ACCME releases examples of real-world compliance with the updated criteria

Click here to access.

True blue?

From the Washington Post article:

The Afghan chieftain looked older than his 60-odd years, and his bearded face bore the creases of a man burdened with duties as tribal patriarch and husband to four younger women. His visitor, a CIA officer, saw an opportunity, and reached into his bag for a small gift.

Four blue pills. Viagra.

"Take one of these. You'll love it," the officer said. Compliments of Uncle Sam.

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Doctor Nemeroff steps down

From Emory's news release:

Emory University has conducted an investigation into allegations of conflicts of interest involving Dr. Charles Nemeroff, the long-time chair of the Department of Psychiatry and Behavioral Sciences at the Emory University School of Medicine. Based on the results of that investigation, Dr. Nemeroff has agreed to step down from the departmental leadership post he held for 17 years and to follow new restrictions on his outside activities.

Additionally, Emory will not submit any NIH or other sponsored grant or contract requests in which he is listed as an investigator or has any other role for a period of at least two years. He will remain in the Department as a professor and will focus on clinical care, teaching and other academic pursuits.

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Medical Board of California changes CME requirements

From the California Physician article:

New CME reporting requirements recently passed by the medical board take effect in 2009. Physicians will now be required to complete 50 CME hours during every two-year licensure period. Previously, physicians were required to complete 100 hours every four years. CME will also be calculated based on the physician’s personal license renewal date (the last day of the month of your birthday), not the calendar year.

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Wishing Everyone Happy Holidays!

Gratitude is not only the greatest of virtues, but the parent of all others.
- Cicero (106 BC - 43 BC), 'Pro Plancio,' 54 B.C.

Medical publisher and Wyeth under scrutiny

From the New York Times article:

Mr. Grassley, a member of the Senate Finance Committee who is investigating drug company influence on doctors, contends that Wyeth commissioned the articles and had them ghostwritten by a medical writing firm. Only after the articles were conceived and under way did the firm line up doctors to put their names on them, Mr. Grassley contends.

“The charges made by Senator Grassley’s office with regard to the article published in 2003 by Dr. Eden are a significant concern to The Journal and Elsevier,” Glen P. Campbell, the senior vice president for Elsevier’s US Health Sciences Journals unit, said in a statement. “As with any charge of misconduct or inappropriate publishing acts, The Journal has launched its own investigation into the claims of ghostwriting and undisclosed financial support.”

The journal article, published more than a year after a landmark federal study linked Wyeth’s Prempro hormone product to breast cancer in women, said there was “no definitive evidence” the hormones caused breast cancer.

Click here to access the NYT article.

Barbara Barnes, MD, and Claudette Dalton, MD Named Chair and Vice Chair of the Accreditation Council for Continuing Medical Education

Click here to access this ACCME news release.

Wilford Brimley receives American Diabetes Association award

From the tcpalm.com article:

“I didn’t know about this,” he said after accepting the award. “I’m truly honored. I don’t know what to say here about this. I do know that I am responsible to share my experience, whatever strength I may have and my hope with anybody who cares to jump in the water.”

Click here to read the article.

"'CME-like'"

Apparently a new term coined by Emory? Check out Senator Grassley's most recent letter to the NIH regarding Dr. Nemeroff's conflict of interest "issues"; click here to access.

ADA/ACCF/AHA issue position statement

"Intensive Glycemic Control and the Prevention of Cardiovascular Events: Implications of the ACCORD, ADVANCE, and VA Diabetes Trials"; click here to access.

Breast Cancer and HRT

From the The Washington Post article:

Taking menopause hormones for five years doubles the risk for breast cancer, according to a new analysis of a big federal study that reveals the most dramatic evidence yet of the dangers of these still-popular pills.

Even women who took estrogen and progestin pills for as little as a couple of years had a greater chance of getting cancer. And when they stopped taking them, their odds quickly improved, returning to a normal risk level roughly two years after quitting.

Collectively, these new findings are likely to end any doubt that the risks outweigh the benefits for most women.

Click here to access the WP article.

PhRMA issues guiding principles on DTC advertising

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Electronic prescribing

The authors of a study just published in the Archives of Internal Medicine report that electronic prescribing and formulary decision support could result in substantial cost savings ($845,000 per 100,000 patients). Click here to access the abstract.

Drug combo for hypertension superior?

From the New York Times article:

The trial compared two pills, each containing two drugs used to lower blood pressure. Patients taking pills that combined an ACE inhibitor with a calcium-channel blocker suffered 20 percent fewer heart attacks, strokes, heart procedures and deaths than those taking an ACE inhibitor with a diuretic, the investigators found.

