|
Study cites hazard in some painkillersWomen taking daily amounts of non-aspirin painkillers – such as an extra-strength Tylenol – are more likely to develop high blood pressure than those who don’t, a new study suggests. It is the only drug that is not a non-steroidal anti-inflammatory drug (NSAID), a class of medications the federal government just required to carry stricter warning labels because of risk for heart-related problems. Those include ibuprofen (sold as Advil and Motrin) and naproxen (sold as Aleve). Aspirin still remains the “safest” medicine for pain relief. Researchers found women ages 51-77 who took an average dose of more than 500 milligrams of acetaminophen – one extra-strength Tylenol per day – had about double the risk of developing high blood pressure within about three years. Associated Press, Dallas, TW, August 16, 2005. The hazards continue (from the editor’s files):
To sell their drugs, companies increasingly rely on medical doctorsMigraine treatment “should be bread and butter for primary-care medical doctors,” a neurologist told a dozen doctors in a private alcove off a dining room recently. While patients might say they’re having a sinus headache, there’s a good chance it’s actually a migraine and can be treated with a migraine drug, he said. It was a message friendly to migraine-drug makers, and no wonder: The sponsor of the talk was a drug company, maker of the best-selling migraine pill Imitrex. The drug company picked up the tab for dinner, paid the neurologist a fee, supplied some of his slides, and scattered Imitrex notepads on the table. The speakers (medical doctors) are often pocketing $750 or more per speaking engagement from the drug company. In 2004, 237,000 meetings and talks sponsored by drug companies featured medical doctors as speakers, compared with only 134,000 meetings led by drug company representatives. Those who question the talks say drug companies are bombarding medical doctors with one-sided information through the seemingly neutral medium of independent medical doctors. The Wall Street Journal, July 2005. Coffee closer to being health foodCoffee not only helps clear the mind and perk up the energy, it also provides more healthful antioxidants than any other food or beverage in the American diet, according to a study released on August 28, 2005. Of course, too much coffee can make people jittery and even increase cholesterol, so food experts stress moderation. The findings by Joe A. Vinson, a chemistry professor at the University of Scranton in Pennsylvania, give a healthy boost to the warming beverage. Antioxidants, which are thought to help battle cancer and provide other health benefits, are abundant in grains, tomatoes and many other fruits and vegetables. The conclusion of the study is that the average adult consumes 1,299 milligrams of antioxidants daily from coffee. The findings were released in conjunction with the annual convention of the American Chemical Society in Washington. A team of Japanese researchers reported in February in the Journal of the National Cancer Institute that people who drink coffee daily, or nearly every day, had half the liver cancer risk of those who never drank it. The protective effect occurred in people who drank one to two cups a day and increased at three to four cups. Researchers at the Harvard School of Public Health found last year that men drinking coffee cut the risk of developing the most common form of diabetes (Type 2) by half (women by 30 percent), compared with people who did not drink coffee, according to the study in Annals of Internal Medicine. Associated Press, TW, August 29, 2005. Physicians urged to detect RX drug abuseMedical leaders say physicians and medical students need more training to spot and treat medical prescription drug abuse. This would help reduce the high number of abusers of controlled prescription drugs. A total of 15.1 million Americans abused controlled prescription drugs in 2003 – nearly double the 7.8 million in 1992. More patients abused these drugs than the combined number of abusers for cocaine, hallucinogens, inhalants and heroin, according to the report by the National Center on Addiction and Substance Abuse at Columbia University in New York. Only 19 percent of physicians surveyed in 2004 said they had received any medical school training in identifying prescription drug diversion. Just four in 10 medical doctors said they had been trained in medical school to identify prescription drug abuse and addiction. American Medical News, August 8, 2005 Medical errors plan approvedA national system designed to increase reporting of medical errors won final congressional approval on July 27 and was sent to President Bush. It is estimated that more than 250 Americans die every day as a result of preventable medical errors. Under the legislation approved by the House, officials would voluntarily report medical errors to patient safety organizations, which would use a network of databases to analyze the data and make recommendations. The Kansas City Star, July 28, 2005. U.S. looking at marketing by Johnson & JohnsonJohnson & Johnson’s aggressive marketing of its heart-failure treatment Natrecor has become the subject of an inquiry by the Justice Department. The company has received a subpoena from the U.S. attorney in Massachusetts, whose office is known for its prosecution of health care fraud. It said the company encouraged widespread and frequent use of intravenous Natrecor therapy in outpatient clinics by medical doctors, one or more times a week for some patients. Natrecor has provided a profit center for some cardiologists who bill hundreds of dollars for each infusion. Partly fueled by such off-label use, Natrecor sales reached $400 million in 2004. The sales slowed markedly this spring, after two medical journal articles linking Natrecor to kidney problems and higher death rates among patients. The New York Times, July 21, 2005. Patterns of medication use in the U.S.A substantial proportion of health care dollars in the U.S. goes toward the purchase of medications, 2004 statistics reveal. However, comprehensive information on the full range of medications that people take, including prescription and over-the-counter drugs, vitamins/minerals, and herbal/natural supplements is not generally available. In any given week, 82 percent of U.S. adults take at least one medication (prescription or nonprescription drug, vitamin/mineral, herbal/natural supplement); 30 percent take at least five (Figure 1). Prescription drugs are taken by 55 percent of the population, with 11 percent taking at least five. The heaviest users are women 65 years of age or older: 64 percent take at least five medications; 29 percent take at least five prescription medications. A total of 42 percent of U.S. adults take vitamins; 27 percent take multivitamin products. Nineteen percent take products containing herbals or other natural supplements. Nonprescription analgesics (acetaminophen, aspirin, ibuprofen) are the most frequently used drugs, taken by 16-20 percent of U.S. adults.
