Welcome to this month’s Comp Medical News recap. Sleep apnea, a mouse-scorpion dynamic that could lead to new painkillers, and fitness tracker inaccuracies are your top stories heading into April 2016.
First, wellness and the devices used to mathematize it are under consideration in two recent studies:
Fitness Trackers are Unreliable, Often Vastly Over- or Underestimate Calories Burned
Fitness trackers like Fitbit and Jawbone promise to improve patients’ understanding of their own metrics in order to help them make better lifestyle choices, and they are often a part of employee wellness programs. However, a recent Japanese study found that the devices’ ability to accurately assess calories burned was variable and inaccurate. Scientists pitted 12 devices against two proven methods of monitoring energy expenditure – locking people in a room to assess every calorie consumed and burned, or asking people at home to drink specially treated water that makes it possible to detect energy output with a urine test. In the first experiment, measurements from the fitness trackers deviated from the lab results in a typical day by underestimating energy expenditure by as much as 278 calories or overestimating by up to 204 calories. With the second experiment, the devices ranged from 69 to 590 calories lower than the urine tests.
Read more from Reuters here.
Wellness Programs Can Help Mitigate Heart Disease Effects
A recent study by health care management platform HealthMine Inc. found that wellness programs can play a pivotal role in guiding workers to better heart health while lowering employers’ costs. Given that 27.6 million U.S. residents had heart disease in 2014, a wellness plans’ financial impact can be considerable. HealthMine surveyed 501 people who either already had or were at substantial risk for heart disease. Fifty-one percent of those surveyed said their condition reduces their productivity at work, and 46 percent said they have lost work days because of their heart condition. Further, 20 percent of respondents said they were hospitalized in the past year and one-quarter had to visit the emergency room or urgent care at least once as a result of their heart disease, which often has one or more comorbid conditions. Only 38 percent of people surveyed were enrolled in a wellness program, but a full 79 percent of that group said the program helped them manage the disease and its costs.
Second, pharmacy is in the spotlight for both cost and scope:
Physicians Rally to Contest Rising Drug Prices
The American College of Physicians joined the chorus of voices calling for increased control over prescription drug pricing practices, as medication costs put increasing strain on the U.S. health system as a whole. The ACP published a position paper in the Annals of Internal Medicine last week calling for the government and industry to take steps to rein in spiraling costs. The article explains that the U.S. is the only country in the 34-member Organization for Economic Cooperation and Development, which includes most advanced economies, that doesn’t have any government regulation of drug prices.
Further, as NPR reports, the paper offered seven recommendations including allowing Medicare to negotiate prices with drugmakers and re-importing drugs from countries like Canada, where they’re often sold at a lower cost. The organization also called for pharmacy corporations to disclose the actual research and production costs of developing and manufacturing each drug, and to disclose the prices paid for drugs — including discounts and rebates — that take advantage of basic research funded by the government, such as the National Institutes of Health and the Department of Veterans Affairs.
Read complete coverage from NPR here.
Letters Telling Physicians that They are Outlier Prescribers of Addictive Medications Did Not Change Behavior
Letters sent to specific doctors from the government indicating that analysis showed that they overprescribed opioids and benzodiazepines compared to their nearby peers in similar specialties did not curb the number of prescriptions written. Study authors told Reuters that previous research on the effectiveness of letters has found that comparisons to peers can encourage doctors to vaccinate their patients and people to pay their taxes, but in this case, the method was ineffective.
For this research, scientists with the Mailman School of Public Health at Columbia University analyzed Medicare Part D data and identified 1,525 outlier healthcare providers prescribing Schedule II controlled substances. An average outlier provider was responsible for 406 percent more prescription drug fills than comparable peers. About 60 percent of the providers were general practitioners, another 20 percent were nurse practitioners, and only 20 percent were specialists. The doctors were assigned to two groups, with one group receiving a letter from the CDC informing them of their outlier status and the extent to which they exceeded other doctors. They plan to repeat the experiment with warnings of the danger of overprescribing using a different medication.
Read more from Reuters here.
Next, the future of pain relief, and the issues that come with current opioid treatment, are at the forefront of research:
New Study Confirms that One Month of Opioid Treatment Causes Gray Matter Loss
Scientists from the United States and Australia have confirmed there is reduced gray matter volume in several areas of the brains of people who take opioids for more than a few days. The researchers randomly assigned 11 people with low back pain to receive morphine daily for a month and another 10 to receive placebo. Subsequent imaging identified loss of gray matter in several reward- and pain-related regions of the brain in the morphine group but not the placebo group. There were no appreciable gray matter losses in the placebo group despite significant pain reduction. The changes observed by the investigators corroborate evidence from an earlier study they published that showed alterations in the brain’s reward-related networks after one month of daily morphine use.
Read the full report from Pain Medicine News here.
The Interaction Between a Specific Scorpion/Mouse Combo in Arizona Could Lead to New Pain Treatments in Humans
Researchers at Michigan State University are studying the behavior of the Arizona bark scorpion and how the humble Southern grasshopper mouse has developed evolutionary protections against the creature’s venom. Apparently, the grasshopper mouse species particularly enjoys eating scorpions, and has become resistant to the toxins contained in the venom. A video of the mouse hunting the bark scorpion reveals how the mouse is initially stunned and then appears to be unaffected by multiple stings. The hope is that unlocking the grasshopper mouse’s mechanisms of tolerating the scorpion’s venom might one day help scientists learn to make more precise forms of painkillers for humans – ones that block the channels responsible for perceiving pain.
Watch the video and read more about the animals from NPR’s KQED Science here.
Finally, it isn’t just sleep deprivation that can increase the risk of worker injuries:
Sleep Apnea Increases Likelihood of Workplace Injuries
A Canadian study of more than 1,200 sleep clinic patients found that those with obstructive sleep apnea were twice as likely as others to suffer a workplace injury and three times more likely to have one that was related to failed vigilance – such as tripping, falling or getting burned. Sleep apnea causes people to wake numerous times a night when their airways become blocked, which results in fragmented sleep. An estimated 22 million Americans suffer from sleep apnea and the vast majority of cases are undiagnosed. Researchers with the British Colombia Hospital Sleep Laboratory followed 1,236 patients that had come in to be screened for obstructive sleep apnea between 2003 and 2011 – 994 were diagnosed with the condition and 242 were not. Records showed that 111 patients experienced occupational injuries in the past five years, representing about 9 percent of the group. People with sleep apnea were twice as likely as those without the condition to have experienced workplace injuries. Just over five percent of people without sleep apnea got injured, while nearly 10 percent of those with sleep apnea suffered injuries at work.
Read more from Reuters here.
Image Credit: A Southern grasshopper stalks its prey. (Layne Cameron/Michigan State University) via NPR