Offers New Guidelines to Reduce Risk of Antibiotic Resistance
This week is “Get Smart About Antibiotics Week,” and the American Academy of Pediatrics (AAP) has released new guidance that would limit the over-prescription of antibiotics that is contributing to the growing public health issue of antibiotic resistance. The guidance, formulated in collaboration with the U.S. Centers for Disease Control and Prevention (CDC), focuses on the three common upper respiratory tract infections in children that are unlikely to be helped by antibiotics: ear infections, sinus infections and sore throats. The report includes clinical criteria to help physicians determine whether an upper respiratory tract infection is viral or bacterial, which will improve care while limiting opportunities for bacteria to become resistant to antibiotics. “Our medicine cabinet is nearly empty of antibiotics to treat some infections,” said CDC Director Tom Frieden, MD, MPH. “If doctors prescribe antibiotics carefully and patients take them as prescribed we can preserve these lifesaving drugs and avoid entering a post-antibiotic era.” Read more on prescription drugs.
Study: Half of Teens with Mental Disorders Receive No Treatment
Despite ever-increasing knowledge about psychiatric conditions and their links to other health issues, more than half of American teenagers with psychiatric disorders do not receive treatment, according to a new study in the journal Psychiatric Services. The study found that treatment rates varied by disorder. For example, adolescents with ADHD received care more than 70 percent of the time, while adolescents with phobias or anxiety disorders were the least likely to receive mental health care. The analysis also found racial disparities, with white youths far more likely to receive care than black youths. The lack of qualified child mental health professionals also hinders access to care, with pediatricians, school counselors and probation officers being asked to provide care for which they are not actually trained, according to E. Jane Costello, a Duke University professor of psychology and epidemiology and associate director of the Duke Center for Child and Family Policy. "We need to train more child psychiatrists in this country," she said. “And those individuals need to be used strategically, as consultants to the school counselors and others who do the lion's share of the work." The study included data from the National Comorbidity Survey Adolescent Supplement, as well as a survey of more than 10,000 U.S. teenagers. Read more on mental health.
Study: Acetaminophen Use and Even Light Drinking Dramatically Raises Kidney Dysfunction Risk
Acetaminophen use when paired with even moderate or light drinking can increase the risk of kidney dysfunction by 123 percent, according to a new study released today at the American Public Health Association’s 141st Annual Meeting in Boston. Using data from the 2003-2004 National Health and Nutrition Examination Survey, researchers analyzed data on more than 10,000 people who were asked questions about their alcohol consumption, use of acetaminophen and health conditions. “Pain is the most common symptom among the general public and is also most frequently self-treated with acetaminophens,” noted Harrison Ndetan, lead researcher of the study. “Where this becomes a greater concern is among young adults, who have a higher prevalence of alcohol consumption. These findings highlight a serious concern among health professionals who deal frequently with pain patients, particularly those with mild pain who are more susceptible to consuming both.” Read more on substance abuse.
Flight Attendants: Expanded Use of Electronic Devices In-flight Needs Reworked Safety Messaging for Flyers
The decision by the Federal Aviation Administration (FAA) last week to let passengers use electronic devices—but not make cell phone calls—during all phases of a flight has flight attendants concerned that the ruling could compromise passenger safety if flyers are distracted by the devices when the cabin crew makes its safety announcements before takeoff.
Most airlines will introduce the new rule on devices by the end of the year. To qualify they have to assure the FDA that their fleet’s airplanes can tolerate any potential radio interference from the devices. Flight attendants would like heavy devices stored under seats or in the overhead bins during takeoff and landing for added safety. In a statement released just after the FAA ruling, the Association of Flight attendants said “AFA will work diligently alongside the FAA and industry to find creative, science-based approaches to ensure that passengers comply with the new operator policies and that their attention is not diverted from the important safety information provided by cabin crew during routine pre-flight briefings and unexpected emergencies, and that risks posed by loose items in the cabin are safely managed during the most critical portions of [a] flight.” Read more on injury prevention.