In any given week, 56 percent of those younger than 18 years take at least one medication; 19 percent take at least one prescription drug (Figure 2). As with adults, nonprescription analgesics (acetaminophen, ibuprofen) are the most commonly used medications, particularly among children 12-17 years old. Vitamins are taken by 22 percent of children overall, and by 28 percent of children less than 5 years old. Use of herbals and other natural supplements is uncommon in the pediatric population. Medical Benefits, July 30, 2005.
Medical Benefits, July 30, 2005. Spinal cement raises questionsIt used to be that a patient with osteoporosis who broke a vertebra was pretty much out of luck. The only recourse was wearing a back brace and waiting to heal. But in the past few years, medical doctors have been offering and patients demanding what some call a miraculous treatment: vertebroplasty, in which a form of cement is injected into the broken spinal bone. No one is sure why it helps, or even if it does. The hot cement may be shoring up the spine or merely destroying the nerve endings that transmit pain. Or the procedure may simply have a placebo effect. So, is vertebroplasty worthwhile in the long run? Some small studies have found a suggestion of high fracture rates in vertebrae adjacent to those injected with cement. The procedure may or may not be worthwhile, said Dr. Mary Bouxsein, a bone biomechanics researcher at Harvard Medical School. The New York Times, August 28, 2005. New study correlating aspirin use with bleedingA new study found that taking 14 aspirin per week might cause eight cases of bleeding severe enough to require hospitalization or a blood transfusion.The study suggests most people should not take pain relievers to try to prevent colon cancer. USA Today, TW, August 24, 2005. FDA tightens access to acne drug AccutaneIt’s about to get tougher to buy the acne drug Accutane, as the government imposes a last-ditch effort to prevent birth defects caused by the “skin-clearing” pills. Starting at year’s end, thousands of Accutane users – plus medical doctors who prescribe it and stores that sell it – must enroll in a national registry that ensures they understand all the drug’s risks, and take special steps to avoid the most notorious one, Accutane-damaged pregnancies. TW, Associated Press, August 13, 2005. The Food and Drug Administration (FDA) hoped that the new rules would reduce the hundreds of miscarriages, birth defects and abortions associated with the drug each year. Experts say that time after time over the last decade, medical doctors have ignored the advice, prescribing and dispensing drugs to patients at risk of complications. Due to this fact, the Agency announced on August11 it would restrict distribution programs to ensure that medical doctors follow its guidelines. Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group said the FDA was recognizing that patients needed protection from irresponsible medical doctors and pharmacists. Dr. Wolfe added that drug companies were largely to blame. Approximately 170,000 prescriptions of Accutane are written each month, half of which to women. State medical doctor and pharmacy licensing boards have proved largely unwilling to investigate or even to question their members’ decisions regarding the use of controversial drugs. The New York Times, August 13, 2005. Plan would compile, analyze medical errorsNearly six years after the nation’s most prestigious body of medical researchers reported that as many as 100,000 Americans die each year from medical mistakes, Congress the week of July 29 passed long-debated legislation aimed at improving patient safety. The 1999 report on medical errors from the Institute of Medicine called for a nationwide mandatory reporting system. The bill passed the week of July 29, however, would make such reporting voluntary. Reports would be confidential, and the information could not be used in malpractice suits. Currently, 23 states have systems for collecting reports of mistakes, all but one of them make reporting mandatory. Washington Post, July 29, 2005. Birth-control patch may pose health riskAbout a dozen women, most in their