Doctor Housecalls Blog

Healthcare related news and updates



There are some new methods of preventing and treating the flu, which could be available in the coming year. A company in Osaka, Japan called Shionogi & Co. Ltd. has announced that an experimental drug called baloxavir marboxil has been able to reduce the virus to undetectable levels, effectively killing it within 24 hours for half of the 414 individuals who were involved in their study.



Antibiotics – Are You Taking Them for Longer Than You Should?

According to a study published in JAMA Internal Medicine, many doctors are prescribing antibiotics to patients who are suffering with sinus infections for durations that are too long. Infectious disease doctors recommend only taking acute sinus infection antibiotics for five to seven days, yet many people are taking them for ten or more days.

“Any time antibiotics are used, they can cause side effects and lead to antibiotic resistance,” Dr. Katherine Fleming-Dutra, deputy director of the Office of Antibiotic Stewardship at the U.S. Centers for Disease Control and Prevention in Atlanta, explained. The findings published recommend that people only take antibiotics when absolutely necessary and to only take them for the minimum effective duration.

Side effects for antibiotics include: rash, dizziness, nausea, diarrhea, and yeast infections, as well as life threatening allergic reactions. They can also cause Clostridium difficile infection, which can lead to severe colon damage.

When antibiotics are over prescribed and used for longer time periods, bacteria develop the ability to beat the drug, causing the antibiotic to lose its effectiveness in the future. For acute sinus infections, patients typically  recover within 5-7 days. Therefore, there is no need to take an antibiotic for longer and risk becoming immune to it. The reason many people take antibiotics for too long is largely due to people firmly believing they should take their full prescription and many doctors have not yet switched to the new guidelines. Most doctors are still prescribing these antibiotics for 10 or more days.

“Older . . . acute bacterial sinusitis guidelines were written with the belief that if antibiotics were taken for shorter durations of time, that the bacteria would not be completely eradicated and that would risk persistent, recurrent and antibiotic resistant infections,” said Dr. Sharon Meropol, a researcher at Case Western Reserve University School of Medicine in Cleveland, Ohio, who wasn’t involved in the study. However, the recommendations for this have changed after several subsequent studies. The medical community learned that it not necessary to stay on antibiotics for acute sinus infections for 10 or more days, and doing so can make you resistant to the drug.



Failing to Take Prescribed Medication: An American Epidemic

Americans are facing an epidemic that is 100 percent preventable: “non-adherence to prescribed medication.” The New York Times suggests that this is a widespread problem and is affecting people more than any disease. According to the Annals of Internal Medicine, studies show that 20 to 30 percent of medicine prescriptions are left unfilled and about 50 percent of medications prescribed for chronic diseases are not taken as they are prescribed. It was also reported that people who do take their prescribed medications only take about half of the prescribed dosage.

“This lack of adherence is estimated to cause approximately 125,000 deaths and at least 10 percent of hospitalizations, and to cost the American health care system between $100 billion and $289 billion a year,” The New York Times reported. Drugs cannot work if people do not take them. The article suggests that this partly explains why medications that have done well in studies have failed to perform as well in the commercial market. It also explains why patients do not get better or suffer from relapses.

The article details improvements that can be made to help this epidemic, such as “Multiple drugs for a condition could be combined into one pill or packaged together, or dosing can be simplified. Doctors and pharmacists can use digital technology to interact with patients and periodically reinforce the importance of staying on their medication.” Patients who forget to take drugs can also use apps and devices to help them remember.

 



Despite Patient Satisfaction Ratings, VA Hospitals Are Top Quality

Reuters Health reported that a new study from JAMA Internal Medicine suggests that VA Hospitals are among the top in quality, while scoring low in patient satisfaction ratings. Data from 129 Veterans Affairs Hospitals and 4,010 non-VA Hospitals throughout the United States was examined. The JAMA researchers “found the VA had lower rates of six complications tied to quality: pressure ulcers, deaths of surgical patients with serious treatable conditions, care-related lung injuries, clots in the vein in surgical patients, catheter-related bloodstream infections, post-operative bloodstream infections and post-operative surgical wound ruptures.” They also found that the VA Hospitals had “lower mortality rates and fewer cases of repeat hospitalizations than other hospitals.”

