Kenyon Connects

Major breakthroughs and changes in medicine and health care occurred in 2010; some will have profound effects on the home health, hospice and home care industry. Since we care for clients/patients who are affected by these changes, it is important to be aware of the latest trends and issues facing our patients and individual practices. Here is a brief overview:

To begin with, the national healthcare system overhaul is the most extensive since 1965.
• The program expands the number of people able to buy health insurance through subsidization. It also penalizes those who refuse to carry health care insurance and limits the cases for which insurance companies can deny coverage.
• All providers of health care will eventually be compensated on the quality of health care provided. It also bars copayments by insurance companies for preventative health services.
• Children can be carried by their parents until age 25.
• Increases in insurance premiums must be substantiated with data. Additionally, 85% of all premiums paid MUST be used for care and cannot be used for executive compensation or bonuses.

Substantial changes occurred on the drug scene with major breakthroughs for HIV and MS.
• Pre-exposure chemoprophylaxis (PrEP) and the combination of oral antiviral therapy (Truvada) demonstrated significant effectiveness against HIV with a 44% lower rate for those individuals taking the PrEP treatment versus the control group in the study. For those that took their medication 90% or more during the study, their risk of infection decreased by 70%. Experts are calling the results “game-changing.”
• Fingolimod, the first oral treatment to receive approval by the FDA for MS, demonstrated reduction in relapses and delays the disability progression with the relapsing forms of MS.
• Propoxyphene, a long-used drug known as Darvon or Darocet, was pulled from the marketplace by the FDA because of potential adverse side effects. This drug, linked to gastric problems, now shows that it puts patients at significant risk for potentially serious or even fatal heart rhythms.
• Abbott labs pulled the obesity drug sibutramine from the market due to the increased risk for stroke and myocardial infarctions

The FDA also issued some warnings about the use of certain drugs or vitamins;
• A large study found that calcium supplements taken without Vitamin D may increase the risk for heart attack by as much as 30%. The study suggested that calcium be discontinued and substituted with a high calcium diet.
• A warning was issued for the off-label use of quinine for leg cramps that may result in serious and life-threatening hematologic adverse effects.
• 80-mg dose of simvastatin is associated with increased risk for myopathy including rhabdomyolysis when used alone.
• Opiod Tramadol is linked to increased suicide risk
• Bisphosphonates used to treat osteoporosis has been linked to an increased risk for atypical femur fractures
• Tigecycline was associated with an increased risk for death in patients with certain severe infections.

Along with drug changes, there were improved tests for diseases, such as:
• The increased sensitivity of the prostate specific antigen (PSA) screening test can now detect the disease early in the course, allowing for improved patient outcomes.
• New guidelines from the American Diabetic Association allows hemoglobin A1c, a prediabetic screen, to be used more widely, reducing the number of undiagnosed patients in the U.S. The test measures average blood glucose levels for up to 3 months.
• An eight-year National Lung Screening Trial in the U.S. showed the use of low dose helical computed tomography (CT) screening for heavy smokers significantly reduced deaths from lung cancer compared with screening with chest X-rays.

Other developments and discoveries on the healthcare front include:
• NDM, a gene that makes bacteria impervious to many antibiotics, is spreading worldwide. The gene, first identified in India, Pakistan and Bangladesh, has now been found in England, Canada, US, Sweden, Australia and the Netherlands.
• New research has provided the first direct evidence that attention-deficit/ hyperactivity disorder (ADHD) is genetic.
• Scientists at the Venter Institute reported the creation of the first “synthetic cell,” mycoplasma capricolum.
• The CDC changed the recommendations of the 23-valent pneumococcal polysaccharide vaccine. All persons ages 19 to 64 years with chronic or immunosuppressive medical conditions, including asthma, should receive the vaccine.

And finally, a study by Canadian researchers suggests that higher chocolate consumption may be associated with a lower risk for stroke and stroke related mortality. There was no information as to whether it was dark chocolate or light. My recommendation? Eat equal amounts of both every day to make sure you’re protected – and enjoy the sheer satisfaction that only chocolate can give.

Staying in touch with the latest changes in the home health field can be challenging. That is why Kenyon HomeCare Consulting works to stay abreast of the changes and keep you informed.

Category: Ginny's Blog, News