Below is an abstract I can across this morning. Unfortunately I am traveling to the memorial service for the great American poet, William Meredith, at my alma mater and do not have the time to read or research everything today. Just wanted to give you a clip of some interesting work - although (again) it is self-reported, the numbers are more in line with the average.
Department of Public Health and Community Medicine, Göteborg University, Box 453, SE-405 30 Göteborg, Sweden.
Beliefs about medicines and self-reported adherence among pharmacy clients.
OBJECTIVES: To analyse any association between general beliefs about medicines and self-reported adherence among pharmacy clients. Further, to examine general beliefs about medicines by background variables.
METHODS: The data were collected by questionnaires including the general section of the Beliefs about Medicines Questionnaire (BMQ), the self-reporting Medication Adherence Report Scale (MARS) and the following background variables: gender, age, education, country of birth and medicine use. The General BMQ measures beliefs about medicines as something harmful (General-Harm), beneficial (General-Benefit) and beliefs about how doctors prescribe medicines (General-Overuse).
RESULTS: Of the 324 participating pharmacy clients, 54% were considered non-adherent. An association was found between General-Harm and adherence. Adherent behaviour and higher level of education were associated respectively with more beneficial and less harmful beliefs about medicines. Those born in the Nordic countries regarded medicines as more beneficial. Current users of herbal medicines and non-users of medicines were more likely to believe that doctors overprescribed medicines.
CONCLUSIONS: General-Harm was associated with adherence to medication among Swedish pharmacy clients. Country of birth, education and medicine use influenced beliefs about medicines.
PRACTICE IMPLICATIONS: Increased awareness of the patient's beliefs about medicines is needed among healthcare providers. We should encourage patients to express their views about medicines in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication.
Friday, October 5, 2007
Thursday, October 4, 2007
Half of Hypertensive CA Adults Take Drugs for Blood Pressure
This is a press release from the American Heart Association. I have been at a conference this week, but wanted to post this information. My comments will come at a later date.
About half of California adults diagnosed with high blood pressure, or hypertension, do not take medication to lower it, researchers reported today at the American Heart Association’s 61st Annual Fall Conference of the Council for High Blood Pressure Research.
Of those who do, regularly seeing a doctor makes a big difference in their medication adherence.
In a study of California adults, of 42,044 respondents, 11,467 of them said a doctor had told them they had high blood pressure. When adjusted for age, this yielded a prevalence rate of 24.5 percent.
Researchers also found, on an age-adjusted basis, that 49.4 percent of those diagnosed with hypertension, a potentially life-threatening disease, were not taking drugs to lower it. People who had seen a physician during the prior year were more than five times more likely to be on medication than were those who had not.
“That was informative,” said David J. Reynen, M.P.P.A., M.P.H., lead author of the study. “It really underscores the importance of having routine care.”
High blood pressure is a major risk factor for heart attacks and strokes, and it increases a person’s risk of heart failure, kidney disease and blindness.
Doctors recommend drug treatment when a person’s blood pressure consistently measures 140/90 millimeters of mercury (mm Hg) or higher.
Reynen and his colleagues at the California Department of Public Health’s Heart Disease and Stroke Prevention Program in Sacramento wanted a clearer picture of high blood pressure in their state. They proposed a series of questions to be included in the California Health Interview Survey, which is conducted by telephone every two years, and then analyzed the results.
“Unfortunately, the data are collected in such a way that we don’t know to what degree the individual respondents have hypertension,” Reynen said. “One in four adults in California, including one in three African Americans, is hypertensive,” he said. “We talk about people needing to know their numbers. That means not just whether your blood pressure is high or low, but your actual numbers. This study reinforces that.”
The researchers used age-adjustment to standardize the survey results so they could more accurately compare various groups.
Among those surveyed with high blood pressure, the analysis showed that the age-adjusted odds of a person taking drugs to lower blood pressure are:
5.23 times higher for people who saw a physician within the past year compared to those who did not;
2.47 times higher for those with diabetes than those without the disease;
2.05 times higher for those who had health insurance than those who did not;
1.71 times higher for African Americans than for whites (the racial/ethnic groups, respectively, with the highest and lowest high blood pressure rate);
1.46 times higher for people who described their health as poor or fair compared to those in good health;
1.40 times higher for patients diagnosed with heart disease than those without it;
1.38 times higher for smokers than nonsmokers;
1.27 times higher for U.S.-born individuals than foreign-born;
1.21 times higher for people with some form of formal education after graduating high school than those with less formal education.
