Elderly Lack Preventive Care
Many elderly Medicare patients fail to get routine preventive care, according to a study by researchers at the Center for Studying Health System Change (HSC) and Memorial Sloan-Kettering Cancer Center. In analyzing six preventive services covered by Medicare (routine blood tests and eye examinations for diabetes patients; colon and breast cancer screening; and influenza and pneumococcal vaccinations), researchers found that half of eligible Medicare beneficiaries or fewer received the recommended care in 2001. Specifically, 48% and 56% of beneficiaries with diabetes received eye examinations and hemoglobin A1c tests, respectively; 47% of women aged 65–75 years received mammograms; and 47% of all beneficiaries received flu shots. However, Medicare patients cared for by board-certified physicians in larger practices treating fewer poor patients were the patients most likely to receive cancer screenings and other preventive care. The study appeared in the July 27 Journal of the American Medical Association.
Clinician's Guide to Alcoholism
Physicians have a new tool to help them identify and care for patients with heavy drinking and alcohol use disorders. About 3 in 10 U.S. adults drink at levels that increase their risk for physical, mental health, and social problems. Of these heavy drinkers, about one in four currently has alcohol dependence problems that often go undetected in medical and mental health care settings. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recently released a new guide called “Helping Patients Who Drink Too Much: A Clinician's Guide,” which offers guidance for conducting brief interventions and managing patient care. If a patient drinks heavily (five or more drinks in a day for men or four or more for women), the guide shows physicians how to look for symptoms of alcohol abuse or dependence. The guide is at
Influence of Free Drug Samples
Readily accessible, free drug samples can influence the prescribing behavior of residents, according to a study from the University of Minnesota and Abbott Northwestern Hospital. Researchers observed 29 internal medicine residents over a 6-month period in an inner-city primary care clinic. After selecting drug classes where samples of heavily advertised drugs were provided to the clinic, and where lower-priced alternative formulations existed, the authors looked for prescribing differences between physicians who had access to free samples and those who had been randomized to a group that agreed not to use samples. “We found that resident physicians with access to drug samples in clinic were more likely to write new prescriptions for heavily advertised drugs and less likely to recommend over-the-counter drugs than their peers,” said lead author Richard F. Adair, M.D. There was also a trend toward less use of inexpensive drugs. The study was published in the August issue of The American Journal of Medicine.
The OxyContin Wars
The federal Drug Enforcement Administration's efforts to stop illegal use of the prescription painkiller OxyContin have “cast a chill over the doctor-patient candor necessary for successful treatment,” Ronald T. Libby, Ph.D., a political science professor at the University of North Florida in Jacksonville, wrote in a policy analysis for the Cato Institute, a libertarian think tank. The DEA's campaign includes elevating OxyContin to the status of other schedule II substances and using “aggressive undercover investigation, asset forfeiture, and informers,” he noted. When asked to comment, a DEA spokeswoman referred to a recent statement by DEA Administrator Karen Tandy. “We employ a balanced approach that recognizes both the unquestioned need for responsible pain medication, and the possibility of criminal drug trafficking,” Ms. Tandy said, noting that physicians “are an extremely small part of the problem.”
Osteopathic Medical Concepts
Osteopathic terminology for the first time has been added to the latest version of the College of American Pathologists' Systematized Nomenclature of Medicine (SNOMED) clinical terms. The latest release incorporates more than 230 osteopathic medical concepts including procedures, diagnoses, and even subtle anatomic aberrations well known to osteopathic physicians. “The availability of the osteopathic medical content in SNOMED clinical terms represents an additional opportunity to make unique terminology available to national and international clinical and research audiences,” said Franklin R. Elevitch, M.D., chair of SNOMED International Authority. The American Osteopathic Association collaborated with SNOMED on the project to include the terminology.
Call to Action on Disability
The U.S. Surgeon General has issued his first-ever Call to Action on Disability. The report outlines goals for improving the lives of individuals with disabilities. Goals include increasing knowledge among health care professionals; providing them with tools to screen, diagnose, and treat the whole person with a disability with dignity; and increasing accessible health care and support services to promote independence for people with disabilities. “The reality is that for too long we provided lesser care to people with disabilities,” Surgeon General Richard H. Carmona said in a statement. “Today, we must redouble our efforts so that people with disabilities achieve full access to disease prevention and health promotion services.” The document is available at