A recent report from Hertfordshire Cohort, published in the journal Bone, has found new data showing when clinicians know their patients’ fall history, they are able to effectively predict future fractures. New tools have been created to help clinicians assess the level of risk patients may have after falls. Dr Mark Edwards, Clinical Research Fellow at the MRC Lifecourse Epidemiology Unit, University of Southampton says “Fracture prediction is extremely important to allow us to target treatment to those at greatest risk.” More here
According to a paper authored by Albert Mulley of the Dartmouth Center for Health Care Delivery Science, doctors often recommend treatments for their patients without an understanding of their preferences and priorities. For example, a recent study found that doctors believed 71 percent of breast cancer patients rated keeping their breast as a top priority, but the number among their patients was only seven percent. Research has also shown that people will choose different treatments as they become better informed about the risks and benefits associated with a particular treatment. According to Mulley, providing a better diagnosis of patients’ preferences is not only the right thing to do but it may also reduce healthcare costs, as better informed patients are often more careful about the number of procedures they undergo. More here.
A study from the Barcelona Biomedical Research Institute has found that a combination of daily exercise and a daily dose of melatonin can help regulate circadian rhythm and protect against brain deterioration in mice. The research studied the effects of exercise and melatonin on a group of mice in the earliest phases of Alzheimer’s disease and found those receiving treatment showed signs of significant regression in the disease. Researcher Coral Sanfeliu said it’s been known for years that combinations of anti-aging therapies such as physical exercise, a Mediterranean diet, and not smoking add years to one’s life. According to Sanfeliu, melatonin also appears to have important anti-aging effects. More here.
Among people over the age of 65, more than half have at least three chronic conditions, such as heart disease, diabetes, arthritis, high blood pressure, or Alzheimer’s disease. But, according to a new report from the American Geriatrics Society, healthcare providers often follow standard clinical guidelines for an individual disease when they may not be the safest or most effective treatment for a patient with multiple conditions. Cynthia M. Boyd, MD, MPH, of the Johns Hopkins University School of Medicine, said a clinician prescribing medications according to standard guidelines for an individual disease may end up with a patient who is taking too many medications and running a risk for drug interactions and harmful side effects. The report recommends a number of guiding principles for caring for seniors with multiple health problems, such as considering patient preferences, weighing risks, benefits, and burdens, interpreting research, and accounting for the complexity and feasibility of treatment options. More here.
A patient’s beliefs about treatment options and the cause of a disease can influence their willingness to follow a prescribed medication regimen, according to a study by Todd Ruppar of the MU Sinclair School of Nursing. Ruppar’s research focused on older patients being treated for high blood pressure, which affects nearly 70 million Americans. According to Ruppar, patients often have underlying beliefs about the causes of high blood pressure and how it can be treated, which lead them to underuse their medication. If a patient, for example, believes they can effectively control their blood pressure through diet and exercise they are less likely to faithfully follow their prescribed medication regimen. Ruppar believes practitioners should encourage more frequent monitoring of blood pressure levels to help patients associate taking their pills with health benefits. More here.
A study of nearly 6,000 men with prostate cancer found that those taking aspirin regularly as part of their treatment had a lower risk of death than those who didn’t take any type of anticoagulants. The study, authored by Dr. Kevin Choe of UT Southwestern Medical Center, suggests men who have received surgery or radiation as a treatment for prostate cancer may benefit from taking aspirin. Aspirin, along with other anticoagulation medication, has been shown to inhibit cancer growth and metastasis but there has previously been little clinical data on the topic. Dr. Choe said the results of the study suggest aspirin prevents growth of tumor cells, though there needs to be more research before recommending it to all prostate cancer patients. More here.
More than 100 million American adults suffer from chronic pain, according to a report from the Institute of Medicine. That’s nearly one-third of all Americans and more than the number affected by heart disease, cancer, and diabetes combined. But despite costing nearly $635 billion a year in treatment and lost productivity, chronic pain receives less attention and focus than other diseases and conditions. According to the report, government agencies, healthcare providers, professional associations, educators, and public and private funders of health care need to lead a transformation to better prevent, treat, and understand pain of all types. Among the recommendations offered by the Institute of Medicine were increased education and research to help health professionals better understand pain and the available treatments, as well as improving care by increasingly tailoring it to each patient’s experience. More here and here.
After reviewing medical literature produced between 1978 and 2009, researchers at Mount Sinai School of Medicine in New York concluded that there is a lack of evidence on overuse of medical services, with the exception of a few areas of limited study. Overuse, defined as services performed that have no benefit or do more harm than good, account for an estimated 30 percent of U.S. healthcare spending. But despite the staggering amount of waste produced by unnecessary medical treatment, diagnostic tests, medication, and therapeutic procedures, there is very little collected data on the issue and the majority of available studies concentrated on the overuse of antibiotics for upper respiratory tract infections and three cardiovascular procedures. The authors said that understanding the prevalence of overuse in healthcare services is necessary in order to improve quality and eliminate waste. More here and here.
The authors of a new study published in the New England Journal of Medicine used the records of the Massachusetts General Hospital to examine 200 years of healthcare trends. Their findings show that, during the hospital’s first 100 years, healthcare costs didn’t rise very quickly but, as mortality rates began to drop in the 20th century, so did the cost of treatment. Greg Meyer, MD, author of the study, said the review is the longest population health run ever looked at and noted the changing trajectory of costs over the past 10 years. Though there was a correlation between increasing costs and more effective treatments during the 20th century, the past 10 years has seen accelerated health expenses without a corresponding drop in mortality rates. Meyer said their findings highlight the need to work toward developing a more sustainable healthcare system. More here.
Atrial fibrillation is a heartbeat irregularity that can lead to stroke. But, according to recent research from Dr. Chen-Ying Hung, statins, widely used for cholesterol, may help prevent heartbeat abnormality in elderly patients with high-blood pressure. The study reviewed the medical records of 1 million people and found statins reduced the risk of developing atrial fibrillation by 19 percent. Despite the results, however, the study’s authors caution that the findings are preliminary and couldn’t yet confirm the effectiveness of statins for treatment of heartbeat abnormalities. Still the study is encouraging and adds to growing research testing the usefulness of statins for other diseases and conditions. More here.