Two Questions Could Help Diagnose Strep, Reduce Unnecessary Antibiotic Prescriptions
“Do you have a cough and have you had a fever in the last 24 hours?” These two simple questions could help people determine whether they need to see a doctor for strep throat, which could in turn limit unnecessary antibiotic prescriptions, according to a new study in the Annals of Internal Medicine. While high fevers can indicate strep, coughs do not. The study found the questions, when paired with an accounting of how common strep infections were in a particular area, where nearly as effective as lab tests at determining whether a patient actually had a strep infection. "This enables us to use the test of time," said co-study author Dr. Kenneth Mandl, a professor of bioinformatics at Harvard. "If we determine that you're low risk and most cases will not have an important complication from strep anyway, then you can be followed clinically rather than come in for a test right away, and you may improve." About 15 million people in the United States see a doctor for a sore throat each year, with 70 receiving antibiotics; estimates indicate that only 20-30 percent of children and 5-15 percent of adults actually benefit from the medications. Read more on prescription drugs.
CDC: U.S. Malaria Cases Reached 40-year High in 2011
U.S. malaria cases reach a 40-year high in 2011, with 1,925 total cases and five associated deaths, according to a supplement of the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR). The 2011 total was a 14 percent increase over the 2010 statistic. According to the CDC, the vast majority of the U.S. cases were acquired overseas, with about 69 percent coming from Africa, and 63 percent of those cases from West Africa. “Malaria isn’t something many doctors see frequently in the United States thanks to successful malaria elimination efforts in the 1940s,” said CDC Director Tom Frieden, MD, MPH. “The increase in malaria cases reminds us that Americans remain vulnerable and must be vigilant against diseases like malaria because our world is so interconnected by travel.” Preventative measures include antimalarial drugs, insect repellent, insecticide-treated bed nets, and protective clothing. Read more on infectious disease.
FDA Proposes New Rules to Combat Prescription Drug Shortages
The U.S. Food and Drug Administration (FDA) yesterday proposed a new plan to combat drug shortages by requiring drug and biotechnology firms to immediately notify the FDA of any potential disruptions in the supply of medically important drugs. These drug shortages can delay or even deny care to patients in critical need. There were 117 drug shortages in 2012, down from 251 in 2011, when the White House issued an executive order to solve the public health problem. The new plan calls for companies to promptly notify the FDA of a permanent discontinuance or a temporary interruption likely to disrupt the supply of a prescription drug. Early notification enables the FDA to work with manufacturers to investigate the reasons for disruptions; identify other manufacturers who can help make up for the shortfall; and expedite inspections and reviews of drugs that could help mitigate a shortage. The FDA also released a strategic plan that “highlights opportunities for drug manufacturers and others to prevent drug shortages by promoting and sustaining quality manufacturing.” “The complex issue of drug shortages continues to be a high priority for the FDA, and early notification is a critical tool that helps mitigate or prevent looming shortages,” said Janet Woodcock, MD, director of the FDA’s Center for Drug Evaluation and Research. “The FDA continues to take all steps it can within its authority, but the FDA alone cannot solve shortages. Success depends upon a commitment from all stakeholders.” Read more on prescription drugs.
March of Dimes: U.S. Preterm Birthrate at 15-year Low, But Country Still Gets a ‘C’ Grade
The U.S. preterm birthrate fell to a 15-year low of 11.5 percent in 2012, according to a new report from the March of Dimes. While that’s also a six consecutive year of lower rates, the national still received a “C” on the report card when compared to other countries. "Although we have made great progress in reducing our nation's preterm birth rate from historic highs, the U.S. still has the highest rate of preterm birth of any industrialized country. We must continue to invest in premature birth prevention because every baby deserves a healthy start in life," said Jennifer Howse, MD, president of the March of Dimes. Only six U.S. states received an “A” on the annual report card: Alaska, California, Maine, New Hampshire, Oregon and Vermont. An infant is premature if they are born before 37 weeks of pregnancy; the potential health complications include breathing problems, developmental delays, cerebral palsy and even death. Read more on maternal and infant health.
