Doctor Radio?

Yep! Sirius Satellite Radio has launched "Doctor Radio" which features real doctors responding to callers' questions. Click here to find out more.

Epocrates and Joslin Launch Mobile Resource Center on Diabetes

From the Epocrates press release:

Clinicians across America now have access to the knowledge and opinions of a renowned diabetes expert, thanks to a collaboration between Joslin Diabetes Center, the world’s largest diabetes clinic, research center and provider of diabetes education, and Epocrates Inc., a leading developer of handheld clinical applications.

Richard Jackson, M.D., Director of Medical Affairs, Healthcare Services, Joslin Diabetes Center, is the sole contributing editor for Epocrates' new diabetes mobile resource center. This convenient handheld resource is designed to provide an intelligent, editorially independent summary of the most important clinical news and research in diabetes.

With diabetes rates on the rise among Americans and the influx of medical news and developments, clinicians need a trusted source to help them sort through the clutter and keep current. The mobile resource center’s content, including scientific articles, research findings and breaking news, is selected and commented upon by Dr. Jackson to support clinicians' care of patients with diabetes and its related conditions.

Click here to read the entire press release.

ACCME, ANCC and ACPE CEOs respond to Macy report

Click here to access.

Back to the drawing board for CEJA Report 1?

According to the Policy and Medicine blog, the AMA House of Delegates rejected CEJA Report 1 in its current form. However, don't expect this issue to just fade away. Click here to access the Policy and Medicine blog posting.

Survey results on patient use of physician rating websites

From the amednews.com article:

A Harris Interactive poll commissioned by the California HealthCare Foundation found that although more than 80% of the state's adults turn to the Internet for health-related information, less than one-quarter have looked at physician ratings sites. Only 2% of those surveyed made a change in physicians based on information posted on a rating site.

Click here to access the article.

Fasten your seatbelts!

Lay your eyes on the new ACCME policy announcements and calls for comments. Click here to access. And check out the ACCME Statement in response to IOM. Click here to access.

SACME survey results on proposed CEJA policy

SACME recently surveyed its members regarding CEJA's proposed policy which would pretty much ban industry support of "CME" although industry could still train physicians on new equipment or new devices.

Per SACME President Melinda Steele the survey results of 56 SACME members on the proposed policy "...should in no way be construed as an official position or opinion of SACME." The results of two survey questions:

The CEJA report accurately represents the current environment in academic CME:

Strongly Disagree 33.9%
Disagree 23.2%
Neutral 8.9%
Agree 23.2%
Strongly Agree 10%

The CEJA report should be referred back to CEJA for further action:

Strongly Disagree 10.7%
Disagree 7.1%
Neutral 3.6%
Agree 28.6%
Strongly Agree 50.0%

If the entire survey results get posted, I'll provide the url.

Doctor Nurse?

From the amednews.com article:

Starting this fall, doctor of nursing practice graduates will be able to take a certification test that proponents say will set a national standard for DNPs and add to the profession's credibility.

The voluntary test, being created by the National Board of Medical Examiners, is based on the medical licensing exam. It will be offered at a time of growing momentum in the DNP movement: About 200 nursing schools are expected to offer the two-year DNP degree by 2015 -- more than double the programs available today.

Click here to access the article.

Psych researchers under scrutiny

From the New York Times article:

A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators.

By failing to report income, the psychiatrist, Dr. Joseph Biederman, and a colleague in the psychiatry department at Harvard Medical School, Dr. Timothy E. Wilens, may have violated federal and university research rules designed to police potential conflicts of interest, according to Senator Charles E. Grassley, Republican of Iowa. Some of their research is financed by government grants.

Click here to access the article.

Supreme Court justices divest their pharma stock

From the AP article:

Chief Justice John Roberts and Justice Samuel Alito, whose investments forced them to sit out cases before the Supreme Court, have reduced their stock holdings, their latest financial disclosures show.

Click here to access. Hat Tip to Pharmalot.

A little dimmer or a little brighter?

You decide. From the BMJ article:

The US drug industry has persuaded key Congressional legislators to water down proposed legislation that would require detailed public disclosure of payments and gifts to doctors.

Click here to access.

More on Pri-Med survey of physicians regarding CEJA Report 1

The full results of the poll can be found on Pri-Med's website at www.pri-med.com. Click here to access.

RWJF announces $300 million commitment to improve quality of health care in U.S.

From the RWJF news release:

With increasing reports of dangerous deficiencies in the quality of health care, the nation’s largest health care foundation today announced a $300-million commitment to improve quality in regions across the United States.

Underscoring the scope of the problem, the Robert Wood Johnson Foundation (RWJF) also released new research showing that the quality of care people receive can vary dramatically depending on their race and where they live.

The $300-million commitment to improve health care in 14 communities, that together cover 11 percent of the U.S. population, is the largest effort of its kind ever undertaken by a U.S. philanthropy. Known as Aligning Forces for Quality, the community-focused program will lift the overall quality of health care, reduce racial and ethnic disparities and provide models for national reform.

“Across America, there are serious gaps between the health care that people should receive and the care they actually receive,” said Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation.

Click here to access the news release.

