The top ways to empower yourself and take your health care into your hands this year
http://rss.cnn.com/~r/rss/cnn_health/~3/uSyw4UWdILY/index.html
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The top ways to empower yourself and take your health care into your hands this year
http://rss.cnn.com/~r/rss/cnn_health/~3/uSyw4UWdILY/index.html
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http://www.medpagetoday.com/PrimaryCare/Obesity/17690
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I tell all my patients to bring with them a list of all the medicines they take. I tell them to please write down questions prior to our visit. I give them paper to takes notes during our visit. I try and provide them with a list of websites I have visited that I think provides good quality info (see my blog for a list of these sites).
Here's the article:
"Doctors are often rushed, so patients must come to appointments prepared. Learn five steps to having a successful doctor appointment."
http://rss.cnn.com/~r/rss/cnn_health/~3/J655gMaI74M/index.html
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Research on sub-lipid particles, like LP(a), will be useful to measure to help reduce patients "residual risk", once LDL is < 70mg/dL.
"A novel genetic study provides the strongest evidence to date that Lp(a) is a causative factor for coronary disease; the results suggest that medications targeting Lp(a) could lower the risk of..."
For complete story visit theheart.org.
http://feedproxy.google.com/~r/Theheartorg/~3/hUUOufRwL5U/1036877.do
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Originally published in MedPage Today
by Katrina Woznicki, MedPage Today Contributing Writer
Hospitalized patients were often clueless when asked about their medications, with almost all of them unable to name all their medications and many leaving out as many as a half-dozen drugs they have been prescribed, according to a small survey of patients in a Colorado hospital.
Ninety-six percent of the 50 patients surveyed left out at least one drug when they were asked to list their medications, and, on average, patients omitted 6.8 medications, Ethan Cumbler, MD, of the University of Denver, and colleagues reported in the Dec. 10 issue of Journal of Hospital Medicine.
Moreover, 44% of the patients thought they were taking a medication that had not been prescribed.
The researchers conducted the patient survey as part of a larger project examining a potential role for patients in reducing medication errors and improving patient safety.
"This study is a first for raising the questions How involved should patients be in their hospital medication safety?' and How do you involve them?'" Cumbler told MedPage Today.
"We don't live in a perfect healthcare system and errors do occur. If you have a patient who wants to be involved in their medication safety, you have to let him or her know what they're taking and to let them be an active participant."
Among scheduled medications, patients commonly omitted several important therapeutics, including antibiotics, cardiovascular drugs, and antithrombotics.
When asked about PRN medications, patients were most likely to omit analgesics and gastrointestinal medications.
"The patient, as the last link in the medication administration chain, represents the final individual capable of preventing an incorrect medication administration," Cumbler et al wrote in the journal article.
But if the survey reflects the average hospital patient, this is a weak link.
The majority of the participants, 81%, said seeing a hospital medication list would improve their satisfaction with the care they received; however, only 28% reported that they saw such a list.
A total of 50 participants answered questions about their outpatient and inpatient medications and described their attitudes about hospital medications and level of interest in patient involvement in hospital safety.
The findings, Cumbler added, only provide a snapshot of one small group of inpatients at one hospital.
The average age of participants was 54, 46% were men, and 74% were non-Hispanic white.
Patients were on an average of 5.3 outpatient prescription medications, 2.2 over-the-counter medications, and 0.2 herbal remedies.
Age did prove to be a factor in patients' ability to accurately identify their hospital medications. Patients age 65 and younger omitted 60% of their PRN medications, whereas patients 65 and older failed to report 88% (P=0.01).
Hospital organizational culture and the complexity of medicine itself pose challenges for inpatients to keep track of their medications, said Ruth S. Day, PhD, Director of the Medical Cognition Laboratory and Associate Professor of Psychology and Neuroscience at Duke University, who was not involved in the study.
"People have trouble perceiving, pronouncing, and remembering medication names even under the best of circumstances," Day said in an interview.
Protocols for outpatient medication monitoring have garnered a lot of attention, added Derung Mimi Tarn, MD, PhD, Assistant Professor of Family Medicine at the University of California at Los Angeles Medical Center, who was not a part of the study.
However, there has been very little focus on the inpatient setting, and it is not routine to give patients medication lists in the hospital. The issue, Tarn said in an interview, warrants further investigation.
Moreover, whether patients could even be effective at reducing hospital medication errors is uncertain.
Patients with dementia or delirium or those in the ICU may not prove helpful in ensuring hospital medication safety, said Tang. "However, there are definitely patients in the hospital who could serve as a valuable stopgap for example, obstetrics patients and parents of pediatric patients," she said. "The level of patient participation would need to be individually based."
Cumbler agreed that "one solution will not work for all," and that approaches to inform inpatients may have to be customized depending on factors such as condition and age.
The study, he added, was only designed to assess whether patients were informed about their hospital medications and whether they were interested and prepared to be more active participants in their care.
Visit MedPageToday.com for more hospital news.
Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook.
Related Posts
Medication reconciliation
Is the hospital July phenomenon a myth?