FDA Recommends Tighter Regulations for Hydrocodone
The U.S. Food and Drug Administration (FDA) is recommending that products that contain hydrocodone be reclassified more restrictively, possibly putting them in the Schedule II category that already includes other opioid painkillers such as oxycodone and morphine. Products that contain less than 15 milligrams of hydrocodone, such as Vicodin, are currently classified as Schedule III controlled substances. The change would mean patients would need to present a written prescription at a pharmacy and could not get as many refills before returning to their doctors for a new prescription. While this would help limit access by addicts, these greater restrictions would also affect people with legitimate chronic pain, potentially placing undue hardship on their already painful conditions. The Drug Enforcement Agency (DEA) is pushing for the restrictions in an effort to combat the increasing problem of prescription drug abuse;
the change must be approved by the U.S. Department of Health and Human Services and the DEA, which will make a final scheduling decision. This Saturday is also National Prescription Drug Take-Back Day, sponsored by the DEA, when people can anonymously and safely dispose of expired or unused prescription medicines. Read more on prescription drugs.
ONC Releases New Online Security Tool for Disaster Preparedness
The Office of the National Coordinator for Health Information Technology (ONC), part of the U.S. Department of Health and Human Services, has released a new online security training tool to help health care providers and staff with contingency planning in the case of power outages, floods, fires, hurricanes or other events. Such events can damage important patient information, or even make it unavailable. "We know from recent experiences such as Hurricane Sandy, that these events can very adversely impact the delivery of health care," said ONC Chief Privacy Officer Joy Pritts. "We hope that this video game will raise awareness of contingency planning and help practices begin to develop their own disaster plans, backup and recovery processes and other vital activities." The "CyberSecure: Your Medical Practice” tool is available here. Read more on disasters.
Study: Kids with Concussion at Higher Risk for Depression
Children with concussions or other head injuries are at increased risk of later being diagnosed with depression, according to new findings to be presented today at the American Academy of Pediatrics national conference in Orlando, Fla. Researchers found that about 15 percent of children and teenagers who ever suffered a brain injury were later diagnosed with depression, compared to the national average of 4 percent. While the findings did not determine causation, they do suggest that doctors should make assessments or mood and behavior problems part of and follow-up treatment for head injuries. Read more on mental health.
In 2008, the U.S. Department of Veterans Affairs (VA) sent Army paratrooper Jeffrey Waggoner to an Oregon hospital to recover from an addiction to painkillers. However, once there they instead gave him a steady stream of medications, eventually releasing him for a weekend with 19 prescription drugs in hand. He was found dead of an overdose three hours later.
“As a parent, you’d want to know how this happened to your child,” said his father, Greg Waggoner, according to a new report from The Center for Investigative Reporting (CIR). “You send your child to a hospital to get well, not to die.”
In its investigation, CIR found that, post 9/11, the VA has increasingly been treating addictions with a variety of drugs, “feeding addictions and contributing to a fatal overdose rate among VA patients that is nearly double the national average.” Over the past dozen years, prescriptions for the four opiates hydrocodone, oxycodone, methadone and morphine have increased by 270 percent.
Waggoner’s weekend leave medications included 12 oxycodone pills.
As part of its investigation, CIR has created a comprehensive interactive tool that shows the VA systems with the highest prescription rates and allows users to search for information by region and system. The data is culled from CIR’s own research, as well as information from the VA and the U.S. Census Bureau.
Trust for America’s Health also recently released an interactive tool on the growing public health issue of prescription drug abuse—about 6.1 million Americans use or abuse prescription drugs. The tool allows users to search state-by-state prescription drug overdose death rates and find out how each scores on 10 key steps to curb abuse.