Physicians Disagree with Proposed Ban of Commercial Support of CME

Pri-Med recently conducted a survey of 268 physicians regarding the CEJA proposed policy; some of the results:

1. The CEJA of the AMA published a report last week that stated industry-support of CME should end. Do you agree, disagree or have no opinion?

• 92% of the doctors disagree with the ban

2. If industry funding of CME ends, how would this impact the ways in which you obtain CME?

On the whole, physicians state three primary ways it will impact them:

• It will be more expensive to receive continuing medical education, which makes it more difficult for physicians to stay up-to-date
• The quality of CME will decrease
• Fewer opportunities available will hurt patient care

A hat tip to Marissa Seligman, Ph.D., of Pri-Med for these results. (To the best of my knowledge, the survey results are not yet posted online, when and if they are I will certainly repost with the link.)

AMSA PharmFree Scorecard 2008

The American Medical Student Association (AMSA) has posted their 2008 PharmFree Scorecard. Click here to check it out (encourage y'all to read the methodology information before freaking out).

May issue of Pharma Marketing News

Chock full of great information, especially on the issue of patient compliance (or lack thereof). And the photo of the pharma brand manager in another article made me lol! Click here to access.

NAAMECC and CHC express concerns re: CEJA's Report 1

Check out the joint memo issued by NAAMECC (North American Association of Medical Education and Communications) and CHC (Coalition for Healthcare Communication) regarding CEJA's proposed policy relative to industry support of CME. Click here to access the memo.

"Four score and seven years ago

our fathers brought forth on this continent a new nation, conceived in Liberty, and dedicated to the proposition that all men are created equal.

Now we are engaged in a great civil war, testing whether that nation, or any nation, so conceived and so dedicated, can long endure. We are met on a great battle-field of that war. We have come to dedicate a portion of that field, as a final resting place for those who here gave their lives that that nation might live. It is altogether fitting and proper that we should do this.

But, in a larger sense, we can not dedicate—we can not consecrate—we can not hallow—this ground. The brave men, living and dead, who struggled here, have consecrated it, far above our poor power to add or detract. The world will little note, nor long remember what we say here, but it can never forget what they did here. It is for us the living, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced. It is rather for us to be here dedicated to the great task remaining before us—that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion—that we here highly resolve that these dead shall not have died in vain—that this nation, under God, shall have a new birth of freedom—and that government of the people, by the people, for the people, shall not perish from the earth."

-Abraham Lincoln

FDA Sentinel Initiative

From the FDA's website:

On May 22, 2008, FDA launched the Sentinel Initiative with the ultimate goal of creating and implementing the Sentinel System--a national, integrated, electronic system for monitoring medical product safety.

The Sentinel System will enable FDA to query multiple, existing data sources, such as electronic health record systems and medical claims databases, for information about medical products. The system will enable FDA to query data sources at remote locations, consistent with strong privacy and security safeguards. Data sources will continue to be maintained by their owners.

This historic new system will strengthen FDA's ability to monitor the performance of a product throughout its entire life cycle, thus enhancing the protection and promotion of public health. Such a system could also ultimately facilitate data mining and other research-related activities.

Click here for add'l information.

Perseverance

MA medical society up in arms over physician rankings

From the Boston Globe article:

The Massachusetts Medical Society yesterday sought to derail a two-year-old plan under which physicians are ranked for cost and quality measures by health plans associated with the Group Insurance Commission, the agency that oversees health insurance for thousands of public employees at state and local levels.

In a lawsuit filed in Suffolk Superior Court, the society - which represents the state's doctors - alleges the commission's plan hurts physicians and patients.

Click here to access.

Zimmer contemplating buyout of surgeons' royalty contracts

From the Financial Times article:

Zimmer, one of the world’s biggest makers of orthopaedic implants, is reviewing its contracts with hundreds of US surgeons in a move that could take the company’s bill for clearing up a legal case last year to more than $450m.

Under procedures intended to make its dealings with surgeons with whom it has consultancy relationships more transparent, Zimmer is considering terminating its royalty contracts with many of these doctors.

Click here to access the article.

Make It Do is an AQHA Hall of Famer!

From the American Quarter Horse Association's website:

America’s Horse, May 1, 2008 – Five individuals and three horses will be inducted into the American Quarter Horse Hall of Fame during the 2009 American Quarter Horse Association Convention, March 6-9 in San Antonio, Texas.

The American Quarter Horse Hall of Fame was established in 1975 to honor people and horses instrumental in the development of the breed and the American Quarter Horse Association. Induction into the Hall of Fame is one of the highest honors bestowed by AQHA...

Make It Do

Make It Do was born in 1964. A six-time winner on the track, the sorrel gelding who was nicknamed “Peanuts” would use his speed to chase down steers in the rodeo arena and end up in two Halls. Peanuts was purchased off the race track in 1968 and went on to be a rodeo legend. In 1977, the Professional Rodeo Cowboys Association awarded a trophy for the first time to the season’s best steer wrestling horse. The top 30 money winners in the event were up for the award and the winner in 1977-78 was Peanuts, who was owned by C.R. Jones of Lakeside, California. Peanuts was inducted into the ProRodeo Hall of Fame in 1979.

