Health and Medical News and Resources

General interest items edited by Janice Flahiff

Rising reports of bad reactions to drugs

Rising reports of bad reactions to drugs

From the March 28 2011 Health Day news item   By Alison McCook

NEW YORK (Reuters Health) – Official reports of negative reactions to prescription drugs have increased dramatically over the last decade, according to a new study.

In a U.S. Food and Drug Administration (FDA) database launched in 1969, researchers found that over half the reports of “adverse events” suspected to be caused by a particular drug or device date from just the past 10 years.

The FDA currently receives about half-a-million such reports of health problems, and even deaths, associated with medical products each year. In 2000, they came in at a rate of nearly five for every 10,000 office visits in which at least one prescription was written. By 2005, that rate had risen to nearly seven per 10,000 visits, according to the new analysis published in the Archives of Internal Medicine.

Between 2000 and 2010, the number of reports coming in grew steadily by more than 11 percent every year. By 2010, they added up to 2.2 million reports — 55 percent of the entire database total.

Study author Dr. Sheila Weiss-Smith of the University of Maryland in Baltimore cautioned that the number of reports does not equal the true number of negative reactions to drugs.

Manufacturers are required to report to the FDA any health problem they suspect stems from one of their products, but for doctors, patients, lawyers, and anyone else who reports these reactions, it’s entirely voluntary, she told Reuters Health.

It’s hard to estimate how many negative reactions to drugs actually occur, Weiss-Smith noted. Some experts suggest official reports represent one-tenth of the number of actual negative reactions, but she said she doesn’t trust that figure. “We just don’t know. We don’t know what percentage of events actually gets reported.”…
…More people are taking drugs, and for longer times, which increases the potential for bad reactions, and negative interactions between drugs, she said….

…Negative reactions can occur from a variety of drugs, and patients need to take steps to protect themselves, Weiss-Smith urged. “Drugs are chemicals. And you’re putting something in your body. You need to know what it is.” [Editor Flahiff's emphasis]She recommended that everyone tell their doctors what they are taking, and try to go to one pharmacy, “so someone can keep track of all the different things,” preventing negative interactions.

If you keep adding drugs to your daily routine, talk to your doctor about whether you can cut back on others, so that you are only taking the minimum necessary amount, she said. Read all the material that comes with medicines, and tell someone immediately if you start to feel unwell. “If something doesn’t feel right, talk to your doctor, talk to your pharmacist.” [Flahiff's emphasis]

Are you looking for information about a drug? to use for consultations with your health care provider?
Please use reputable resources that strive to provide unbiased information.
Pharmacists are great sources of information. Practicing pharmacists are college graduates (many with Master’s degrees) that are state licensed. Many give free information at their place of business, they seldom ask if you are one of their customers!!

Also, don’t forget librarians as your personal, professional guides to information in print and online resources.
Contact your local public, academic, or medical library. Many medical and academic libraries, especially those state funded, give at least some assistance to the public. Call ahead. You may be pleasantly surprised!

And, as always, contact me( jmflahiff who virtually resides at yahoo.com)

Some examples of good drug information Web sites

Drugs, Supplements, and Herbal Information (from a MedlinePlus page)

Prescription and over-the-counter medication information contains answers to many general questions including topics as what a drug is used for, precautions, side effects, dietary instructions, and overdoses. From the American Society of Health System Pharmacists

Herb and supplement information includes information on uses based on scientific evidence as well as safety and potential interactions with drugs, herbs, and supplements. From Natural Standard, an independent group of researchers and clinicians.


Drugs and Supplements (sponsored by the Mayo Clinic)

Somewhat lengthy drug and over-the-counter medicationinformation with these sections: description, before using, proper use, precautions and side effects. From Micromedex, a trusted source of healthcare information for health professionals. 

Herb and supplement information includes information on uses based on scientific evidence as well as safety and potential interactions with drugs, herbs, and supplements. From Natural Standard, an independent group of researchers and clinicians.

Drug Information Portal

A good central source of drug information by the US government (the National Institutes of Health). It links you to information on over 12,000 drugs from trusted consumer drug information sources, the US Food and Drug Information, and LactMed (summary of effects on breastfeeding), It also gives any summaries from medical and toxicological articles (however, some whole articles may not be for free on the Internet).


March 30, 2011 Posted by | Consumer Health, Consumer Safety, Finding Aids/Directories, Health Education (General Public), Librarian Resources | , , , | Leave a comment

Peer-To-Peer Health Care

Peer-To-Peer Health Care reports on the use of online connections, especially by those with chronic conditions,  to supplement professional medical advice.