“Understanding these factors may allow us to develop better strategies to increase the use of blood-pressure-lowering drugs among those with high blood pressure,” Reynen said.
The age-adjusted prevalence of high blood pressure and drug treatment sometimes varied considerably among the various groups surveyed:
African Americans had the highest prevalence of high blood pressure (35 percent), followed by American Indians (29.8 percent), Pacific Islanders (27.2 percent), those of other race/ethnicity (25.9 percent), Latinos (25.0 percent), Asians (24.5 percent) and whites (23.1 percent).
African Americans had the highest rate of drug use to control their high blood pressure (56.6 percent), followed by American Indians (53.1 percent), Asians (52.1 percent), Pacific Islanders (52 percent), whites (49 percent), Latinos (45.8 percent) and those of other race/ethnicity (44.4 percent).
“Physicians should be mindful of these kinds of associated factors when developing treatment plans, and public health officials should be mindful of them when developing public health interventions,” Reynen said. “Knowing someone’s racial/ethnic group may be helpful to us when we try to target messages to this population to tell them they need to see a physician if they have high blood pressure.”
About half of California adults diagnosed with high blood pressure, or hypertension, do not take medication to lower it, researchers reported today at the American Heart Association’s 61st Annual Fall Conference of the Council for High Blood Pressure Research.
Of those who do, regularly seeing a doctor makes a big difference in their medication adherence.
In a study of California adults, of 42,044 respondents, 11,467 of them said a doctor had told them they had high blood pressure. When adjusted for age, this yielded a prevalence rate of 24.5 percent.
Researchers also found, on an age-adjusted basis, that 49.4 percent of those diagnosed with hypertension, a potentially life-threatening disease, were not taking drugs to lower it. People who had seen a physician during the prior year were more than five times more likely to be on medication than were those who had not.
“That was informative,” said David J. Reynen, M.P.P.A., M.P.H., lead author of the study. “It really underscores the importance of having routine care.”
High blood pressure is a major risk factor for heart attacks and strokes, and it increases a person’s risk of heart failure, kidney disease and blindness.
Doctors recommend drug treatment when a person’s blood pressure consistently measures 140/90 millimeters of mercury (mm Hg) or higher.
Reynen and his colleagues at the California Department of Public Health’s Heart Disease and Stroke Prevention Program in Sacramento wanted a clearer picture of high blood pressure in their state. They proposed a series of questions to be included in the California Health Interview Survey, which is conducted by telephone every two years, and then analyzed the results.
“Unfortunately, the data are collected in such a way that we don’t know to what degree the individual respondents have hypertension,” Reynen said. “One in four adults in California, including one in three African Americans, is hypertensive,” he said. “We talk about people needing to know their numbers. That means not just whether your blood pressure is high or low, but your actual numbers. This study reinforces that.”
The researchers used age-adjustment to standardize the survey results so they could more accurately compare various groups.
Among those surveyed with high blood pressure, the analysis showed that the age-adjusted odds of a person taking drugs to lower blood pressure are:
5.23 times higher for people who saw a physician within the past year compared to those who did not;
2.47 times higher for those with diabetes than those without the disease;
2.05 times higher for those who had health insurance than those who did not;
1.71 times higher for African Americans than for whites (the racial/ethnic groups, respectively, with the highest and lowest high blood pressure rate);
1.46 times higher for people who described their health as poor or fair compared to those in good health;
1.40 times higher for patients diagnosed with heart disease than those without it;
1.38 times higher for smokers than nonsmokers;
1.27 times higher for U.S.-born individuals than foreign-born;
1.21 times higher for people with some form of formal education after graduating high school than those with less formal education.
“Understanding these factors may allow us to develop better strategies to increase the use of blood-pressure-lowering drugs among those with high blood pressure,” Reynen said.
The age-adjusted prevalence of high blood pressure and drug treatment sometimes varied considerably among the various groups surveyed:
African Americans had the highest prevalence of high blood pressure (35 percent), followed by American Indians (29.8 percent), Pacific Islanders (27.2 percent), those of other race/ethnicity (25.9 percent), Latinos (25.0 percent), Asians (24.5 percent) and whites (23.1 percent).