On medication lists
A doctor posts bail to give an inmate his medication
Are patients refusing doctors who no longer do hospital work?
http://www.kevinmd.com/blog/2009/12/medication-mistakes-happen-hospital.html
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Thank you for contacting me regarding your concerns about decreased Medicare payments to physicians and other providers of Medicare services. I, too, am very concerned about a viable long-term solution to the payment formula and have taken numerous actions in the Senate to achieve this. Fair payments to physicians and other health care providers are critical to preserving access for more than 44 million American senior citizens who depend on the Medicare program for their essential health services.
I understand and share your views that the rising costs attributable to physicians' services must be taken into consideration when determining Medicare reimbursement. As you know, Medicare law specifies a formula for calculating the annual update in payments for physicians' services. Many Members of Congress, myself included, continue to be concerned about the potential impact of payment reductions on patients' access to services. During my time in the Senate, I supported a number of efforts to examine Medicare updates for payments under the physician fee schedule, as well as legislation designed to undo any impending Medicare cuts to physicians, hospitals, nursing homes, home health care agencies, and other health care providers; and I will continue to do so.
While legislative interventions have prevented payment reductions from occurring in the past, Congress has not addressed the underlying issue of the payment formula accurately reflecting practice costs. Because of my continued concerns about ensuring sufficient payments to physicians, last Congress I sent letters to the Administrator of the Centers for Medicare and Medicaid Services in support of a viable solution to the Medicare physician reimbursement formula and asked congressional leadership to bring legislation to the floor to stop impending cuts and find a long-term solution to the issue. I understand these cuts in physician payments for Medicare services are unsustainable, especially given the rising costs of health care services; and I made my concerns known to those who serve on the Senate Finance Committee as they worked to craft physician payment legislation. In addition, I was supportive of legislative efforts to pass a two-year payment fix so that Congress would not have to repeat this process every year and physicians would have stability in payments beyond one calendar year.
Medicare payment policies and potential changes to these policies are of continuing interest to Congress. The Medicare program has been a major focus of deficit reduction legislation since 1980. With certain exceptions, reductions in program spending have been achieved largely through regulating payments to providers, primarily hospitals and physicians.
Although the task confronting Congress in rectifying the Medicare physician payment formula is formidable, it is one to which I remain committed to finding a more lasting solution. Any actions the Administration can take to more accurately account for the realities of spending on practitioner services under this formula, both as to actual spending and target spending, will help facilitate Congress' efforts and enhance access to the high-quality care that Medicare patients need and deserve.
Please be assured that I remain firmly committed to restoring adequate funding to Medicare physician and patient services during this 111th Congress and beyond. As we debate comprehensive health care reform policy, this issue is critical toward ensuring the ability of providers to deliver high-quality care and services and for Medicare beneficiaries to continue to access essential health care services.
Thank you again for sharing your views and concerns with me. I hope you will continue to visit my website at http://lieberman.senate.gov <http://lieberman.senate.gov/> for updated news about my work on behalf of Connecticut and the nation. Please contact me if you have any additional questions or comments about our work in Congress.
Sincerely,
Joseph I. Lieberman
UNITED STATES SENATOR
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Please contact you Congressmen to ask them to support this very
important bill.
http://lewinreport.acc.org/post/Our-Bill-Was-Introduced.aspx
" AHA is, this year, trying to focus minds on cardiovascular health, rather than cardiovascular disease, as it unveils its latest statistics. Understanding the numbers that underlie cardiovascular...
For complete story visit theheart.org."
http://feedproxy.google.com/~r/Theheartorg/~3/dJpOphZ4doQ/1036145.do
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The Food and Drug Administration (FDA) Endocrinologic and Metabolic Drugs Advisory Committee voted 12 to 4 today, with one abstention, in favor of broadening the indication for rosuvastatin (Crestor, AstraZeneca) to include patients with normal LDL-cholesterol levels but who are at low to moderate risk for cardiovascular disease based on other risk factors, most notably elevated levels of high-sensitivity C-reactive protein (hs-CRP).
Specifically, the advisory panel felt there was sufficient evidence of benefit to justify the risks of prescribing rosuvastatin in men >50 years old and women >60 years old who had fasting LDL-cholesterol levels <130 mg/dL, hs-CRP >2.0 mg/dL, triglycerides <500 mg/dL, and no prior
http://feedproxy.google.com/~r/Theheartorg/~3/O0tKRhDBo5E/1035155.do
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http://www.womenshealthmag.com/node/17904
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http://www.webmd.com/menopause/news/20091211/ldl-rises-around-time-of-menopause?src=RSS_PUBLIC
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http://www.medpagetoday.com/Cardiology/Atherosclerosis/17456
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http://www.medpagetoday.com/OBGYN/Menopause/17450
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http://feedproxy.google.com/~r/wsj/health/feed/~3/WPSNTEqtUtA/
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Last week I finished listening to his book "Complications"
His writings on the health care debate have been seminal (and he has the ear of Obama)
http://m.npr.org/news/playlist/121229972
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A report by the American Cancer Society says cancer deaths overall in the United States have been dropping since the 1990s. Researchers say that the decades-long effort to improve diets and reduce bad habits, like smoking, have begun to pay off.