If it's possible to have a crush on a horse, then I had certainly had one on Peanuts! My Uncle Stan (Immenschuh) trained Peanuts as a racehorse, before he went onto rodeo arena glory. Congratulations, Peanuts!

AMA draft report on "Industry Support of Professional Education in Medicine"

It's now posted on the AMA's website:

Per Policy D-600.992, AMA Board and Council reports are being posted here as they have become available for “review by all physicians and the public and comment by AMA members.”

Readers should note that these reports refer only to items to be considered by the AMA House of Delegates during its 2008 Annual Meeting (June 14-18). No action has been taken on these items, and all reports should be considered informational at this time. Only items which have been acted on finally by the House of Delegates can be considered official, with final results reflected in the Proceedings of the House of Delegates...

Click here to access.

Macy Foundation Conference proceedings

Yep, that one! Continuing Education in the Health Professions: Improving Healthcare through Lifelong Learning. Click here to read the whole enchilada.

ACCME posts new forms

What are they? (Drum roll). They are the Surveyor Report Form and Documentation Review Form that reflect the Updated Accreditation Criteria. Click here to access.

AMA CPPD Town Hall Meeting June 14, 2008

From the AMA News Brief email alert:

The AMA’s Division of Continuing Physician Professional Development will hold its annual Town Hall Meeting on Saturday, June 14 (1:00 – 2:30pm, Comiskey Room) in conjunction with the AMA Annual Meeting. Topics included will be updates from the Council on Medical Education, ACCME accreditation criteria, the AMA's Initiative to Transform Medical Education, the AMA PRA 40th Anniversary, and other emergent AMA issues related to CME/CPPD. This meeting is open to all individuals with an interest in learning more about AMA CPPD issues and the AMA PRA credit system. For more information about this meeting, please contact us at cppd@ama-assn.org.

Click here to go the AMA's website.

Updated code of conduct for British drug makers

The Association of the British Pharmaceutical Industry has an updated code of practice, effective July 1, 2008. According to the ABPI press release:

Many of the changes relate to even greater transparency, and include:

• Companies will have to make publicly available a short description of their support for patient organisations for both financial and significant indirect support.
• Sponsorship declarations must accurately reflect the nature of the company’s involvement.
• It will be a breach of the code to fail to disclose details on ongoing clinical trials.
• Companies will need to have a contract for health professionals and others employed as consultants, and are strongly encouraged to require consultants to declare this as an interest.
• Companies are also encouraged to make publicly available information about donations and grants to institutions etc that support healthcare and research.

Click here to access the ABPI's press release. Click here to access the code. Hat tip to Pharmalot.

Wishing you a laid back weekend...(well, maybe not that laid back)

Misuse, overuse, underuse...

Check out "A Good Framework for Distributing Information About Off-Label Uses" written by Scott Gottlieb, M.D. and published on the American Enterprise for Public Policy Research's website; an excerpt:

Just as delays in transmitting information about a drug’s safety can lead to poorly informed medical decisions, the same phenomenon applies when it comes to information about a drug’s effectiveness.

Click here to access the article.

Statement issued on DTC hearing

From the sootoday.com article:

Stupak delivered the following statement:

Nearly 10 years ago, the U.S. Food and Drug Administration (FDA) relaxed its rules related to direct-to-consumer (DTC) advertisements for prescription pharmaceutical products.

Since then, spending on DTC ads has increased from about $1.1 billion in 1997 to about $4.2 billion in 2005.

This nearly 300 percent increase in DTC ad spending dwarfs the 86 percent spending increase in advertisements to physicians and the 103 percent spending increase in research and development over the same period.

Click here to read the entire statement (and article). I say we blame it all on Joan Lunden.

Are freebies really costies?

From the msnbc.com opinion piece from Dr. Craig in response to AAMC's report on industry support of medical education:

When was the last time you were bribed by a piece of pizza or a logo pen with five days worth of ink?

Click here to read.

Survey results regarding "CME Linkages"

Thanks to those of you who completed the survey! Here are the top-rated areas y'all would like to see addressed in CME Linkages:

CME Best Practices
CME Collaboration
Legislation/Regulatory Issues
Professional Development
Professional Practice Gaps
Physician Survey Results

Respondents included accredited and non-accredited providers and "neither." If you'd like to add your two cents to this survey:

Click Here to take survey

Something borrowed...prescription meds

From the www.msnbc.msn.com article:

In one-on-one interviews with 700 Americans, roughly 23 percent reported loaning their prescription medications to someone else, and 27 percent reported borrowing prescription medications.
...
The survey also showed that Whites (23 percent) and Hispanics (26 percent) were more apt to share prescription pain medicines than were African Americans (14 percent). Women were more apt than men to share antibiotics (24 percent vs 12 percent).

Click here to access the article.

DTC advertising - Congressional hearing

When: Thursday, May 8, 2008 (10 a.m. EST)

Direct-to-Consumer Advertising: Marketing, Education, or Deception?
Subcommittee on Oversight and Investigations Hearing
10:00 a.m. in room 2123 Rayburn House Office Building

Click here to access the link to this hearing.