late teens and early 20s, died last year from blood clots believed to be related to the birth-control patch Ortho Evra. Dozens more survived strokes and other clot-related problems, according to federal drug safety reports obtained by The Associated Press under a Freedom of Information Act request. Associated Press, July 18, 2005. Fetuses exposed to toxic chemicalsA new study released on July 14 questions the long-held belief that fetuses in the womb are largely protected from dangerous chemicals pregnant women are exposed to. Laboratory tests of the umbilical cord blood of 10 newborns found that the samples contained an average of 200 chemicals that can cause cancer, brain damage, birth defects and other health ailments, according to the study sponsored by the Environmental Working Group. “This is conclusive evidence that babies are being exposed to hundreds of industrial chemicals throughout pregnancy,” said Sonya Lunder, an EWG scientist in Oakland who is five months pregnant. “The placenta isn’t a magic shield,” she added. Associated Press, July 15, 2005. You think it’s good for you but…Here’s some medical news you can trust: A new study confirms that what medical doctors once said was good for you often turns out to be bad – or at least not as great as initially thought. The report is a review of major studies published in three influential medical journals between 1990 and 2003, including 45 highly publicized studies that initially claimed a drug or other treatment worked. Subsequent research contradicted results of seven studies and reported weaker results for seven others. That means nearly one-third of the original results did not hold up, according to the study in the July 14 issue of the Journal of the American Medical Association. Associated Press, July 12, 2005. National Women’s Health ReportA 2005 nationwide survey sponsored by Stanford University Medical Center, ABC News and USA Today found that more than half of all Americans have either on-again, off-again pain or daily chronic pain, with about four in 10 saying their pain interfered with work, mood, day-to-day activities, sleep and their overall enjoyment of life. “Physical pain management includes such things as acupuncture, chiropractic, occupational and physical therapy, exercise and massage.” National Women’s Health Report, June 2005. Ear surgery may be unnecessary for many kidsPlacing tubes to drain fluid doesn’t aid development as thought, a new study found. In a study published in the New England Journal of Medicine on August 11, researchers from Children’s Hospital of Pittsburgh and the University of Pittsburgh found that otherwise healthy 6-year-olds with persistent ear fluid who had received tympanostomy tubes by age 3 showed no marked differences in hearing, speech, language or behavior tests than children who received tubes months later. The fluid problems clear up in most children within three months, the doctors say. Stalling can make the surgery unnecessary for many, with no residual harm to the child. Fluid buildup in the middle ear is one of the most common and persistent childhood conditions in the U.S., with the number of diagnoses second only to the common cold. The research, funded by NIH, has tested long-held beliefs that youngsters with otitis media with effusion (middle ear fluid) could suffer developmental delays if buildup is left untreated. The Wall Street Journal, August 11, 2005. Chiropractic care means fewer days of missed work for injured workersInjured workers who experience chiropractic care miss an average of 33 days of work - 81 percent less than the 176-day average for medical care. Journal of Physiological Therapeutics, September 2004. For arthritic hip pain, manipulation is nearly three times more effective than exerciseWhen checked six months after completing a five-week course of care, manipulation patients noted a 50 percent decrease in hip pain with walking compared to a 17 percent decrease for exercise patients. Arthritis Rheumatism, October 2004. Chronic spine pain: Chiropractic vs. medication vs. acupuncture
Data taken from: Spine Journal, July 15, 2003. How effective is chiropractic for patients with jaw pain?