Copyright © 2009 National Public Radio®. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.
RENEE MONTAGNE, host:
New cancer cases and the death rate from the disease have both dropped significantly over the last five years. Researchers say one reason is that decades of pushing to improve diets and reduce bad habits has begun to pay off. NPR's Patti Neighmond reports on the findings published in the journal Cancer.
PATTI NEIGHMOND: In order to understand what the slow but steady decline in cancer death means, look at it this way, says oncologist Otis Brawley, chief medical officer for the American Cancer Society. Compare the risk in 2006 to 15 years earlier, in 1991.
Dr. OTIS BRAWLEY (American Cancer Society): All told, the population as a whole has a 16 percent lower risk of dying from cancer in 2006 versus 1991.
NEIGHMOND: Men are still more likely to get cancer, but they did see the greatest reduction in risk. 2006 is the most recent year data's available. These findings confirm earlier evidence that cancer rates are down. One huge reason: People are quitting smoking and fewer are starting.
Dr. BRAWLEY: The population went from about 50 percent of people smoking, or men smoking especially, in the 1960s, to now about 25 percent smoking. And that's driven down lung cancer.
NEIGHMOND: The biggest cancer killer. Lung cancer cases are down. So are cases of the second biggest cancer killer - colon cancer. Brawley says people are changing their diets to include more colon-friendly food like fruits, fiber and vegetables. People are exercising more, which also helps. But overwhelmingly, he says, the biggest change is in screening for the disease. Epidemiologist and study researcher Elizabeth Ward with the American Cancer Society says the most effective screening method is colonoscopy.
Dr. ELIZABETH WARD (American Cancer Society): Colonoscopies is in many ways the gold standard of colorectal screening tests, because it allows for examination of the entire colon. The physician can actually visualize polyps or early cancers and in some cases remove them during the exam itself.
NEIGHMOND: Ward says the cancer declines are remarkable but adds quickly it could be better. For example, with colon cancer only about half the people who should be screened are. Many of those who aren't screened are African-American and Hispanic.
Dr. WARD: Both African-American and Hispanic populations still have lower rates of private health insurance and either lack health insurance or are covered by some public programs that don't have access to the full range of colorectal cancer screening tests and may not even be able to readily see a physician when they note signs and symptoms of colorectal cancers such as blood in the stool.
NEIGHMOND: In the meantime, health experts like Brawley worry that the obesity epidemic could undo many of these recent cancer gains.
Dr. BRAWLEY: The increasing obesity epidemic in the United States could very well cause a tsunami of cancer in the next 20 to 30 years. Already we have increases in esophageal cancer, increases in pancreas cancer, that are all related to obesity.
NEIGHMOND: Obesity is also linked to breast, prostrate, uterine, colon, liver and kidney cancer.
Patti Neighmond, NPR News.
The AP (12/8, Neergaard) reports that "a major push is under way around the country to cut rehospitalizations, in part by arming patients with simple steps to keep their recovery on track -- like getting past harried receptionists for quicker follow-up doctor visits, and reducing medication confusion." Dr. Harlan Krumholz, of Yale University, "helped the American College of Cardiology begin a 'Hospital to Home' program this fall, signing up hundreds of hospitals to share solutions with the goal of cutting heart patients' readmissions by 20 percent within three years." Dr. Krumholz said, "Somehow this idea of one in four people landing back in the hospital in a month is treated as business as usual, that it's part of being sick in America. It doesn't have to be that way."
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Vitamin sales in the United States are expected to grow 8 percent this year to $9.2 billion, according to Nutrition Business Journal.
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Unstable Angina originally appeared on About.com Heart Disease on Friday, December 4th, 2009 at 07:16:51.
http://heartdisease.about.com/b/2009/12/04/unstable-angina.htm
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These days, Becky Griggs starts her morning well before the sun comes up, in time to meet her clients at the gym at 5:30. It's a big change from six years ago, when she was 352 pounds and, as she calls it, engaged in a "slow form of suicide."
http://rss.cnn.com/~r/rss/cnn_health/~3/b6mhkBv0oy4/index.html
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Article to follow:
The chance of surviving an out-of-hospital cardiac arrest has not improved since the 1950s, according to a report by the University of Michigan Health System. The analysis shows only 7.6 percent of victims survive an out-of-hospital cardiac arrest, a number that has not changed significantly in almost 30 years...
http://www.medicalnewstoday.com/articles/172809.php
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Elevated blood cholesterol is bad news. Thirty-four million Americans
have levels that can increase their risk of all sorts of health
problems. But if you think you've heard everything you need to know
about this waxy fat, there may be a few surprises in store.
http://rss.cnn.com/~r/rss/cnn_health/~3/8dWwALL5w3Y/index.html
• If too much is circulating in the blood, it can begin to build up on
the walls of blood vessels
• Buildup of cholesterol contributes to the development of plaque in
the blood vessels
• Plaque makes blood vessels narrower and less flexible and increase
the risk for heart attack and stroke