>>Read The Center for Investigative Reporting’s “VA’s opiate overload feeds veterans’ addictions, overdose deaths”
>>Read NewPublicHealth’s story, “New Report: Most States Not Implementing Enough Proven Strategies to Prevent Prescription Drug Abuse”
University of Maryland Study Shows Need for Improved Communication by Dental Professionals
New research from the University of Maryland School of Public Health found that a majority of dentists and dental hygienists are not regularly using recommended communication techniques with their patients that can contribute to improved oral health literacy and prevention of oral disease. The researchers, who published their findings in the Journal of Dental Hygiene, surveyed 540 Maryland dental hygienists to determine the frequency of the use of 18 recommended communication techniques to effectively communicate science-based information to patients. Only one basic technique—use of simple language—was used by more than 90 percent of dental offices, according to survey responders. The survey also found that dental professionals who had taken a communication course in a non-dental educational setting were more likely to regularly use varying types of communication techniques. Read more on health literacy.
Study: Online Medical Searches Not a Good Idea for People Who Struggle With Uncertainty, Anxiety
People who struggle with uncertainty and anxiety might want to stay away from online health information searches, according to a new study in the journal Cyberpsychology, Behavior and Social Networking. The study, which included 512 healthy men and women with a mean age of about 33, analyzed how online searchers affected their anxiety, as well as their reactions to statements such as "I always want to know what the future has in store for me" and "I spend most of my time worrying about my health." "If I'm someone who doesn't like uncertainty, I may become more anxious, search further, monitor my body more, go to the doctor more frequently—and the more you search, the more you consider the possibilities," said Thomas Fergus, an assistant professor of psychology and neuroscience at Baylor University. "If I see a site about traumatic brain injuries and have difficulties tolerating uncertainty, I might be more likely to worry that's the cause of the bump on my head." These persistent worries can increase the likelihood of worrying about potential medical bills, disability and job loss, which in turn can lead to even more online searches, doctors visits, unnecessary medical tests and stress. Read more about technology.
Study: TV Drug Ads Are Often Misleading
A study on the veracity of television drug ads by researchers at Dartmouth and the University of Wisconsin-Madison found that six out of 10 claims could potentially mislead a viewer. The study was published in the Journal of General Internal Medicine. The researchers found misleading claims among television ads for both prescription and nonprescription drugs, and that some of the ads omitted or exaggerated information. The researchers studied the 6:30 to 7 p.m. portion of nightly news broadcast, which often contains drug ads, and reviewed 168 different drug advertisements that aired between 2008 and 2010. Trained researchers classified the ads as truthful, potentially misleading or false. The researchers found only one in ten claims were false, while six in ten were misleading and included errors such as leaving out important information, exaggerating information, providing opinions or making meaningless associations with lifestyles. Read more on prescription drugs.
New Report: Most States Not Implementing Enough Proven Strategies to Prevent Prescription Drug Abuse
Prescription drug-related deaths now outnumber deaths from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 states and Washington, D.C.
A new report about prescription drug abuse released today by Trust for America’s Health (TFAH), finds that few states are implementing more than just a few promising strategies that have been identified to help combat the widespread drug abuse that continues to increase across the U.S. The report, Prescription Drug Abuse: Strategies to Stop the Epidemic, which was funded by a grant from the Robert Wood Johnson Foundation, shows that only two states – New Mexico and Vermont – have implemented all ten strategies.
According to the National Center for Injury Prevention and Control (NCIPC), nationally, sales of prescription painkillers per capita have quadrupled since 1999 – and the number of fatal poisonings due to prescription painkillers has also quadrupled. Enough prescription painkillers were prescribed in 2010 to medicate every American adult continually for a month.
>>Watch a one-minute video on the scope of the prescription drug abuse epidemic in the United States.
The report also found that the number of drug overdose deaths – a majority of which are from prescription drugs – has doubled in 29 states, tripled in ten states and quadrupled in four states since 1999.
“The rapid rise of abuse requires nothing short of a full-scale response – starting with prevention and education all the way through to expanding and modernizing treatment,” said Jeffrey Levi, PhD, executive director of TFAH. “There are many promising signs that we can turn this around – but it requires urgent action,” says Levi.