Journal of Manipulative and Physiological Therapeutics, September 2003. Attitudes change toward health care industriesA Harris poll asks the public what industries generally do “a good job or a bad job of serving their consumers/patients.” Managed care, health insurance and pharmaceuticals only recovered a modest amount from their big decline in the past eight years. The pharmaceutical/drug industry had a net score of 13 points positive – far below the positive net scores the industry previously enjoyed, which was 60 points positive in 1997, and 50 points positive in 1998. Managed care companies still have a net negative score of 13 points. This is the sixth consecutive year of negative scores for this industry. The Executive Report on Managed Care, June 2005. Lawmakers want action on drug commercials/adsWith the federal government preparing to take on a greater role in purchasing prescription medications for seniors, drug companies are coming under increasing political pressure to restrict use of direct-to-consumer advertising. Senate Majority Leader Bill Frist, M.D., has proposed a two-year waiting period before advertising new brand-name drugs directly to consumers because, “Spending on such advertising of prescription drugs has skyrocketed” and, “This blitz in direct marketing has unwittingly led to inappropriate prescribing, which most importantly can compromise patient safety and care.” American Medical News, July 25, 2005. From the Des Moines Register Editorial Board (in part)“The health-care system in this country needs reform. Not tinkering. Not an expansion of the current hodgepodge. It needs reform that will ensure all Americans have access to basic health-care coverage. A logical approach would be to expand current government programs. Yet those opposed to seriously reforming the broken health-care system tend to gravitate toward patchwork, market-based fixes. You’ve heard the ideas: Let people purchase their own health care with money from their tax-sheltered health-savings accounts, and they’ll be more responsible consumers. People should have a direct, financial stake in their care. If they knew the cost of procedures, they’d be better consumers. And so on. So, one afternoon last week, we decided to test out those theories. We went shopping for health care. We picked up the phone and started calling around to ask about the cost of a basic exam. We even tried to simplify the process of comparing prices by asking clinics for something that seemed very specific and common – a “routine gynecological exam.” Of course, nothing is simple in U.S. health care. At one Des Moines office, a breast, pelvic and pap exam was $165 for a new patient and $140 to $150 for established patients. The lab bill of about $32 is separate, according to the woman on the phone. “But if they have to call the pathologist in, it’ll be an additional $45 to whatever is reading it.” It’s hard to budget for “whatever.” The next office said it didn’t give out prices and told us to wait until the office manager returned the next day. “Maybe she’ll tell you,” the woman on the phone said. At a clinic in Ames, a pelvic and breast exam was $34.68. The Pap smear was $36.61. Plus labs. It sounded like a pretty good deal until we found out that didn’t include the office visit - $59 to $193. That’s a big range, making comparisons difficult. A West Des Moines clinic told us it is “kind of hard to give you an exact price.” Anywhere from $100 to $300 for the visit, we were told, plus lab costs of $40 to $70. The unknowns outnumber the knowns. What if you’re one of the millions of Americans without health insurance? What if you’re on a tight budget? What if you’re trying to be responsible about spending your health-care dollars? What do you do? Our health-care system doesn’t allow people to be responsible buyers. Patients can’t really know what the costs of exams or lab tests will be. What’s the alternative? Why not start with a health-care system that provides basic health coverage for all ages, similar to the way Medicare works for seniors? That’s not a radical notion.” The Des Moines Register, August 14, 2005. MRI scanners are cited in a rash of accidentsThe pictures and stories are the stuff of slapstick: wheelchairs, gurneys and even floor polishers jammed deep inside MRI scanners whose powerful magnets grabbed them from the hands of careless hospital workers. The police officer whose pistol flew out of his holster and shot a wall as it hit the magnet. The sprinkler repairman whose acetylene tank was yanked inside, breaking its valve and starting a fire that razed the building. But the bigger picture is anything but funny, medical safety experts say. As the number of magnetic resonance imaging scanners in the country has soared from a handful in 1980 to about 10,000 today, and as magnets have quadrupled in power, careless accidents have become more frequent. Some have caused serious injuries and even death. Safety guidelines drawn up by the American College of Radiology in 2002 and revised last year “have no teeth and are floating out there in intellectual Never-Never Land,” said Tobias Gilk, a Kansas City architect who designs medical scanning rooms. Dr. Kanal, a radiology professor at the University of Pittsburgh Medical Center, said he had personally heard of accidents “dozens of times a year,” often from lawyers, and the FDA’s database is “not even the tip of the iceberg.” The roughly 10,000 scanners in the U.S. are found not just in hospitals, but in storefront clinics and even mounted on trucks, making rounds of small hospitals or parking at malls to do scans for a fee. The New York Times, August 19, 2005. After jail time, salesman scores big with cure-all bookWhen Carol Boruk of La Marque, Texas, saw Kevin Trudeau selling his book on a late-night infomercial last November, she was mesmerized. Mr. Trudeau talked about nonpharmaceutical remedies that could eradicate virtually any disease – and that he said were being suppressed by the government and the drug industry. The book “Natural Cures ‘They’ Don’t Want You to Know About,” has sold millions of copies and has only been outsold by “Harry Potter and the Half-Blood Prince,” according to Nielsen Book-Scan. The book has been on the New York Times list of best-selling how-to books for eight weeks and is currently number one. The book, 570 pages of Mr. Trudeau’s musings on how natural therapies, diet and lifestyle can help people free themselves from illness and disease, has quickly become an unusual success story in the book publishing business. Mr. Trudeau said that those who call him a fraud misunderstand him, and the prison time stemming from activities in his mid-20s was a “youthful mistake.” The New York Times, August 28, 2005. Company executives decry health-care costsStarbucks will spend more on health insurance for its employees this year than on raw materials needed to brew its coffee, the company’s chairman said on September 14. Starbucks has faced double-digit increases in insurance costs each of the last four years. “It’s completely nonsustainable,” said Howard Schultz. Schultz and other executives wanted to call attention to what they called a growing health care-crisis. Bloomberg, AP, staff reports, TW, September 15, 2005. |