However, where they exceeded in quality, they lacked in patient experience. The study found that VA patients were less likely to recommend a VA Hospital to a family or friend than a non-VA Hospital patient.

 



Consumers Saved $230 Billion on Generic Drugs Last Year

Generic drugs made up 88 percent of prescriptions filled, and account for 28 percent of total drug spending, according to a recent report from the Generic Pharmaceutical Association.

Generic brand drugs have saved consumers about $230 billion in prescription spending, according to the report. Generic costs are declining overall, even as more are sold, according to the USA Today.



Although diabetes was thought to have been a problem mainly in wealthier countries, the Washington Post reports that the condition now disproportionately affects poor countries. According to the World Health Organization, diabetes cases have doubled worldwide between 1980 and 2014. This means that one in 12 people around the world is diabetic. This increase in diabetes has been attributed to a number of factors such as excess weight gain, obesity and an aging population.

Not only does diabetes significantly shorten lifespans, it is a huge economic burden. Current health spending to treat diabetes and related conditions is over $800 billion every year. The World Health Organization is calling on all governments to draft legislation that will promote healthier lifestyle decisions and limit the consumption of foods that are high in fat and sugar.

https://www.washingtonpost.com/news/to-your-health/wp/2016/04/06/diabetes-was-once-a-problem-of-the-rich-now-it-belongs-to-the-poor/



A recent front-page story in the Washington Post reported that researchers have detected the Zika virus in Aedes albopictus, a common mosquito that can be found as far north as New England. This greatly increases the number of U.S. states at risk for transmission of the disease. This discovery was reported by the Pan American Health Organization after the virus was detected in Asian tiger mosquitos in Mexico.

https://www.washingtonpost.com/world/the_americas/new-discovery-means-more-us-states-will-face-a-risk-from-zika/2016/04/29/497ffa98-0d59-11e6-bc53-db634ca94a2a_print.html



The Hill reports that 18 million Americans have gained access to healthcare coverage thanks to the Affordable Care Act, known in many circles as ObamaCare. These findings were from a study conducted by the Urban Institute, and they are similar to another recent study that concluded that the A.C.A. allowed about 20 million Americans to have coverage.

The article stated that approximately 16.9 million Americans gained coverage through the Affordable Care Act’s marketplaces and the expansion of Medicaid, the law’s two main provisions. The remaining 1.2 million Americans are young adults who are allowed to stay on their parents’ health plans until the age of 26.

http://thehill.com/policy/healthcare/276692-18m-people-gained-coverage-from-obamacare-study-finds



An article in the “Health and Science” section of the Washington Post reports that suicide rates in the United States have risen 24 percent between 1999 and 2014 to 13 suicides per 100,000 people. The biggest increase has been found in middle-aged white people, particularly women.

There are of course several factors in the increase of suicide rates, but the primary factors are substance abuse, “gray divorce” and the rise in social media and the Internet. Economic stress also seems to be a factor as this increase also coincides with the recent recession.

The suicide rate among girls between the ages of five and 15 years old has also been increasing. Suicide within this population was a rare phenomenon before 1999, but suicide rates among young girls tripled between 1999 and 2014, with one suicide for every 6,660 girls.

https://www.washingtonpost.com/national/health-science/us-suicide-rate-has-risen-sharply-in-the-21st-century/2016/04/21/2b5fa6fe-07d1-11e6-bdcb-0133da18418d_print.html



According to Tim Lahey of the New York Times “Well” blog, “Ten thousand people ages 13 to 24 are give HIV diagnoses every year in the United States,” but many of these young people are unaware that they carry the virus. Part of this problem is “the low rate of HIV testing among young people, despite the recommendation of the Centers for Disease Control and Prevention to that every sexually active person over the age of 13 be tested for HIV. Recent research has also shown that pediatricians and parents are testing five times fewer young people for HIV than what is recommended by national guidelines.

http://well.blogs.nytimes.com/2016/04/27/swipe-right-to-connect-young-people-to-h-i-v-testing/?_r=1&pagewanted=all

http://www.cdc.gov/healthyyouth/sexualbehaviors/pdf/hivtesting_adolescents.pdf


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