In the new report, TFAH, based on consultations with experts in public and clinical health, injury prevention, law enforcement and community organization, reviewed national recommendations and examined strategies currently in use to help curb the epidemic. Recommendations include expanding access to treatment options; ensuring responsible prescribing practices; and improving Prescription Drug Monitoring Programs.
>> Learn how your state scores on the 10 key steps to curb prescription drug abuse, with a new app from the Robert Wood Johnson Foundation.
Ohio is one of several states that have implemented six of the proven strategies recommended in the report and today, in fact, will introduce new prescriber guidelines.
NewPublicHealth spoke with Ted Wymyslo, MD, director of the Ohio Department of Health about that state’s review of drug abuse and recent efforts to reduce the epidemic through a variety of means, including public and provider education.
Average Monthly Cost of Mid-tier Insurance Under Affordable Care Act Estimated at $328
The average monthly cost of a mid-tier health insurance plan under the Affordable Care Act will be $328, and government subsidies will also help reduce that cost for most Americans, according to a new report from the U.S. Department of Health and Human Services. The health exchanges open for enrollment next week and the federal government hopes to enroll as many as 7 million people within the first year. The cost varies from state to state, with Minnesota projected to have the least expensive plan at $192 per month and Wyoming projected to have the highest at $516. Read more on access to health care.
NIH Initiative Will Help Move Science from the Laboratories to the Commercial Sector
The U.S. National Institutes of Health (NIH) has awarded $31.5 million in grants to establish three inaugural NIH Centers for Accelerated Innovations that will work to improve how basic science discoveries move from laboratories to commercial products. The Centers are funded by NIH’s National Heart, Lung and Blood Institute (NHLBI) and will focus on technologies to improve the diagnosis, treatment, management and prevention of heart, lung, blood and sleep disorders and diseases. “These centers essentially will offer a one-stop shop to accelerate the translation of early-stage technologies for further development by the private sector and ultimate commercialization,” said Gary H. Gibbons, MD, director of NHLBI. As a result, the public will gain access sooner to new biomedical products that improve human health while also benefiting from the economic growth associated with the creation of new companies and the expansion of existing ones.” Read more on research.
‘Cycling’ Drugs Could Help Combat Antibiotic-resistant Bacteria
“Cycling” between antibiotics may extend their life and effectiveness, while also enabling doctors to stay ahead of drug-resistant bacteria, according to a new study in the journal Science Translational Medicine. "You cycle between drugs that have reciprocal sensitivities," said study co-author Morten Sommer, a lead researcher with the Novo Nordisk Foundation Center for Biosustainability at the Technical University of Denmark. "If you become resistant to drug A, you will become more sensitive to drug B. That way, you can cycle between drug A and drug B without increasing resistance in the long term.” With the increased use—and overuse—of antibiotics, antibiotic-resistant bacteria are becoming an increasingly serious public health problem, leading researchers and health care professionals in search of new ways to combat the problem. More than 2 million people are made ill and more than 23,000 people die every year in the United States due to antibiotic-resistant infections, according to the U.S. Centers for Disease Control and Prevention. Read more on prescription drugs.
Study: 40 Percent of Antibiotics Released from 1980-2009 Withdrawn from Market
Safety concerns, lack of effectiveness when compared to existing drugs and weak sales led more than 40 percent of the antibiotics released between 1980 and 2009 to be withdrawn from the market, according to a new study in the Journal of Law, Medicine and Ethics. The rate was three times as high as that for any other type of drug. “This study raises the question whether or not money would be better spent on higher quality antibiotics, rather than a larger quantity” and whether “approving a flood of new lower-quality antibiotics might actually trigger much higher levels of resistance,” said author Kevin Outterson, JD, LLM, professor at Boston University School of Law and co-director of the Boston University Health Law Program. Antibiotic use can lead to bacteria becoming resistant to a strain. A recent report from the U.S. Centers for Disease Control and Prevention found that as many as 50 percent of prescriptions for antibiotics are either not needed or prescribed inappropriately. Antibiotic-resistant infections sicken more than two million Americans each year, killing more than 23,000 in the process. Read more on prescription drugs.
