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Monday, 30 April 2012

Princess Health and State prescription drug databases like KASPER cut back doctor shopping and drug abuse, new study shows.Princessiccia

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Research from the University of North Carolina indicates drug databases like the Kentucky All Schedule Prescription Electronic Reporting system do reduce doctor shopping and change prescribing behavior.

Another article showed state drug databases "facilitate a relative decrease over time in prescription drug misuse, despite state differences in program administration," reports Maggie Clark for Stateline, the freshly revised news service of The Pew Center on the States.

A 2010 evaluation of KASPER showed 90 percent of doctors who used the system found it effective in preventing drug abuse and doctor shopping. A new Kentucky law "mandates that all physicians and pharmacists who prescribe schedule II and III drugs, such as oxycodone and hydrocodone, check the patient's prescription records before writing or filling a prescription," Clark reports. Dispensers must also register prescriptions in the state database without 24 hours of writing or filling the prescription.

Clark points out the legislation change sparked a debate about "how to balance patient privacy and law enforcements needs in fighting a serious criminal and public health problem." Attorney General Jack Conway, who wanted KASPER put into his office's hands, lost that fight as part of the legislative compromise. It will remain the responsibility of the Cabinet for Health and Family Services and, by extension, the doctor-run Kentucky Board of Medical Licensure.

Privacy issues have likewise surfaced in Vermont. "The discussion really is about what kind of access the police will have to electronic personal health information," said Allen Gilbert, executive director of the Vermont Civil Liberties Union. (Read more)

Princess Health and Major newspapers publish reflections, reactions and details (including videos) on new law that will fight 'pill mills'.Princessiccia

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Reflections on the new law to fight "pill mills" are in both of Kentucky's major metropolitan newspapers today.

The Courier-Journal, which rightly takes partial credit for focusing attention on the issue, has a story by Laura Ungar that summarizes what the bill will do and not do. In the Lexington Herald-Leader, Kentucky Medical Association President Shawn Jones has an opinion piece defending his organization's lobbying against key parts of the bill.

"Unfortunately, in a desire to pass something, many did not consider the details of proposed legislation, and many of the details were extremely troublesome," writes Jones, right. "Most troubling were the proposed infringements on patient privacy through access to the state's Kentucky All Scheduled Prescription Electronic Reporting, or KASPER, system, which contains what is essentially a log of all of the controlled substances an individual has bought. A controlled substance is not just what many people have characterized as 'pain medicine.' It also includes prescriptions for medicines for anxiety, depression or attention deficit disorder." (Read more)

Jones is among the people featured in videos posted with The Courier-Journal's story. Others include Dr. Greg Cooper of Cynthiana; attorney Fox DeMoisey, who represents physicians accused of malpractice; and Dr. Patrick Murphy, a pain-management physician, talking about the various responsibilities of doctors in his field.

Sunday, 29 April 2012

Princess Health and Tonsillectomies not necessary much of the time; among $158 billion spent each year on unnecessary health care.Princessiccia

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Photo by Matthew Staver, Bloomberg
Tonsillectomies are the most common procedure for children requiring anesthesia. "The only problem is there's no evidence they work for most" kids, reports Sarah Cliff of The Washington Post.

"The procedure does show some benefits for those with really serious symptoms � very sore throats, fevers and other symptoms at least seven times in the past year � but no improvement for those whose indications are milder," Cliff reports.

Yet, more and more of the procedures are being performed. Between 1996 and 2006, the number of tonsillectomies increased by 74 percent.

"It's a silent epidemic of unnecessary care," said David Goodman of the Dartmouth Atlas of Health Care. "In most instances, it's done for patients with much less recurrent symptoms than should be indicated. I think a lot of this is unbeknownst to providers."

Unnecessary health care costs about $158 billion every year, Cliff reports, and the sum is partly to blame on demanding patients, to whom doctors acquiesce. Because doctors are paid based on volume, there is also an incentive to provide more care, even if it's not necessary.

Goodman said the medical education system is one main culprit. "Medical schools and graduate schools are failing us deeply," he said. "We need to move some of these ideas about the evidence being uncertain into the beginning of education. There's been such little work on that." (Read more)

Thursday, 26 April 2012

Princess Health and Couple loses combined 347 pounds in 2 years, pretty simply; similar success stories are always compelling.Princessiccia

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"When Art and Betty Halcomb look at each other, they still have a hard time believing how much weight they have lost," reports Nola Sizemore for the Harlan Daily Enterprise. Together, the couple has lost 347 pounds, a journey that started in April 2010.

Art weighed 384 pounds and Betty was 308. "We decided we were going to do everything we could do in a three-month period to see how much weight we could actually lose," Betty said. That included counting calories and daily exercise, which at first comprised for a half-mile of walking. Within two weeks, they were able to walk one mile.