Maryland e-Care

From the Washington Post article:

The program is designed to supplement the care provided by on-site nurses during overnight shifts in intensive care units by equipping them with instant links to critical care physicians -- specialists known as intensivists -- based at a command center at a Wilmington, Del., hospital.

Click here to access.

Prescription Project releases COI mitigation toolkits

I haven't reviewed them, so am not commenting on them. Click here to access.

A CME success story

From the Washington Post article:

An intensive educational program for physicians and midwives that stresses giving women the drug oxytocin just after a vaginal delivery resulted in significantly fewer cases of excessive bleeding, according to a study done in two South American countries.

Click here to access.

AAMC report on industry funding of medical education

An excerpt from the Executive Summary:

The Report acknowledges the new policy directions being implemented in many medical schools and teaching hospitals to address industry support of medical education, and it urges all academic medical centers to accelerate their adoption of policies that better manage, and when necessary, prohibit, academic- industry interactions that can inherently create conflicts of interest and undermine standards of professionalism. Although the charge to the Task Force was focused on funding from the pharmaceutical and device industries, institutional policies on conflicts of interest should be comprehensive and encompass providers of equipment and services as well. Concomitantly, industry should voluntarily discontinue those practices that compromise professionalism as well as public trust.

Click here to access the report.

Please complete a brief survey regarding my blog!

Click Here to take survey

BPA in your plastics

From the New York Times article:

A draft report from the National Toxicology Program, part of the Department of Health and Human Services, notes that there is no direct evidence that human exposure to BPA harms reproduction or infant development. “I don’t think there’s anything in this brief that should lead to alarm,” said Dr. Michael D. Shelby, director of the Center for the Evaluation of Risks to Human Reproduction, who oversaw the report. “It means we’ve got a limited amount of evidence from some studies that were done in laboratory animals.”

The main concern is the possible risk to infants and pregnant women, although Canada has begun a study to monitor BPA exposure among about 5,000 people to assess any danger to adults.

Click here to access the NYT article.

Seroquel "sequelae"?

From the Cincinnati.com Enquirer article:

The University of Cincinnati will increase scrutiny on a psychiatry professor for not reporting all of the hundreds of thousands of dollars in corporate research money she received from a pharmaceutical giant during the last decade.

Melissa DelBello now has to review all of of her interactions with companies with her department chairman, UC vice president of research Sandra Degen said Friday.

Click here to access the article.

Trends in U.S. mortality

Check out the PLoS Medicine article "The Reversal of Fortunes: Trends in County Mortality and Cross-County Mortality Disparities in the United States"; the authors' conclusions:

There was a steady increase in mortality inequality across the US counties between 1983 and 1999, resulting from stagnation or increase in mortality among the worst-off segment of the population. Female mortality increased in a large number of counties, primarily because of chronic diseases related to smoking, overweight and obesity, and high blood pressure.

Click here to access the online article.

Nepotism

I had to find this myself on youtube.com because my nephew, Erik, would, of course, not let me know this was online. Click here to go to Erik's website.
:)

Zimmer compliance

Looks like at least one medical device manufacturer is responding just like Big Pharma! An excerpt from Zimmer's recent announcement:

The refined compliance model is designed to aggressively reduce potential or perceived conflicts of interest inherent in consulting relationships between the industry and healthcare professionals—while preserving the best of the collaboration that drives innovation in medical devices and services. The model includes fundamental changes in the areas of product development, marketing, surgeon training, educational and charitable funding, and transparency.

Click here to access.

FDA clarification?

From the Wall Street Journal article:

Drug-industry representatives are descending on the capital to protect their freedom to advertise their wares directly to consumers and to push for looser government restrictions on their ability to promote off-label uses of their medicines.

Click here to access the WSJ article (sub. req.).

Primum non nocere

Check out the editorial in JAMA written by Doctors DeAngelis and Fontanarosa regarding the adverse effects of industry influence. Click here to access (free text article).

Check out this NEJM article

"Pharmaceutical Promotion to Physicians and First Amendment Rights" (sub. req.).

The Vioxx "haunting"

Senator Grassley sent a letter to Merck asking for lots of information on the latest revelations regarding Vioxx! Click here to access the Senator's letter.

The start of a trend?

Check out the New York Times article "Citing Ethics, Some Doctors Are Rejecting Industry Pay"; an excerpt:

No longer will they be paid for speaking at meetings or for sitting on advisory boards. They may still work with companies. It is important, they say, for knowledgeable scientists to help companies draw up and interpret studies. But the work will be pro bono.

Click here to access.

A last lecture (better than CME)

Senator Grassley press release

From the Senator's 4-11-08 press release:

Copies of letters that Senator Grassley received from drug makers in response to his request for them to follow Eli Lilly’s lead and disclose financial contributions to continuing medical education are posted with this statement at http://finance.senate.gov. Right now,Senator Grassley does not plan to pursue disclosure legislation separate from the Physician Payment Sunshine Act. He will carefully monitor implementation of the disclosure plans described in these letters and consider additional initiatives, including legislation, if transparency is not achieved.

Click here to read this press release and the response letters from these companies.

