(Press-News.org) WASHINGTON, DC (October 17, 2013)—The District of Columbia Department of Health (DOH) has released a study by the George Washington University School of Public Health and Health Services (SPHHS) investigating prescribing of antipsychotics to District seniors. The study combines pharmaceutical marketing data collected by the District with publicly available data on nursing home quality and Medicare drug claims.
"The good news is that nursing homes in the District of Columbia generally are not prescribing antipsychotic medication at rates higher than the rest of the country," says Susan F. Wood, PhD, lead researcher and an associate professor of health policy and of environmental and occupational health at SPHHS. "However, there are still concerns that District providers are too quick to prescribe these drugs to District seniors and Medicaid beneficiaries."
Antipsychotics are one of the top-selling drug classes, despite widely reported side effects that include weight gain and sedation. Elderly patients suffering from dementia or agitation may be dosed with antipsychotics for their sedative effects, an off-label use that raises ethical questions. Use of antipsychotics puts seniors at increased risk of serious adverse events, including cognitive decline, hip fractures, and death.
"Senior citizens living in the District of Columbia are the city's most vulnerable population," said Dr. Joxel Garcia, Director, DC Department of Health. "The Department of Health will continue to invest in educating physicians on effective use of antipsychotic medications to provide the better health outcomes for all District residents."
The report fulfills the requirement of a 2004 law in the District of Columbia that requires pharmaceutical companies to file annual reports describing their prescription-drug marketing activities in the District. The AccessRx Act also requires analysis of these reports to determine how pharmaceutical marketing may affect healthcare services in the District.
SPHHS researchers searched District of Columbia marketing data for reports of drug-company gifts made in 2007 - 2011 to physicians who currently serve as nursing home medical directors. The search was done to see if pharmaceutical companies were targeting marketing efforts at the medical directors of nursing homes. The report found that nine of the district's 19 nursing home medical directors received no gifts from pharmaceutical companies between 2007 and 2011. Three received cash or checks for speaking or consulting, which totaled $34,639 over five years. Only four received gifts totaling over $1,000 in at least one of the years studied; six received gifts, mostly food or books, totaling $100 to $800 in at least one year.
The study also examined nursing home quality ratings and rates of antipsychotic prescriptions across eight wards in the district, using ratings from the Nursing Home Compare website run by the Centers for Medicare and Medicaid Services (CMS). Thirteen of the District's 19 nursing homes received above-average ratings (four or five stars) for overall quality. The two nursing homes with the lowest ratings (two stars, or "below average") are both located in Ward 7.
Nursing Home Compare also reports the percentage of short-stay nursing home patients receiving new antipsychotic prescriptions and the percentage of long-stay patients receiving antipsychotic medications. In the District, seven out of 18 nursing homes have above‐average prescribing rates for short‐stay patients, and six out of 19 have above‐average rates of long‐stay patients taking antipsychotics. (Average US rates are 2.7 percent for short-stay patients and 22.4 percent for long-stay patients.)
Researchers also examined data on prescriptions of antipsychotics for Medicare Part D patients, the majority of whom are seniors. The SPHHS report compiles information on 67 District providers who wrote antipsychotic prescriptions for large numbers of Part D patients. Nearly one-third (22 of 67) of these prescribed at least one antipsychotic to 70 percent or more of their Part D patients.
"Many doctors in the District write significant numbers of prescriptions of antipsychotic medication to Medicare patients. This provides a window into prescribing practices here," says Adriane Fugh-Berman, MD, a co-author of the report and an associate professor of pharmacology and physiology at Georgetown University Medical Center.
"As we noted in an earlier report for the Department of Health, the District has a very high percentage of Medicaid beneficiaries receiving antipsychotic medications," Wood says. Data released by CMS just after this report was written indicate that nearly 11 percent of the District's Medicaid beneficiaries filled antipsychotic prescriptions in 2009. "High rates of prescribing antipsychotics, whether to children or elders, raises concerns about the quality of care provided to low-income District residents and the role of pharmaceutical marketing in prescribing practices."
The study can be found on the D.C. Department of Health Website by clicking here.
###
About the George Washington University School of Public Health and Health Services:
Established in July 1997, the School of Public Health and Health Services brought together three longstanding university programs in the schools of medicine, business, and education and is now the only school of public health in the nation's capital. Today, more than 1,100 students from nearly every U.S. state and more than 40 nations pursue undergraduate, graduate, and doctoral-level degrees in public health. The school now offers an online Master of Public Health, MPH@GW, which allows students to pursue their degree from anywhere in the world. http://sphhs.gwu.edu/
About the District of Columbia Department of Health:
The Mission of the Department of Health is to promote and protect the health, safety and quality of life of residents, visitors and those doing business in the District of Columbia. Our responsibilities include identifying health risks; educating the public; preventing and controlling diseases, injuries and exposure to environmental hazards; promoting effective community collaborations; and optimizing equitable access to community resources. For more information about the Department of Health or to learn more about administrations and programs please visit http://www.doh.dc.gov.
District nursing homes win high marks for quality, but antipsychotic prescribing remains problematic
2013-10-18
ELSE PRESS RELEASES FROM THIS DATE:
Could Sandy happen again? Maybe, says Tufts geologist
2013-10-18
MEDFORD/SOMERVILLE, Mass. – Almost a year after Hurricane Sandy, parts of New York and New Jersey are still recovering from billions of dollars in flood damage. Tufts University geologist Andrew Kemp sees the possibility of damage from storms smaller than Sandy in the future.