African Americans had the highest rate of drug use to control their high blood pressure (56.6 percent), followed by American Indians (53.1 percent), Asians (52.1 percent), Pacific Islanders (52 percent), whites (49 percent), Latinos (45.8 percent) and those of other race/ethnicity (44.4 percent).
“Physicians should be mindful of these kinds of associated factors when developing treatment plans, and public health officials should be mindful of them when developing public health interventions,” Reynen said. “Knowing someone’s racial/ethnic group may be helpful to us when we try to target messages to this population to tell them they need to see a physician if they have high blood pressure.”
Friday, September 28, 2007
New Weapon for Flu Pandemic: Jello Shots Up Your Nose!
This article is from US - PharmaTechnologist. No real comments save I think this is pretty neat. It will definately help with flu shots, as a number of people hate needles. It could be kind of gross however, if the jelly stays to long! Everyone laughed at me in college, but I knew investing in an aloe vera farm would pay off one day!
No wobbles for jelly nasal spray vaccine
By Katrina Megget
9/27/2007 - It is not the same as jellied pig's trotters, but a jelly nose has the 'exciting potential' to be the next weapon in the arsenal against pandemic flu.
Researchers at Texas A&M University, in conjunction with DelSite Biotechnologies, are working on a pandemic flu vaccine based on a powder nasal spray that forms a jelly in the nose.
While still at animal trial level, studies have so far shown the jelly substance that forms in the nose after spraying keeps the vaccine antigen in the nasal passage for longer giving the immune system a greater and prolonged stimulus.
"When this powder vaccine is puffed into the nose, it forms a jelly-like substance that clings to the inside of the nose and is absorbed into the body much more effectively. It stays longer and it has more time to do its work," Texas A&M University College of Veterinary Medicine and Biomedical Sciences pathobiology professor Dr Ian Tizard said.
The vaccine is formulated using an undisclosed carbohydrate from the Aloe vera plant which is mixed with the vaccine component and dried together to form a powder.
On contact with the moisture of the nasal passage, the powder is reconstituted; dissolving the product and interacting with the carbohydrate to form a jelly.
"This powder form is more effective than a liquid spray because the nose tends to clear liquid sprays out, while the powder turns into a sticky gel and can be a much more potent vaccine," Tizard said.
One or two puffs into the nose was all that was needed to get results. The length of time the jelly would stay in a human nose was currently unknown.
The unique Aloe vera carbohydrate was yet to be approved as an excipient in the vaccine, but meetings with authorities were expected next month to discuss the ingredient, Tizard told US-PharmaTechnologist.com.
The carbohydrate is extracted from the leaves of the Aloe vera through a number of extraction steps thereby removing the other beneficially therapeutic compounds the plant is famous for.
"There is no other evidence the carbohydrate has any other effect other than reducing clearance from the nose," Tizard said.
Besides being retained in the nose for longer in the jelly form, the vaccine had other benefits Tizard said, including being a needle-free vaccine, being formulated as a dry powder which was more stable and could be stored for longer, and showing "significant dose sparing relative to other intranasal vaccines" without the use of an adjuvant.
The vaccine was currently being developed for pandemic bird flu, but Tizard said the technology could work to develop vaccines for other diseases.
"The plan was to try this first as a vaccine for bird flu in humans because there was an immediate concern there, and there still is the possibility that a widespread bird flu epidemic could break out somewhere in the world. But there is no reason to think this method of vaccine treatment would not work for many other diseases too. We think it's an exciting breakthrough that has great potential," Tizard said.
While the development of the vaccine was still early, tests on humans were expected to begin next year.
MedImmune has had its liquid nasal spray flu vaccine, FluMist, on the market since 2003, which was the first needle-free flu vaccine available on the market, and the company is developing a next generation nasal mist flu vaccine.
The nose jelly project is funded in part by a $6m grant from the National Institutes of Health awarded to DelSite Biotechnologies in conjunction with the Texas A&M teams.
No wobbles for jelly nasal spray vaccine
By Katrina Megget
9/27/2007 - It is not the same as jellied pig's trotters, but a jelly nose has the 'exciting potential' to be the next weapon in the arsenal against pandemic flu.