Pennsylvania's 2nd annual hospital-acquired infection report

From the U.S. News & World Report article:

Leafing through the report and fizzing indignantly about the performance of some of the hospitals, I was overheard by Bernadine Healty, my next-office physician colleague (a former medical school dean and director of the National Institutes of Health). She reminded me that there could well be reasons for a number that seems outrageous. A hospital might treat a disproportionate number of patients vulnerable to infection because of HIV or old age, for instance. The data are important and impressive, she said, but the primary purpose is to alert a hospital with high numbers that something may be badly amiss. "Before jumping to conclusions, you need to drill down into the data," she said. "Investigate. Find out what's going on."

Click here to access the USNWR article. Click here to access the "Hospital-Acquired Infections in Pennsylvania" Report (98 pages).

Joint Commission issues pediatric medication safety strategies

From the Washington Post article:

"The vast majority of countries utilize the metric system, and the recommendations for pediatric medication use are based on the metric system," said Dr. Peter Angood, vice president and chief patient safety officer for The Joint Commission, which announced the "Sentinel Event Alert" at a teleconference.

"Sadly, there seems to be a lack of widespread appreciation even among health-care providers that children have unique safety and medication needs," said Dr. Matthew Scanlon, assistant professor of pediatrics-critical care at the Medical College of Wisconsin and a member of the Joint Commission's Sentinel Event Advisory Group.

Click here to access the WP article. Click here to access these Joint Commission recommendations.

HelloCME.com?

Check out Dr. Reece's blog entry "Parkinson's Law..." about HelloHealth.com which is scheduled to launch in June 2008. If you don't laugh out loud when you're reading it, then we should never meet. Click here to access the entry.
:)

This mouse is stirring...

Just say...Yes!

From the CNN.com news article:

One in five respondents to a new survey in the journal Nature say they've used drugs to boost their brain power.

"We were putting our finger in the air to see what our reader response would be. And it was tremendous," said Brendan Maher, an editor with the widely read scientific publication. "What it's suggesting is there are a high percentage of adults using these drugs."

The informal, nonscientific survey, conducted online, polled 1,400 people in 60 countries. Most of the responders, the majority of whom said they worked in biology, physics, medicine or education, reported taking the drugs to improve their concentration.

Click here to access the article.

CDC FoodNet Report

From the WebMD article:

The CDC's Foodborne Diseases Active Surveillance Network, called FoodNet, began tracking cases of food-borne illnesses in 1996 in 10 U.S. states. The idea is to track infection trends for the 10 most important causes of food poisoning.
...
"There is not a particularly important change from the last few years," said Robert Tauxe, MD, MPH, deputy director of the CDC's division of food-borne diseases. "A lot of things have been going on to improve food safety, and we think they are likely to bear fruit ... but we cannot say we have made tremendous progress in the last year."

Click here to access the article. Click here to access the April 11 issue of the MMWR (page 6).

AHRQ National Resource for Health Information Technology

Click here to access.

Patient safety survey stats

From the Washington Post article:

From 2004 through 2006, patient safety errors resulted in 238,337 potentially preventable deaths of U.S. Medicare patients and cost the Medicare program $8.8 billion, according to the fifth annual Patient Safety in American Hospitals Study.

Click here to access.

The unbranded doctor?

Yep! The National Physicians Alliance has a new campaign entitled "The Unbranded Doctor." Click here to check it out.

The health care economics of prevention

Check out the Washington Post article entitled "In the Balance"; an excerpt:

An ounce of prevention may have been worth a pound of cure in households down through the ages, but in the world of health economics the adage, alas, is not true.

An ounce of prevention is sometimes worth more than an ounce of cure (although rarely worth 16 times as much, or the equivalent of a pound). Usually, an ounce of prevention is worth considerably less. Often it is worth (to mix measures) only a gram of cure. Or even just a milligram.

This is a seemingly illogical truth.

Click here to access the WP article. Click here to access the PLoS Medicine article "Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure." Ummmmm

Elephantine art

Response to CMAJ editorial

Courtesy of notification by Anne Taylor-Vaisey, check out the electronic letters that have been sent in to the CMAJ in response to the editorial "The need for an Institute of Continuing Health Education." Click here to access the letters. Click here to check out Annie's blog.

Psychiatric News article on CME and pharma influence

An excerpt:

Intensifying criticism from academia, the media, and regulators has been directed at perceived bias in the large proportion of CME content that often favors a newly marketed product or off-label use of a product manufactured by the sponsor. The Senate report is primarily concerned about such influence on drug expenditures for Medicare and Medicaid.

Click here to read the article.

Carlat's blog posting on Medical Meetings magazine

Check it out by clicking here!
Happy Friday!
:)

Best practices work when it comes to medication safety!

From the Business Wire article:

A demonstration program at UCSF today reported a 56.8% reduction in medication administration errors – increasing the administration accuracy rate at participating hospitals to 93%. These gains were achieved through adherence to a set of six “best practice” procedures for medication administration identified by CalNOC (the California Nursing Outcomes Coalition). The study also reported a reduction in procedural errors of 78.5% – increasing adherence to these “best practice” procedures to 95.6% after 18 months. This study is the first to directly validate a specific set “best practices” for medication administration.

Click here to access the article.

