Welcome to this month’s Comp Medical News update. Dismal physical activity numbers, a breathalyzer for marijuana, and big pharma’s pushback are your headlines for October 2016.
Outpatient Strategies for Some Acute Conditions are Superior
A new review found that many acute medical conditions can be treated without admitting patients to the hospital, with no increased risk and, in some cases, higher patient satisfaction. According To Reuters, researchers analyzed past studies on four alternatives to hospital admission for serious situations like chest pain, heart failure or cancer diagnosis and treatment. The alternatives included emergency room or clinic workup with close outpatient follow-up, specialty quick diagnostic units, “hospital-at-home” care and short stays in dedicated observation units with subsequent outpatient follow-up. In general, there was low mortality and high patient satisfaction for quick diagnostic units, and one study included in the review found that costs were $2,000 to $3,000 lower per patient for quick diagnostic units compared to inpatient care.
Read more here.
One in Four U.S. Adults Over 50 Do Not Engage in Regular Physical Activity
New numbers from the Centers for Disease Control paint a grim picture for exercise among older adults. The agency says that despite the many benefits of moderate physical activity, 31 million Americans (28 percent) age 50 years and older are inactive – that is, they are not physically active beyond the basic movements needed for daily life activities. CDC researchers analyzed data from the 2014 Behavioral Risk Factor Surveillance System for all 50 states and D.C. to examine patterns of inactivity among adults ages 50 and older by selected characteristics. The analysis showed that women were less active than men, the South is the least active part of the nation, people with at least one chronic disease were much less likely to exercise, and lack of physical activity increased with each age bracket. Non-institutionalized adults ages 50 years and older account for $860 billion in health care costs each year; 4 in 5 of the most costly chronic conditions for this age group can be prevented or managed with physical activity.
Read more from the CDC here.
New Breathalyzer Measuring THC Could Improve Policing in the Age of Legal Marijuana
A record number of states will consider legalizing marijuana this year, and most states (including Louisiana) recognize at least some therapeutic benefits of the drug. Although no scientifically proven connection between a certain measurement of THC in your system and dangerous driving exists, states allowing marijuana often have THC blood concentration thresholds, which are notoriously unreliable. A new Oakland-based company called Hound Labs aims to change that with a new device capable of detecting THC from smokable or edible forms of marijuana in the breath. According to the company’s founder Mike Lynn, an ER doctor and reserve deputy sheriff, the breathalyzer is extremely sensitive and is the only one to be tested in roadside, real-life conditions. Critics of the technology warn that THC/impairment measurement is still shaky ground, as chronic use and individual body chemistry create a non-linear pattern, unlike alcohol.
Read more from Vice here.
Drug Company Money May Affect Doctors’ Decision-Making
An FDA review of Chantix, a smoking cessation drug manufactured by Pfizer, found that reports of adverse effects were skewed lower for doctors that took money from the company, and warned that such financially-motivated bias could be more widespread. The FDA’s findings (part of an agency review of Pfizer’s proposal to drop the most severe consumer warning on the drug’s label) demonstrate the federal government’s concern about the influence of consulting and speaking fees on medical decisions. President Obama’s 2010 health law requires drug makers to report such payments for posting to a public database. The disparities are significant for the Chantix safety study at least: in sites where doctors received $25,000 or more from Pfizer, only 1.8 percent of patients who had already been diagnosed with a psychiatric disorder were reported to have side effects, such as anxiety, agitation, hostility or suicidal thoughts, during the study. At locations where physicians received less money or none at all, 6.4 percent of patients reported such problems.
Read more via Insurance Journal here.
Doctors Who Treat Opioid Addiction Have Few Patients
Medication-assisted treatment (MAT) for opioid dependence, a highly effective form of treatment that maintains a low level of opioids in the system to facilitate recovery, is a key part of President Obama’s push to stop the nation’s opioid crisis, however, doctors who treat addiction often have very few patients. Researchers at the RAND Corporation looked at pharmacy records from the seven states with the most doctors approved to prescribe buprenorphine, AKA Suboxone. They found 3,234 doctors who had prescribed the drug to new patients from 2010 to 2013. The median number of patients treated each month was 13. About half of the doctors treated 4 to 30 patients; 22 percent treated less than 4; 20 percent treated 31 to 75. The numbers are surprising given that doctors approved to prescribe MAT can now treat up to 275 patients (up from 100 previously). More rural addicts and a lack of counseling options to accompany MAT may explain the shortfall.
Read more from NPR’s “Shots” blog here.
Big Pharma is Spending Millions to Fight State Efforts to Curb Opioid Use
A new investigation from the Associated Press and the Center for Public Integrity found that large drugmakers have launched a 50 state strategy that includes hundreds of lobbyists and millions in campaign contributions to help kill or weaken measures aimed at stemming the tide of prescription opioids. The report notes that the industry and its allies spent more than $880 million nationwide on lobbying and campaign contributions from 2006 through 2015. That number constitutes more than 200 times what those advocating for stricter policies spent, and eight times more than the National Rifle Association recorded for similar activities during that same period. A key part of the effort involves big pharma pushing bills that encourage the use of patent-protected abuse deterrent formulations of opioids, rather than cutting prescriptions of the addictive class of medications altogether.
Read more from AP here.
At Pain Week in Vegas, Doc Says Blame the Health Care System for Opioid Crisis, Not Individuals
Steven Passik, PhD, formerly of Vanderbilt University and Memorial Sloan Kettering Cancer Center – now an executive at Endo Pharmaceuticals – told attendees at the “Pain Week” convention in Las Vegas that the opioid epidemic was caused by failures in the healthcare system. According to coverage from MedPage Today, Passik said that demonizing providers who prescribe opioids is not the answer. Passik called for a “sense of proportion” in the hysteria over opioid prescriptions, arguing that not only do opioids work for a subset of the chronic pain population (he estimated 25-40 percent), but that stigmatizing a treatment is not going to help people get better. Further, he claimed that the healthcare system sets practitioners up to fail when treating chronic disease, as evidenced by the fact that care coordination is more difficult to access the longer a patient is sick. Passik also said that the opioid epidemic exposed this inability to coordinate care and perform regular risk assessments because the system doesn’t allow for it.
Read the full report on the speech here.
Image Credit: Washingtonarthritis.com