This February 28 2011 report is published by the Pew Research Center, a “nonpartisan “fact tank” that provides information on the issues, attitudes and trends shaping America and the world. It does so by conducting public opinion polling and social science research; by analyzing news coverage; and by holding forums and briefings. It does not take positions on policy issues.” [From the Pew Research Center About Page]

Some excerpts from the report

  • Many Americans turn to friends and family for support and advice when they have a health problem. This report shows how people’s
    networks are expanding to include online peers, particularly in the crucible of rare disease. Health professionals remain the central
    source of information for mostAmericans, but “peer‐to‐peer healthcare” is a significant supplement.
  • One in five internet users have gone online to find others like them.Eighteen percent of internet users say they have gone online
    to find others who might have health concerns similar to theirs.
  • In the moment of need, most people turn to a health professional for information, care, or support.  When asked about the last time they had a health issue, 70% of adults in the U.S. say they receivedinformation, care, or support
    from a health professional.

March 9, 2011 Posted by | Consumer Health | , , , , , , , , , | Leave a comment

What doctors (and patients) can learn from air traffic controllers: What’s that you say?

What doctors (and patients) can learn from air traffic controllers: What’s that you say?

From a March 7 2011 Science Daily news item

ScienceDaily (Mar. 7, 2011) — A review of 35 years of scientific medical studies confirms that the social and emotional context of the doctor-patient relationship have yet to be incorporated into the equation when it comes to health care….

“We are only at the water’s edge in terms of availability of patient-centered care studies because they aren’t being done. We need to encourage researchers to implement clinical trials that evaluate care that focuses on communication between physician and patient. Ultimately, we need processes that have been tested and proven,” said Richard M. Frankel, Ph.D., Regenstrief Institute investigator, professor of medicine at the IU School of Medicine, and a senior scientist in the Veterans Affairs Center of Excellence for Implementing Evidence-Based Practice at the Richard L. Roudebush VA Medical Center. He is the senior author of the JGIM paper.

Dr. Frankel uses an analogy from aviation where safety is given the highest priority. “When the air traffic controller gives an instruction to the pilot, the pilot’s response must be phrased to indicate understanding of the air traffic controller’s message. We don’t have that in medicine. The doctor speaks to the patient and generally does not solicit a response that clearly indicates the patient understood what the doctor wished to convey.”…

Related articles

March 8, 2011 Posted by | Medical and Health Research News | , | Leave a comment

Doctors lax in monitoring potentially addicting drugs

Source: The National Institute on Drug Abuse, ...

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Doctors lax in monitoring potentially addicting drugs
Study: Missed opportunity to reduce opioid-related abuse, addiction and overdose

From a March 3 2011 Eureka news alert

March 3, 2011 — (BRONX, NY) — Few primary care physicians pay adequate attention to patients taking prescription opioid drugs — despite the potential for abuse, addiction and overdose, according to a new study by researchers at Albert Einstein College of Medicine of Yeshiva University.

The study, published in the March 2 online edition of the Journal of General Internal Medicine,*** found lax monitoring even of patients at high risk for opioid misuse, such as those with a history of drug abuse or dependence. The findings are especially concerning considering that prescription drug abuse now ranks second (after marijuana) among illicitly used drugs, with approximately 2.2 million Americans using pain relievers nonmedically for the first time in 2009, according to the National Institute on Drug Abuse (NIDA).

“Our study highlights a missed opportunity for identifying and reducing misuse of prescribed opioids in primary care settings,” said lead author Joanna Starrels, M.D., M.S. , assistant professor ofmedicine at Einstein. “The finding that physicians did not increase precautions for patients at highest risk for opioid misuse should be a call for a standardized approach to monitoring.”…

For suggestions on how to get this article for free or at low cost, click here

March 4, 2011 Posted by | Consumer Safety, Medical and Health Research News | , , , , , , , , | Leave a comment

Health care spending: Study shows high imaging costs for defensive purposes

Health care spending: Study shows high imaging costs for defensive purposes
Costs and frequency of defensive medicine in Pennsylvania

AAOS: American Academy of Orthopaedic Surgeons® / American Association of Orthopaedic Surgeons®

From the February 16, 2011 Eureka news alert

Nearly 35 percent of all the imaging costs ordered for 2,068 orthopaedic patient encounters in Pennsylvania were ordered for defensive purposes, according to a new study presented today at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

For many years now, some physicians have ordered specific diagnostic procedures that are of little or no benefit to a patient, largely to protect themselves from a lawsuit. Until now, however, efforts to actually measure defensive medicine practices have been limited primarily to surveys sent to physicians. Such surveys would simply ask whether or not that individual actually practiced defensive medicine.

“This is the first study we know of that looked at the actual practice decisions of physicians regarding defensive imaging in real time — prospectively done,” says John Flynn, MD.

Flynn, who is Associate Chief of Orthopaedic Surgery at Children’s Hospital of Philadelphia, says that many lawsuits hinge on the plaintiff’s lawyer’s claim that the doctor should have ordered extra diagnostic testing. “And such a claim may be the driving force of so much of the defensive test ordering.”