National survey of hospital patients

From the New York Times article:

Many hospital patients are dissatisfied with some aspects of their care and might not recommend their hospitals to friends and relatives, the federal government said Friday as it issued ratings for most of the nation’s hospitals, based on the first uniform national survey of patients.
...
The new data, part of a survey of patient experiences and perceptions of hospital care, is posted at a government Web site, www.hospitalcompare.hhs.gov.

Richard J. Umbdenstock, president of the American Hospital Association, which helped develop the measures, said they allowed “an apples-to-apples comparison” of hospitals at the state, local and national levels.

Click here to access the NYT article.

Culture and health care delivery

Just read a fascinating article that was published Monday in the Boston Globe entitled "Culture Gap"; an excerpt:

Hinton, speaking in You's native Khmer language, told her to taper off her antipsychotic medications, according to his records, and handed her prescriptions for two other drugs - one to help her sleep, another to control her anxiety attacks. He urged her to continue her traditional Cambodian practices to help "wind" flow.

After regular therapy sessions with Hinton, You's emotions stabilized. And she trusted these words from him: You're not going to die from your neck vessels bursting.

Click here to read the article.

A lot more than shrimp on the barbie?

From the Sydney Morning Herald article:

Australian drug companies forked out more than $30 million in six months hosting doctors at controversial "educational" events, a report has revealed.

Pharmaceutical industry body Medicines Australia has been forced to detail spending on doctors' seminars of up to $2,500 a head, often hosted at expensive hotels and in exotic locations.

A report prepared for Medicines Australia by international consulting firm Deloitte shows that 42 companies spent $31 million, including $16.4 million on direct hospitality costs like meals, flights and hotels, in the second half of last year.

Click here to access the article.

Self assessment

The newest issue of the Journal of Continuing Education in the Health Professions has been published and it has a wealth of articles on self assessment:

Self-monitoring in clinical practice: A challenge for medical educators
Ronald M. Epstein, Daniel J. Siegel, Jordan Silberman

I'll never play professional football and other fallacies of self-assessment
Kevin W. Eva, Glenn Regehr

Making self-assessment more effective
Robert M. Galbraith, Richard E. Hawkins, Eric S. Holmboe

Self-assessment and continuing professional development: The Canadian perspective
Ivan Silver, Craig Campbell, Bernard Marlow, Joan Sargeant

Self-assessment in CPD: Lessons from the UK undergraduate and postgraduate education domains
Tim Dornan

Self-assessment of practice performance: Development of the ABIM Practice Improvement Module (PIM^SM)
F. Daniel Duffy, Lorna A. Lynn, Halyna Didura, Brian Hess, Kelly Caverzagie, Louis Grosso, Rebecca A. Lipner, Eric S. Holmboe

Directed self-assessment: Practice and feedback within a social context
Joan Sargeant, Karen Mann, Cees van der Vleuten, Job Metsemakers

A subscription to JCEHP (and online access) comes with membership in the Alliance for CME.

Ruling on access to JAMA peer review files

From the Wall Street Journal article:

In a court case pitting Pfizer Inc.'s corporate interests against a medical journal's confidential article-review process, a federal magistrate rejected Pfizer's attempt to gain access to documents of the Journal of the American Medical Association.

Click here to access (sub. req.).

Feds focusing on physicians

From the New York Times article:

A long-running federal investigation into the orthopedic device industry’s suspected kickback payments to hip and knee surgeons now has the doctors in the spotlight.

Having reached settlements with the five leading makers of artificial joints last year over the payments, the government has been focusing on the many doctors who receive money as the companies’ paid consultants.

Click here to access the NYT article.

www.PatientsLikeMe.com

An excerpt from the New York Times article on this website:

But PatientsLikeMe seeks to go a mile deeper than health- information sites like WebMD or online support groups like Daily Strength. The members of PatientsLikeMe don’t just share their experiences anecdotally; they quantify them, breaking down their symptoms and treatments into hard data. They note what hurts, where and for how long. They list their drugs and dosages and score how well they alleviate their symptoms. All this gets compiled over time, aggregated and crunched into tidy bar graphs and progress curves by the software behind the site. And it’s all open for comparison and analysis. By telling so much, the members of PatientsLikeMe are creating a rich database of disease treatment and patient experience.

Click here to access the NYT article. www.PatientsLikeMe.com

IOM committee looks into conflicts of interest

From the Medical Marketing & Media article:

Last week's meeting of an Institute of Medicine (IOM) committee gave some hope for a thaw in attitudes toward commercially supported CME, but supporters and providers remain anxious about the group's inquiry into conflicts of interest in medical research and medical education.

Click here to access the article.

NIH establishes new research center

From the New York Times article:

The Center for Genomics and Health Disparities will be led by Charles N. Rotimi, former director of the National Human Genome Center at Howard University.
...
“By understanding the nature of human genetic variation,” Dr. Rotimi said in an interview, “we can see how that overlaps with group identity and individual identity.

Click here to access the article.

Stark introduces new bill on gifts to physicians

From the Kaiser Daily Health Policy Report article:

Reps. Peter DeFazio (D-Ore.) and Pete Stark (D-Calif.) have introduced a bill (HR 5605) that would require pharmaceutical medical device companies to disclose to the public any gifts or payments to physicians valued at $25 or more, CQ HealthBeat reports.