"We did portion control with our meals, actually measuring out serving sizes," Betty said. "I was eating 1,200 calories per day and Art was eating 1,500 calories per day. We didn't limit ourselves to any certain foods. We wanted it to be a lifestyle change, not just another diet."

One of their major motivations was their daughter, Kristen Swanner, a two-time cancer survivor who has endured chemotherapy, radiation and a stem-cell transplant. To watch her "literally fight for her life and we were just throwing ours away, we felt so guilty," Betty said.

When they discovered Swanner was pregnant, after being told by doctors that she couldn't conceive, the couple had even more drive to shed the weight, knowing they were soon to be grandparents.

"Jesus says he wants us to have an abundant life," Betty said. "If we can do this, anyone can do it. Make that decision today to lose weight and live a more happier life. Don't give up � keep trying." (Read more)

Princess Health and Floyd County woman is Kentucky's smoke-free advocate of year.Princessiccia

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For her work spreading the word about second-hand smoke and founding the coalition that ultimately helped Prestonsburg pass a smoke-free ordinance in 2009, Floyd County's Jean V. Rosenberg was named 2012 advocate of the year at the annual Smoke-Free Policy Conference hosted by the University of Kentucky's Kentucky Center for Smoke-Free Policy. She stands with center Director Dr. Ellen Hahn, left, and Dr. Melissa Walton-Shirley, right, the Glasgow cardiologist who won in 2011.

Rosenberg started her work in 2005 when she began working for the Floyd County Health Department as a program specialist to increase awareness about the dangers of second-hand smoke, reports Ann Blackford reports in a university press release. During that time, she founded the Breathe Easy Floyd County Coalition, which educated people about second-hand smoke and supported local smoke-free initiatives.

On Nov. 1, 2009, the City of Prestonsburg implemented a 100 percent smoke-free ordinance in all workplaces and enclosed public places, with Rosenberg at the helm to propel the effort forward. (Read more)

Tuesday, 24 April 2012

Princess Health and Measles is still around; rate in 2011 was highest in 15 years.Princessiccia

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Measles virus (Photo by Scott Camazine/CDC/Getty Images)
In 2000, the Centers for Disease Control and Prevention declared measles had been eliminated in the United States. But last year, the nation had the most cases of the infectious disease since 1997.

A report released last week shows there were 222 cases of measles and 17 measles outbreaks in 2011. In a typical year, there are usually just 50 to 60 cases. This year, there have already been 25 cases.

"Of the 222 reported cases, 50 percent were associated with the 17 outbreaks and 90 percent were associated with importations from foreign countries � 26 percent from U.S. residents traveling abroad and 10 percent from foreign visitors," reports Alexandra Sifferlin for Time magazine.

Each case is treated with intense investigation because of the highly contagious nature of the virus. "You can catch measles just by being in a room where someone with measles has been, even if they left," said Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diesease. "It's serious; one out of three people who got it last year had to be hospitalized." No one died, however.

Of the 196 U.S. residents who contracted the virus last year, 166 had not been or did not know if they had been vaccinated. More than 80 percent of them were eligible for vaccine.

"Many people think diseases like measles are gone and that they do not need to vaccinate themselves or their children," Sifferlin reports. "But the CDC warns measles is still prevalent worldwide. Globally, about 20 million people get measles each year." (Read more)

Princess Health and Beshear OKs prescription bill, telling pill mills, 'Get out of this state'.Princessiccia

Princess Health and Beshear OKs prescription bill, telling pill mills, 'Get out of this state'.Princessiccia

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Saying it couldn't get to his desk quickly enough, Gov. Steve Beshear signed a bill aimed at curbing prescription drug abuse in celebration today, warning so-called pill mills to "Get out of this state, because we're coming after you."

House Bill 1 requires doctors and pharmacists who prescribe or dispense Schedule II and III drugs, such as oxycodone and morphine, to use the Kentucky All Schedule Prescription Electronic Reporting system and requires pain clinics to be owned by at least one physician. Clinics already in operation that have not had trouble with the law but are not owned by doctors will be grandfathered in under the law.

Though there was a strong push for it by law enforcement, the bill will not move KASPER over to the attorney general's office but will stay under the control of the Cabinet for Health and Family Services and the doctor-controlled Kentucky Board of Medical Licensure.

House Speaker Greg Stumbo, who sponsored the bill, called the legislation "a major step forward in the ongoing battle to put the brakes on prescription drug abuse."

Though KASPER will not move to  Attorney General Jack Conway's office, as Conway wanted, he endorsed the effort. "It helps keep entrepreneurs out of the pill mill business and requires doctors, with reasonable exceptions, to use the KASPER system," he said. "I encourage those who are fearful of increased oversight to end the hyperbole and begin a constructive process with the legislature and executive branch to implement this bill." (Read more)
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