Locations of Drinking Can Influence Types of Partner Violence
Where and when a person drinks can affect the type of partner violence that can follow, according to a new study from the journal Addiction. The study looked at six drinking locations: restaurants, bars, parties at someone else's home, quiet evenings at home, with friends in one's own home and in parks/other public places. Researchers from the Prevention Research Center in California and Arizona State University found that men drinking in bars and at partners away from home and women drinking in parks/other public places were linked with an increased rate of male-to-female violence. They also found that men drinking during quiet evenings at home was associated with increased female-to-male violence. The findings could help prevent partner violence by encouraging people in risky relationships not to drink in particular places/situations, which could prove more effective than counseling people simply to drink less. Read more on alcohol.
Multiple Myeloma Group Hopes Opening Records to Hundreds of Patients Will Advance Research
The Multiple Myeloma Research Foundation's (MMRF) Researcher Gateway is opening global online access to genetic and research data on hundreds of patients in an effort to help identify biological targets for future treatments, improve enrollment in studies by pairing them with the right patients and enhance researcher collaboration. The MMRF Research Gateway is a $40-million program funding by the foundation and drug company partners. The main component of the effort will be the Commpass study which will enroll 1,000 new multiple myeloma patients and monitor them throughout the course of the disease; cancer tissue banks typically include only one sample per patient. "There is going to be new information generated there that you would never get unless you followed patients through first relapse and second relapse and beyond," said George Mulligan, director of translational medicine for Millennium Pharmaceuticals, Japan's Takeda Pharmaceutical Co.’s oncology unit, which is one of the co-sponsors. "The size of it in patient numbers and the breadth and richness of it on a biological level, it's going to grow over time and mushroom into something that's going to be really special.” About 86,000 people are diagnosed with multiple myeloma each year, with about 20,000 of those from the United States. Read more on research.
For the last several years, each incoming president of the Association of State and Territorial Health Officials (ASTHO) has introduced a President’s Challenge for the year of their presidency to focus attention on a critical national health issue. Previous challenges have included injury prevention, health equity and reducing the number of preterm births. This year, incoming ASTHO president Terry Cline, PhD, will focus his President’s Challenge on prescription drug abuse, a national public health crisis that results in tens of thousands of deaths each year.
>>Follow our ASTHO Annual Meeting coverage throughout the week.
Just before the ASTHO annual meeting began, NewPublicHealth spoke with Cline about the scope of the issue and steps Cline will introduce to help health officers collectively focus their attention on reducing this public health crisis.
NPH: Why have you chosen prescription drug abuse as your President’s Challenge?
Terry Cline: If you look at the trend lines in the United States, we’ve seen a very rapid increase in the number of deaths from the misuse of prescription drugs. We’ve also seen a huge increase in the number of children born with neonatal abstinence syndrome, which has actually tripled in the last decade. Prescription drug abuse has created an incredible burden on the health of people in the United States. Deaths are just one indicator; others include lost productivity, absenteeism and health care costs. Just using neonatal abstinence syndrome as an example, in 2000 the total hospital charges were about $190 million and in 2009, which is the last year we have that data, it was $720 million. Because in many states Medicaid pays for a large percentage of the births, in 2000 that amount was about $130 million out of the $190 million, and in 2009 it was $560 million of the $720 million. So that is becoming a larger and larger financial burden on states as well, and that does not include the long-term effects on babies.
The President’s Challenge will be looking at the absolute number—bringing down the number of deaths, which stand at more than 16,000 deaths per year. We’ve seen opioid deaths increase and continue every year over the last decade. And in most states now, the number of deaths from prescription drugs is actually greater than the number of deaths from automobile accidents, which has steadily gone down over the last decade. So, one is an example of a public health success; the decrease in motor vehicle deaths stems from a comprehensive approach and work with multiple sectors to bring that death rate down. The other, prescription drug deaths, is an alarming increase. My hope is that with the President’s Challenge, we can really increase awareness and leverage public health agencies across the country to mobilize around this issue.