The legislation is a companion to a bill (S 2029) sponsored by Sens. Chuck Grassley (R-Iowa) and Herb Kohl (D-Wis.) (CQ HealthBeat, 3/14). Under the bill, companies with at least $100 million in annual revenue would be required each quarter to disclose gifts or payments exceeding $25 in value, and the information would then be posted on a Web site.

Click here to read the article.

Senate Special Committee on Aging requests documents from Schering-Plough

Click here to access the press release. Click here to read the letter sent to Schering-Plough.

New book on pharma by former reporter

"Our Daily Meds" was recently reviewed by the New York Times -- an excerpt of that review:

“Our Daily Meds” begins by illustrating the established drug-company practices that have led to this sorry juncture. There is the rigging of studies, so that to be deemed “effective” a drug need only perform better than a sugar pill. There are the promotional strategies that evade the need for F.D.A. warnings by, say, planting logos for the sexual enhancement drug Viagra and the antidepressant Wellbutrin on Nascar vehicles. There is the co-option of doctors and university researchers by aggressive, payola-dispensing drug company representatives.

Ms. Petersen, who has done much of her digging with the help of obscure but gratifying corporate documents, even finds feedback from doctors about the bribe-style amenities offered by drug company junkets. (“Hotel too cold inside,” one said, in an evaluation of a June 1998 drug company program, adding, “Resort places preferred.” From a different doctor, miffed at the lack of a chauffeur at another event: “Hired car would have been much preferable.”

Click here to read the entire review.

A red face for the AAD?

From the MedPageToday article:

The American Academy of Dermatology is locked in a furor with a subset of its membership over whether to sell its name, prestige, and a special seal for endorsement of commercial sunscreens.

The imbroglio has an eerie similarity to the infamous Sunbeam logo-for-sale scandal that rocked the AMA a decade ago.

Click here to access the article.

What can CME providers do to promote safe medication practices?

Well, for one thing they can provide guidance to their CME faculty and give them the Institute for Safe Medication Practices' List of Error-Prone Abbreviations, Symbols, and Dose Designations! Click here to access this list.

H&P

Methinks Dr. Brewer over at the Wall Street Journal makes several important points today:

Patients present their doctors with undifferentiated problems, such as fever or trouble sleeping. Sometimes a common disease like a sore throat will present in a striking way. Or worse, a serious problem like lung cancer will present with a common symptom like a stubborn cough.

There's a steep penalty for being mistaken, however. An uncertain diagnosis often leads to expensive defensive medicine in the form of extra X-rays and lab tests. Tests like those can be a crutch. In my experience, they don't always help with diagnosis as much as a thorough medical history or physical exam.

Click here to access (sub. req.).

FDA may go further on anemia drugs

From the businessweek.com article:

The Food and Drug Administration has toughened warning labels on the anemia drugs -- Aranesp, Epogen and Procrit -- three times since last March, but now it is considering more drastic action. Amgen manufactures all three drugs, which treat the blood-disorder anemia in kidney-failure or chemotherapy patients, though New Brunswick, N.J.-based Johnson & Johnson sells Procrit.

In documents posted online Tuesday, regulators laid out several options for addressing safety risks, including withdrawing their use for chemotherapy patients.

Click here to access the article.

CT sues Lilly over Zyprexa

From the reuters.com article:

Attorney General Richard Blumenthal, who announced the suit, is seeking to recover "millions of taxpayer and consumer dollars improperly spent on Zyprexa as a result of its illegal marketing, and millions more spent for treatment of serious side effects from Zyprexa," according to a press statement from his office.
...
In the lawsuit filed Tuesday, Lilly is accused of promoting Zyprexa for unapproved uses, including the treatment of children, and of hiding dangerous side effects, such as increased risk of diabetes, weight gain and heart problems.

Click here to access.

Senate hearing on academic detailing set

From the seniorjournal.com article:

“The drug industry’s educational outreach is essentially a marketing program, and evidence shows that doctors’ prescribing patterns can be heavily influenced by pharmaceutical sales representatives,” says the news release from the Senate Special Committee on Aging that announced the hearing...The hearing – Under the Influence: Can We Provide Doctors an Alternative to Biased Drug Reviews? – will be at 10:30 a.m., March 12, in Room 562 of the Dirksen Senate Office Building...The hearing will be Webcast and the link can be found at the committee webpage: www.aging.senate.gov

Click here to access the article.

Oregon Academy of FPs just says no to pharma

From the Register-Guard article:

The Oregon Academy of Family Physicians, representing 1,300 doctors around the state, announced last week that it would no longer accept financial support from the pharmaceutical industry, swearing off unrestricted grants for continuing education seminars, sponsorship of events or advertisements in its publications. But individual members can still see pharmaceutical reps at their discretion.

“This is about taking the institutional view that as a professional medical society, we are committed to decision-making that is based on scientific evidence,” said Kerry Gonzales, the group’s executive director. “We want to avoid even the perception of influence or impropriety.”

Click here to access the article.

One in four female teenagers have an STD!

From the New York Times article:

The first national study of common sexually transmitted diseases among teenage women has found that one in four are infected with at least one of the diseases, federal health officials reported on Tuesday.

