Posts Tagged ‘University of Pittsburgh’
Higher medication spending doesn’t indicate best prescribing quality
Medicare patients in regions that spend the most on prescription medications are not necessarily getting better quality care, according to a new study of spending practices from the University of Pittsburgh Graduate School of Public Health (GSPH). The findings, published in the Nov. 3 Online First issue of the New England Journal of Medicine, reveal great variation across the country in both drug spending and the rate of inappropriate prescriptions for the elderly.
Lead investigator Yuting Zhang, Ph.D., assistant professor of health economics at GSPH, said that even after demographic characteristics such as age and sex, individual health status and insurance coverage are taken into account, it’s clear that Medicare drug spending varies broadly among hospital-referral regions (HRRs).
“Higher spending can be justified if it’s for drugs that are necessary and appropriate and improve patients’ health,” she said. “But if certain drugs are being incorrectly prescribed to seniors, then that can lead to complications and expensive interventions, such as hospitalization. As we try to reform health care to get costs under control, we need a better understanding of how spending differs regionally to make a positive impact…”
Regions where beneficiaries were more likely to be given prescriptions for high-risk or potentially harmful drugs did not necessarily spend more on drugs overall than regions where beneficiaries were less likely to use high-risk or harmful drugs.
In addition, the researchers found that regions where non-drug medical spending was higher also were the places where there was a greater likelihood of high-risk or harmful drugs being prescribed for Medicare beneficiaries.
“That contradicts the idea that high spending leads to better prescription practices,” Dr. Zhang noted.
Computational analysis of a half-million Medicare patients used for the study.
Interesting maps. Interesting study.
Walking may keep brain from shrinking in old age
Walking at least six miles a week may be one thing people can do to keep their brains from shrinking and fight off dementia, say U.S. researchers.
A study of nearly 300 people in Pittsburgh who kept track of how much they walked each week showed that those who walked at least six miles had less age-related brain shrinkage than people who walked less.
“Brain size shrinks in late adulthood, which can cause memory problems. Our results should encourage well-designed trials of physical exercise in older adults as a promising approach for preventing dementia and Alzheimer’s disease,” said Kirk Erickson of the University of Pittsburgh, whose study appears in the journal Neurology…
Erickson and colleagues tested to see if people who walk a lot might be better positioned to fight off the disease.
They studied 299 volunteers who were free of dementia and who kept track of how much they walked.
Nine years later, scientists took brain scans to measure their brain volume. After four more years, they tested to see if anyone in the study had cognitive impairment or dementia.
They found that people who walked roughly six to nine miles a week halved their risk of developing memory problems.
“Our results are in line with data that aerobic activity induces a host of cellular cascades that could conceivably increase gray matter volume,” the team wrote.
They said more studies need to be done on the effects of exercise on dementia, but in the absence of any effective treatments for Alzheimer’s, walking may be one thing people can do that may help down the road.
Phew. I made it into the parameters.
Vaccine to prevent colon cancer starting human tests
Researchers at the University of Pittsburgh School of Medicine have begun testing a vaccine that might be able to prevent colon cancer in people at high risk for developing the disease. If shown to be effective, it might spare patients the risk and inconvenience of repeated invasive surveillance tests, such as colonoscopy, that are now necessary to spot and remove precancerous polyps…
In a novel approach for cancer prevention, the Pitt vaccine is directed against an abnormal variant of a self-made cell protein called MUC1, which is altered and produced in excess in advanced adenomas and cancer. Vaccines currently in use to prevent cancer work via a different mechanism, specifically by blocking infection with viruses that are linked with cancer. For example, Gardasil protects against human papilloma virus associated with cervical cancer and hepatitis B vaccine protects against liver cancer.
“By stimulating an immune response against the MUC1 protein in these precancerous growths, we may be able to draw the immune system’s fire to attack and destroy the abnormal cells,” Dr. Schoen said. “That might not only prevent progression to cancer, but even polyp recurrence.”
According to co-investigator Olivera Finn, Ph.D., MUC1 vaccines have been tested for safety and immunogenicity in patients with late-stage colon cancer and pancreatic cancer.
“Patients were able to generate an immune response despite their cancer-weakened immune systems,” she noted. “Patients with advanced adenomas are otherwise healthy and so they would be expected to generate a stronger immune response. That may be able to stop precancerous lesions from transforming into malignant tumors.”
About a dozen people have received the experimental vaccine so far, and the researchers intend to enroll another 50 or so into the study.
If it’s going to help some of us live longer and better, I’m all for it. Let the spookier ethicists talk to themselves over in the corner. I think if and when treatments like this become common, individuals can make up their own minds about opting in.