The study was funded by Novartis, which makes both of the two-in-one pill treatments evaluated, and published in Thursday’s issue of The New England Journal of Medicine.
...
Dr. Aram Chobanian, a professor of medicine and pharmacology at Boston University School of Medicine and author of the editorial, said he had questions about whether the diuretic was used appropriately in this trial, adding that a single trial is “not enough to recommend that everyone be on a calcium-channel blocker and an ACE inhibitor.”

Click here to access the NYT article.

Penn School of Medicine to disclose doc industry ties online

From the Philadelphia Inquirer article:

Some local patients may soon be able to learn whether their doctors are paid on the side by pharmaceutical firms or medical-implant makers.

In the spring, the University of Pennsylvania School of Medicine and its health system, known collectively as Penn Medicine, plan to launch a Web site that will contain searchable information on all outside activities of its doctors and scientists.

"When all of us are up there transparently, it may make us a little more responsible," said Arthur H. Rubenstein, dean of the medical school and head of Penn Medicine. "It is just human nature: If you know someone else is going to know what you are doing, you may be more careful."

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Cleveland Clinic's new online disclosure plan

From the New York Times article:

The Cleveland Clinic plans to announce this week it has begun publicly reporting the business relationships that any of its 1,800 staff doctors and scientists have with drug and device makers.

The clinic, one of the nation’s most prominent medical research centers, is making a complete disclosure of doctors’ and researchers’ financial ties available on its Web site, www.clevelandclinic.org.
...
“They are breaking a new path here,” said Dr. David J. Rothman, the president of the Institute on Medicine as a Profession, a nonprofit group based at Columbia University that studies potential conflicts of interest.

Click here to access the NYT article.

IOM report on resident fatigue

From the Washington Post article:

Medical and surgical residents in hospitals should work no more than 16 hours without taking a mandatory five-hour sleep break, and they should get one full day off a week and at least two back-to-back days off a month, a panel of experts at the Institute of Medicine recommended yesterday.

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Brand-name versus generic, is perception reality?

Check out the recent JAMA article "Clinical Equivalence of Generic and Brand-Name Drugs Used in Cardiovascular Disease." The results and the authors' conclusions:

Results: We identified 47 articles covering 9 subclasses of cardiovascular medications, of which 38 (81%) were randomized controlled trials (RCTs). Clinical equivalence was noted in 7 of 7 RCTs (100%) of β-blockers, 10 of 11 RCTs (91%) of diuretics, 5 of 7 RCTs (71%) of calcium channel blockers, 3 of 3 RCTs (100%) of antiplatelet agents, 2 of 2 RCTs (100%) of statins, 1 of 1 RCT (100%) of angiotensin-converting enzyme inhibitors, and 1 of 1 RCT (100%) of {alpha}-blockers. Among narrow therapeutic index drugs, clinical equivalence was reported in 1 of 1 RCT (100%) of class 1 antiarrhythmic agents and 5 of 5 RCTs (100%) of warfarin. Aggregate effect size (n = 837) was –0.03 (95% confidence interval, –0.15 to 0.08), indicating no evidence of superiority of brand-name to generic drugs. Among 43 editorials, 23 (53%) expressed a negative view of generic drug substitution.

Conclusions: Whereas evidence does not support the notion that brand-name drugs used in cardiovascular disease are superior to generic drugs, a substantial number of editorials counsel against the interchangeability of generic drugs.

Click here to access (sub. req.).

Disruptive Docs

From the New York Times article:

A survey of health care workers at 102 nonprofit hospitals from 2004 to 2007 found that 67 percent of respondents said they thought there was a link between disruptive behavior and medical mistakes, and 18 percent said they knew of a mistake that occurred because of an obnoxious doctor. (The author was Dr. Alan Rosenstein, medical director for the West Coast region of VHA Inc., an alliance of nonprofit hospitals.)

Another survey by the Institute for Safe Medication Practices, a nonprofit organization, found that 40 percent of hospital staff members reported having been so intimidated by a doctor that they did not share their concerns about orders for medication that appeared to be incorrect. As a result, 7 percent said they contributed to a medication error.

There are signs, however, that such abusive behavior is less likely to be tolerated. Physicians and nurses say they have seen less of it in the past 5 or 10 years, though it is still a major problem, and the Joint Commission is requiring hospitals to have a written code of conduct and a process for enforcing it.

Click here to access.