Nearly half of African-American teenage women were infected with at least one of the diseases monitored in the study — human papillomavirus (H.P.V.), chlamydia, herpes simplex type 2 and trichomoniasis, a common parasite.

That figure compared with 20 percent of white teenage women.

Click here to access the NYT article.

It's a small, small, small world?

From the mlive.com article:

At least one pharmaceutical was detected in tests of treated drinking water supplies for 24 major metropolitan areas, according to an Associated Press survey of 62 major water providers and data obtained from independent researchers.

Click here to access the article.

Check out Dr. Carlat's blog posting on the two recent journal articles on industry-supported CME

Click here.

Expert witness testifies on Lilly drug

From the New York Times article:

Eli Lilly, the drug maker, could and should have warned physicians as early as 1998 about the link between Zyprexa, its best-selling schiophrenia medicine, and diabetes, an expert witness told jurors Friday in a lawsuit that claims that Zyprexa has caused many mentally ill people to develop diabetes.

Instead, Lilly hid Zyprexa’s risks from doctors to protect the drug’s sales, according to the witness, Dr. John Gueriguian. Lilly waited until 2007 to add strong warnings to Zyprexa’s label to reflect the drug’s tendency to cause severe weight gain and blood sugar changes.

...

A lawyer for Lilly said after Dr. Gueriguian’s testimony that the company had shared all it knew with the F.D.A. and that the question of the link between Zyprexa and diabetes was still a subject of scientific debate.

Click here to access the NYT article.

Prescription drug costs rise for seniors

From the Washington Post article:

Drugmakers increased prices by an average of 7.4 percent last year for the brand-name medicines most commonly prescribed to the elderly, according to the advocacy group AARP.

The increase far exceeded inflation, continuing a longtime trend.

...

The trade group representing drugmakers, the Pharmaceutical Research and Manufacturers of America, said AARP's numbers reflect neither the true amounts consumers pay for medicine nor a slowing in the growth of drug prices when taking into account generics.

Click here to access.

Hospitals and drug errors

From the Wall Street Journal article:

Hospitals are taking steps to prevent errors in the use of so-called high-alert medications -- those that, when given in the wrong dose or used incorrectly, have the highest risk of seriously harming or even killing a patient.
...
While there are 19 categories of high-alert medications, according to the Institute for Safe Medication Practices, studies show that about eight medications, including heparin, account for 31% of all medication errors that harm patients.

Click here to access (sub. req.).

Testimony Before the Senate Committee - Physicians and the Device Companies

Click here to access.

NYT Weekly Health Quiz

Check it out, click here and take the quiz! How well did you do?

Will MA ban industry gifts to physicians?

Maybe -- from the Boston Globe article:

Senate President Therese Murray proposed today a broad measure to control healthcare costs by in part banning all gifts and freebies to doctors from drug companies, saying the perks have helped drive up costs for consumers.

If adopted, the legislation would make Massachusetts the first state in the country to place an outright ban on drug-industry gifts. Prohibited gifts would include any payments, entertainment, meals, travel, honoraria, subscriptions -- and even a pen bearing a drug company logo. Companies would be forbidden from offering the gifts and doctors, their families and employees would be forbidden from accepting them.

Under the proposal, anyone who violates the ban could be fined $5,000, face two years imprisonment or both.

Click here to access the BG article.

"the Jarvik episode"

Check out the New York Times article "Drug Pitchman: Actor, Doctor or Pfizer's Option" by Doctor Zuger; an excerpt:

Years ago, a large poster featuring an appealingly sweaty and smiling young man climbing a mountain appeared in my subway station, directly across from my usual waiting spot. Purportedly he had been invigorated by one of the first AIDS drugs marketed directly to the public. He looked magnificent on top of his mountain, a lot better than my AIDS patients — a lot better than me.

Click here to access.

The heart of a champion

From the New York Times article:

The high school wrestling career of Dustin Carter ended Friday in defeat but with an ovation from the crowd at the Schottenstein Center in Columbus, Ohio.

Carter, who had an acute bacterial infection in his bloodstream at age 5 and had parts of all of his limbs amputated, battled his way into Ohio’s Division II wrestling tournament as a 103-pound senior for Hillsboro High School.

...

“I told him, ‘Dusty, you went way beyond your expectations,’ ” Russ Carter said by telephone. “ ‘With everything you did, you inspired people out there.’ ”

I've categorized this as "Off topic," but is it really? Click here to access the article.

Rise in nursery product injuries

From the Wall Street Journal article:

Nursery products were involved in 66,400 injuries that sent children to emergency rooms in 2006, an 11% increase from the year earlier, according to the Consumer Product Safety Commission.

The agency said in a report yesterday that the number of injuries to infants and children under age five involving cribs, high chairs, walkers and other items rose by 6,600 from 59,800 in 2005.

Click here to access the article (sub. req.).

The China syndrome?

From the Wall Street Journal article:

The Food and Drug Administration needs more inspectors and a comprehensive computer database to better track products entering the U.S. from foreign sources, a top drug-safety official told lawmakers.

Click here to access (sub. req.).

FDA Public Health Update

Recall of Heparin Sodium Injection and Heparin Lock Flush Solution (Baxter)