"Rising sea levels exacerbate flooding," says Kemp. "As sea level rises, smaller and weaker storms will cause flood damage." An assistant professor in Tufts' Department of Earth and Ocean Sciences, Kemp co-authored a study on sea-level change close to New York that was published recently in the Journal ...
Prescription drug use among Medicare patients highly inconsistent
2013-10-18
Lebanon, N.H. (October 15, 2013) – A new report from the Dartmouth Atlas Project shows that the use of both effective and risky drug therapies by Medicare patients varies widely across U.S. regions, offering further evidence that location is a key determinant in the quality and cost of the medical care that patients receive.
In their first look at prescription drug use, Dartmouth researchers also find that the health status of a region's Medicare population accounts for less than a third of the variation in total prescription drug use, and that higher spending is not ...
'Traffic-light' labeling increases attention to nutritional quality of food choices
2013-10-18
A simple, color-coded system for labeling food items in a hospital cafeteria appears to have increased customer's attention to the healthiness of their food choices, along with encouraging purchases of the most healthy items. In their report in the October issue of Preventive Medicine, Massachusetts General Hospital (MGH) investigators describe customer responses to surveys taken before and after the 2010 implementation of a system using green, yellow or red "traffic light" labels to reflect the nutritional quality of items.
"Several small, experimental studies have ...
Tropical Storm Octave makes landfall in western Mexico
2013-10-18
Tropical Depression 15-E formed on Oct. 12 at 11 p.m. EDT and strengthened into Tropical Storm Octave. Four days later NASA's Terra satellite saw the weakened storm headed for landfall in western Mexico.
TD15-E formed about 470 miles/755 km south of the southern tip of Baja California, near 16.1 north and 110.2 west. By 5 a.m. EDT on Oct. 13, TD15-E became Tropical Storm Octave. Octave's maximum sustained winds peaked at 65 mph/100 kph at 11 p.m. EDT on Oct. 13 when it was about 215 miles/345 km northwest of Socorro Island, near 20.6 north and 113.7 west.
The Moderate ...
Virginia Tech researchers publish study on jellyfish energy consumption that will improve bio-inspired robotic designs for Navy
2013-10-18
Virginia Tech College of Engineering researchers are part of a national study that has cracked how jellyfish move with the lowest cost of transport of any animal. The findings will be used as researchers continue to design bio-inspired jellyfish for the U.S. Navy.
Published in a recent issue of the Proceedings of National Academy of the Sciences, the study highlights jellyfish as one of the most energetically efficient natural propulsors on the planet. Researchers found that rather than moving continuously through water while swimming, jellyfish use a critical pause between ...
Tropical Storm Priscilla's short life
2013-10-18
Tropical Storm Priscilla lived just 3 days in the eastern Pacific Ocean making for one of the shortest-lived tropical storms of the season.
Priscilla skipped the depression phase and went from a low pressure area to a full-blown tropical storm at 5 a.m. EDT/0900 UTC on Oct. 14. Priscilla formed near 14.3 north and 115.7 west, about 705 miles/1,135 km southwest of the southern tip of Baja California. Priscilla moved north-northeast and had maximum sustained winds near 40 mph/65 kph at birth.
On Oct. 15 Priscilla had already weakened to a depression because of wind shear ...
NASA sees Typhoon Francisco headed to the other side of Guam
2013-10-18
NASA's Aqua satellite passed over Typhoon Francisco on Oct. 17 after it had passed the eastern side of Guam and started to head on a track that would take it past the western side of Guam. Tropical Storm Warnings are in effect for Guam on Oct. 17 and 18 (local time).
The Moderate Resolution Imaging Spectroradiometer instrument aboard NASA's Aqua satellite captured an image of Typhoon Francisco on Oct. 17 at 04:05 UTC in the Pacific Ocean as it started turning to the northwest after passing the eastern side Guam. The MODIS image clearly showed Francisco's eye, indicating ...
Statin, osteoporosis drug combo may help treat parasitic infections
2013-10-18
Statin, osteoporosis drug combo may help treat parasitic infections
Athens, Ga. – Researchers at the University of Georgia have discovered that a combination of two commonly prescribed drugs used to treat high cholesterol and osteoporosis may serve as the foundation of a new treatment ...
Will health insurance expansion cut ER use? U-M study in teens & young adults may help predict
2013-10-18
ANN ARBOR, Mich. — As the nation's health care system prepares for uninsured Americans to gain health insurance coverage under the Affordable Care Act, a question hangs over crowded hospital emergency departments: Will the newly insured make fewer ER visits than they do today?
According to the results of a new University of Michigan Medical School study in teens and young adults, the answer likely reflects a balance of ER care versus clinic visits. While the number of ER visits will likely stay about the same, clinic visits will likely go up.
The results, from the ...
Unique skull find rebuts theories on species diversity in early humans
2013-10-18
This news release is available in German. This is the best-preserved fossil find yet from the early era of our genus. The particularly interesting aspect is that it displays a combination of features that were unknown to us before the find. The skull, found in Dmanisi by anthropologists from the University of Zurich as part of a collaboration with colleagues in Georgia funded by the Swiss National Science Foundation, has the largest face, the most massively built jaw and teeth and the smallest brain within the Dmanisi group.
It is the fifth skull to be discovered ...