Category:

Drug labels sometimes warn that the medications may disrupt sleep, but a new study suggests these drugs don't cause troubled sleep for most people...researchers found "barely" any link between medications that warned about potential sleep disturbances and actual sleep problems among thousands of people interviewed for the study...Sleep disturbances are a frequent problem especially in older people and we wanted to find out whether this might be due to the intake of sleep disturbing drugs... We found that drugs labeled as sleep disturbing . . . are not a major risk factor for sleep disturbances in the general population...Even taking a number of potentially sleep disturbing drugs barely led to more sleep disturbances...the individual or a specific patient can still suffer from sleep disturbances caused by drugs - especially drugs against diseases of the central nervous system...One limitation of the study is that the results are based on self reports by the participants and not devices that track sleep...

There’s an unfortunate irony for people who rely on morphine, oxycodone, and other opioid painkillers: The drug that’s supposed to offer you relief can actually make you more sensitive to pain over time. That effect, known as hyperalgesia, could render these medications gradually less effective for chronic pain, leading people to rely on higher and higher doses. A new study...the first to look at the interaction between opioids and nerve injury for months after the pain-killing treatment was stopped—paints an especially grim picture. An opioid sets off a chain of immune signals in the spinal cord that amplifies pain rather than dulling it, even after the drug leaves the body...Yet drugs already under development might be able to reverse the effect...spinal cord...microglia—sentinels of the nervous system that scout for infection...release inflammatory signaling molecules into the spinal cord, which activate neurons that shoot pain signals up to the brain...Researchers are...exploring drugs that interrupt this pathway to treat pain or improve the performance of opioids. A clinical trial recently launched at Yale University, for example, will test whether an antibiotic that inhibits glial cells prevents the inflammatory effects of opioids.

A majority of Americans opposes federal regulatory changes to speed up the development and approval of new medical treatments, a new STAT-Harvard poll finds — suggesting the public has serious doubts about legislation now moving through Congress...both parties are pushing to change government regulatory standards that they blame for slowing the approval process to get new products to patients...nearly 6 out of 10 Americans said they oppose changing government safety and effectiveness standards to allow for faster approvals of new prescription drugs by the Food and Drug Administration, while 38 percent said they’re in favor of speedier FDA action...The poll sheds new light on how Americans balance their priorities between speed and safety in the approval of new medical treatments.

...Office of the Actuary in the Centers for Medicare & Medicaid Services certified that the Diabetes Prevention Program reduces net Medicare spending and improves patient care...the Diabetes Prevention Program...enrolled Medicare beneficiaries at high risk of diabetes. The goal was to decrease the risk of developing serious diabetes-related illnesses...Over a 15-month period, Medicare estimated that participants in the program each saved $2,650...This program has been shown to reduce health care costs and help prevent diabetes, and is one that Medicare, employers and private insurers can use to help 86 million Americans live healthier...We are now working to determine the best strategies for incorporating the Diabetes Prevention Program into Medicare...

Providing genetic test results over the phone to patients at risk for cancer-causing genetic mutations does not cause individuals additional stress and could be an effective way to help reduce costs and access burdens compared with those who receive results in person, a recent study found...While health care providers deliver results for many tests over the phone, results of genetic tests have traditionally been delivered in-person because of the complexity, potential for increased levels of distress, or confusion over what the results could mean...delivering results over phone...does not generate more distress, even for those with positive results and even now that we are using multi-gene testing...those who received their results over the phone had fewer barriers in accessing genetic counseling services compared with patients given their results in-person.

A recent Wall Street Journal op-ed assessing ways to reduce medical errors in the U.S. strongly recommends including pharmacists on care teams. "How to Make Hospitals Less Deadly" by James B. Lieber notes that pharmacists’ extensive knowledge of medications offers an important barrier to common medical errors... "Doctors have only glancing knowledge of how an ever-multiplying number of drugs interact with diet, age, disease, body type and each other," he writes, pointing to a study that showed placing pharmacists in patient areas decreased errors by 45% and cut errors leading to death or severe harm by 94%..."Studies have long demonstrated that pharmacists have much to offer in terms of ensuring appropriate prescribing and optimal medication therapy outcomes," said ASHP CEO Paul W. Abramowitz, Pharm.D.

Importance The optional free-text Notes field in ambulatory electronic prescriptions allows prescribers to communicate additional prescription-related information to dispensing pharmacists. However, populating this field with irrelevant or inappropriate information can create confusion, workflow disruptions, and potential patient harm.

Objectives To analyze the content of free-text prescriber notes in new ambulatory e-prescriptions and to develop recommendations to improve e-prescribing practices.

Main Outcomes and Measures Reviewers classified free-text prescriber notes as appropriate, inappropriate, or unnecessary.

Results 66.1% contained inappropriate content...

Conclusions and Relevance The free-text Notes field in e-prescriptions is frequently used inappropriately, suggesting the need for better prerelease usability testing, consistent end user training and feedback, and rigorous postmarketing evaluation and surveillance of EHR or e-prescribing software applications. Accelerated implementation of new e-prescribing standards and rapid adoption of existing ones could also reduce prescribers’ reliance on free-text use in ambulatory e-prescriptions.

Nevada’s senior citizens’ health and quality of life were again ranked among the lowest nationally in a UnitedHealthcare report released last week, placing 42nd...America’s Health Rankings’ 2016 Senior Report takes into account 35 factors, including senior obesity and smoking rates, prevalence of falls, flu vaccination statistics and senior volunteerism...Nevada’s ranking was dragged down by factors including the state’s excessive drinking rate among seniors — self-reported at 9.2 percent...Nevada also suffers from comparatively low community support expenditures and flu vaccination coverage...The state’s strengths include a low prevalence of falls among seniors and a low rate of preventable hospitalizations among Medicare beneficiaries...Sandra Owens, a UNLV social work professor and expert in senior care, reviewed the report and described it as a good assessment of a state with work to do to improve health care for its elderly and overall populations.

Two recently released reports from the University of Nevada School of Medicine say Nevada has remained near the bottom of many health care rankings partly because of population growth...The 2016 editions of Physician Workforce in Nevada and Health Workforce Supply in Nevada...offer insight into the state’s health care workforce, including what researchers say is the importance of education and training opportunities in meeting the state’s health care needs...Nevada falls well below the national rates of medical doctors per 100,000 members of the population and doctors in patient care per 100,000 population...Nevada has seen increases in the number of health care practitioners in many fields, but that growth isn’t reflected in per capita numbers because of the state’s growth...Per capita, Nevada ranks 48th in the nation in physicians and 50th in primary care physicians...Trying to keep up with the demand is a real challenge, so that’s part of the issue...Another part of the issue is that in order to educate the health care workers of the future, you have to have clerkships and internships for them in the state....

Pharmacists may do a better job than doctors helping chronically ill patients manage their blood pressure, cholesterol and blood sugar levels if they're allowed to direct people's health care, a new evidence review suggests...The review also found that pharmacists could manage chronic diseases with about the same efficiency as doctors...current evidence doesn't show whether pharmacists can actually improve a patient's overall health if they take over someone's care from a doctor...The reason for the interest in pharmacist-driven care is that some areas of the United States don't have enough doctors. Due to these shortages, other types of health care workers, such as nurse practitioners or physician assistants, are being called on to help fill the gaps...New legislation introduced in Congress would establish pharmacists as health care providers, and pay them accordingly through Medicare in communities where there aren't enough doctors...Pharmacists are paid less than physicians, and having them handle day-to-day chronic disease care would free up doctors to see patients with more serious and complex health problems...