According to Flynn, 72 orthopaedic surgeons, who are members of the Pennsylvania Orthopaedic Society, voluntarily participated in this study, which included some 2,068 patient encounters throughout the state of Pennsylvania. Most patients in this study were adults. The study found that 19 percent of the imaging tests ordered were for defensive purposes. Defensive imaging was responsible for $113,369 of $325,309 (34.8 percent) of total imaging charges for this patient cohort, based on Medicare dollars. The overall cost of these tests was 35 percent of all imaging ordered because the most common test was an MRI, an imaging test which costs more than a regular X-ray.

One piece of this problem to remember, Flynn says, is that the legal environment that drives physicians to order additional tests has an effect on patients too, in a way that involves more than costs. “Patients are sometimes put through tests that maybe otherwise would not be ordered.”

The finding from this research that surprised Flynn the most was that surgeons were more likely to practice defensively if they had been in practice for more than 15 years.

“This was counterintuitive,” he says. “I thought that young doctors would come out of medical school immediately after training, be less confident because they weren’t experienced, and order more defensive tests. Then, as they become more comfortable and confident after 10 or 20 years in practice, they would order many fewer tests.”

“In fact, the opposite was true. We found that — in Pennsylvania at least — a surgeon’s defensive nature gets worse over time. In this legal environment, orthopaedic surgeons order more imaging tests of a defensive nature, because over time they become more concerned that someone is going to second guess or sue them.”

Flynn says that medical liability awards typically are given because of the severity of a bad outcome, and not necessarily because of negligence. In fact, a May 2006 study published in the New England Journal of Medicine (Studdert DM) showed that 37 percent of claims did not involve medical errors, and in 3 percent of claims, no injury occurred at all.

Flynn pointed to various studies that show that defensive medicine, in general, is quite prevalent. One such study in the June 2005 Journal of the American Medical Association (Studdert DM) reported that almost 93 percent of 824 physicians in Pennsylvania responding to a survey practiced defensive medicine.

“Ideally, as a next step, we would hope to try to get a broader national picture using this prospective practice audit methodology, so we could get a better sense of the true costs of defensive imaging in orthopaedics,” says Flynn.

“Ultimately, if you had doctors from multiple specialties — from OB/Gyn to Neurosurgery to Emergency Medicine — do this type of practice audit, you could accurately quantify how much of our nation’s healthcare resources are wasted on defensive medicine.”

 

 

 

 

February 16, 2011 Posted by | Medical and Health Research News | , , , , , | Leave a comment

Physicians on Twitter

Physicians on Twitter

From the Dr. Shock MD PhD Blog

In the latest issue of the JAMA the results of a survey is published. The authors did a search on physicians using twitter. They extracted the public profile pages of the physicians using twitter with 500 or more followers between May 1 and May 31, 2010. They analyzed the tweets of these professionals.

Of the 5156 tweets analyzed, 49% (2543) were health or medical related, 21% (1082) were personal communications, 14% (703) were retweets, and 58% (2965) contained links. Seventy-three tweets (1%) recommended a medical product or proprietary service, 634 (12%) were self-promotional, and 31 (1%) were related to medical education.

But what is somewhat worrying were their findings of potential patient privacy violations andconflicts of interest. Thirty-eight tweets (0.7%) represented potential patient privacy violations, of the 27 users responsible for these privacy violations 25 were identifiable by full name on the profile, by photo or link to their personal website. Twelve tweets were about a product they were selling on their Web site or repeatedly promoting specific health products, 10 were statements about treatments not supported by the official guidelines.

Using social media by physicians does broadcast useful medical information, unprofessional content in tweets by physicians is rare.
Chretien KC, Azar J, & Kind T (2011). Physicians on twitter. JAMA : the journal of the American Medical Association, 305 (6), 566-8 PMID: 21304081 ***

*** The abstract of this article may be found here.

For suggestions on how to get the full text of this article (letter to the editor) for free or at low cost, click here

 

 

February 16, 2011 Posted by | Medical and Health Research News | , , , , , , , , , | Leave a comment

How to Talk to Your Doctor

The National Institutes of Health Senior Health site has new information on how to talk to your doctor.

It includes information on planning an office visit, how to get the most out of an office visit, and conversations after diagnosis.

Includes links to related videos.

Not for seniors only!

Related Resources

illustration of an older man talking to his doctor

  • Talking to Your Doctor links you to NIH resources that can help you make the most of your conversations with your doctor.
    Communication is key to good health care.
    Get tips for asking questions and talking openly about your symptoms and concerns.

Includes general guides as well specific advice in these areas: cancer, eye health, diabetes, hearing, heart health, kidney
disease, urologic conditions, weight loss, complementary and alternative medicine, and  aging



June 25, 2010 Posted by | Consumer Health | , , , , , | Leave a comment

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