Researchers at Texas A&M University, in conjunction with DelSite Biotechnologies, are working on a pandemic flu vaccine based on a powder nasal spray that forms a jelly in the nose.
While still at animal trial level, studies have so far shown the jelly substance that forms in the nose after spraying keeps the vaccine antigen in the nasal passage for longer giving the immune system a greater and prolonged stimulus.
"When this powder vaccine is puffed into the nose, it forms a jelly-like substance that clings to the inside of the nose and is absorbed into the body much more effectively. It stays longer and it has more time to do its work," Texas A&M University College of Veterinary Medicine and Biomedical Sciences pathobiology professor Dr Ian Tizard said.
The vaccine is formulated using an undisclosed carbohydrate from the Aloe vera plant which is mixed with the vaccine component and dried together to form a powder.
On contact with the moisture of the nasal passage, the powder is reconstituted; dissolving the product and interacting with the carbohydrate to form a jelly.
"This powder form is more effective than a liquid spray because the nose tends to clear liquid sprays out, while the powder turns into a sticky gel and can be a much more potent vaccine," Tizard said.
One or two puffs into the nose was all that was needed to get results. The length of time the jelly would stay in a human nose was currently unknown.
The unique Aloe vera carbohydrate was yet to be approved as an excipient in the vaccine, but meetings with authorities were expected next month to discuss the ingredient, Tizard told US-PharmaTechnologist.com.
The carbohydrate is extracted from the leaves of the Aloe vera through a number of extraction steps thereby removing the other beneficially therapeutic compounds the plant is famous for.
"There is no other evidence the carbohydrate has any other effect other than reducing clearance from the nose," Tizard said.
Besides being retained in the nose for longer in the jelly form, the vaccine had other benefits Tizard said, including being a needle-free vaccine, being formulated as a dry powder which was more stable and could be stored for longer, and showing "significant dose sparing relative to other intranasal vaccines" without the use of an adjuvant.
The vaccine was currently being developed for pandemic bird flu, but Tizard said the technology could work to develop vaccines for other diseases.
"The plan was to try this first as a vaccine for bird flu in humans because there was an immediate concern there, and there still is the possibility that a widespread bird flu epidemic could break out somewhere in the world. But there is no reason to think this method of vaccine treatment would not work for many other diseases too. We think it's an exciting breakthrough that has great potential," Tizard said.
While the development of the vaccine was still early, tests on humans were expected to begin next year.
MedImmune has had its liquid nasal spray flu vaccine, FluMist, on the market since 2003, which was the first needle-free flu vaccine available on the market, and the company is developing a next generation nasal mist flu vaccine.
The nose jelly project is funded in part by a $6m grant from the National Institutes of Health awarded to DelSite Biotechnologies in conjunction with the Texas A&M teams.
Monday, September 24, 2007
Quotes from Heart and Soul Researcher
Here is a little follow-up to my post on 9.17.07 regarding the Heart and Soul Study. Here are some quotes from the researcher Dr Anil K Gehi from Emory University School of Medicine, Atlanta, GA. These quotes are from an article on the website theheart.com by Lisa Nainggolan 9.24.07:
"We've shown that simply asking the patient whether they were adherent to their medication is a pretty decent way to identify those patients we might need to focus on," Gehi told heartwire.
"The bottom line is that medication nonadherence is a big predictor of adverse cardiovascular outcomes, and we found that the risk associated with nonadherence was equivalent to that associated with diabetes or smoking. Nonadherence is really a big deal that a lot of physicians don't look at carefully, and it's not a difficult thing to find out."
"We have shown that it's not a difficult thing to find out about adherence, but this is something that perhaps physicians overlook. Our study helps emphasize how important it is; then, something can be done about addressing the specific issues relating to adherence with that patient."
Those who are found to be nonadherent can be targeted with a number of approaches; Gehi suggests such strategies as pillboxes, getting family involved in medication, and arranging more frequent follow-up visits.
"Also, sometimes simply explaining to a patient what a pill is for and the importance of that medication can make a big difference.".
COMMENTS:
Uh, duh? I am greatful that this study was done to show how important medication non-adherence is to the world (also highlighted in the NCPIE study, and the WHO Study, countless articles, and this blog). But again, come on, if you don't take your pills you are not going to be healthy. Plain and Simple.
"We've shown that simply asking the patient whether they were adherent to their medication is a pretty decent way to identify those patients we might need to focus on," Gehi told heartwire.
"The bottom line is that medication nonadherence is a big predictor of adverse cardiovascular outcomes, and we found that the risk associated with nonadherence was equivalent to that associated with diabetes or smoking. Nonadherence is really a big deal that a lot of physicians don't look at carefully, and it's not a difficult thing to find out."
"We have shown that it's not a difficult thing to find out about adherence, but this is something that perhaps physicians overlook. Our study helps emphasize how important it is; then, something can be done about addressing the specific issues relating to adherence with that patient."
Those who are found to be nonadherent can be targeted with a number of approaches; Gehi suggests such strategies as pillboxes, getting family involved in medication, and arranging more frequent follow-up visits.
"Also, sometimes simply explaining to a patient what a pill is for and the importance of that medication can make a big difference.".
COMMENTS:
Uh, duh? I am greatful that this study was done to show how important medication non-adherence is to the world (also highlighted in the NCPIE study, and the WHO Study, countless articles, and this blog). But again, come on, if you don't take your pills you are not going to be healthy. Plain and Simple.
EU Approval for Exelon
I have writen about patches in the past - both pro and con. With the EU approval of Exelon, caregivers and patients with Alzheimer's have reason to cheer for better medication adherence. I can only imagine how difficult it must be to care for a parent or spouse with Alzheimer's - not to mention their medication regime. Hopefully the Exelon patch will have a successful launch and adoption in the EU.
The Exelon patch was approved in the US in July and some expect sales to reach the $1B mark.
Here is a blurb from 9/24 Nursing In Practice website, no author provided:
The European Commission has on today approved the use of a transdermal patch to deliver medicine to patients with mild-to-moderately severe Alzheimer's disease. The patch is the first type of transdermal treatment for Alzheimer's disease and is applied once a day to the back, chest or upper arm of patients.
Experts say the patch improves compliance for Alzheimer's patients and also reduces side-effects.
"All these benefits offer the potential for improved outcomes in patients," said James Shannon, global head of development at Novartis Pharma.
"Exelon patch represents a therapeutic innovation that is designed specifically to meet the needs of patients, caregivers and physicians involved with this devastating disease."
Bruno Dubois, Professor of Neurology in Paris, France, agrees that the patch provides vital reassurance that patients have "taken" their medicine, adding: "Just having to apply a patch can help reduce the burden of family life for people with Alzheimer's disease and their families."
In a survey of Alzheimer's caregivers, 70% said they preferred the patch to oral medicines as it helped them follow their treatment schedules and was easier to use.
"People with Alzheimer's disease and their caregivers welcome every new therapy for the disease," said Mark Wortmann, executive director of Alzheimer's Disease International. "I am pleased that the patch offers a new approach to treatment."
The Exelon patch was approved in the US in July and some expect sales to reach the $1B mark.
Here is a blurb from 9/24 Nursing In Practice website, no author provided:
The European Commission has on today approved the use of a transdermal patch to deliver medicine to patients with mild-to-moderately severe Alzheimer's disease. The patch is the first type of transdermal treatment for Alzheimer's disease and is applied once a day to the back, chest or upper arm of patients.
Experts say the patch improves compliance for Alzheimer's patients and also reduces side-effects.
"All these benefits offer the potential for improved outcomes in patients," said James Shannon, global head of development at Novartis Pharma.
"Exelon patch represents a therapeutic innovation that is designed specifically to meet the needs of patients, caregivers and physicians involved with this devastating disease."
Bruno Dubois, Professor of Neurology in Paris, France, agrees that the patch provides vital reassurance that patients have "taken" their medicine, adding: "Just having to apply a patch can help reduce the burden of family life for people with Alzheimer's disease and their families."
In a survey of Alzheimer's caregivers, 70% said they preferred the patch to oral medicines as it helped them follow their treatment schedules and was easier to use.
"People with Alzheimer's disease and their caregivers welcome every new therapy for the disease," said Mark Wortmann, executive director of Alzheimer's Disease International. "I am pleased that the patch offers a new approach to treatment."
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