Author Interviews, Opiods, Pharmacology, University Texas / 11.12.2014

Barbara J Turner MD, MSEd, MA, MACP James D and Ona I Dye Professor of Medicine Director, Center for Research to Advance Community Health (ReACH) University of Texas Health Science Center San AntonioMedicalResearch.com Interview with: Barbara J Turner MD, MSEd, MA, MACP James D and Ona I Dye Professor of Medicine Director, Center for Research to Advance Community Health (ReACH) University of Texas Health Science Center San Antonio Medical Research: What is the background for this study? What are the main findings? Dr. Turner: Daily dose of opioid analgesics has been widely used to assess the risk of overdose death and this risk has been reported to be greatest for a morphine equivalent dose at least 100 to 120 mg per day. However, the total dose of filled opioid prescriptions over a period of time may offer a complementary measure of the risk to that provided by the daily dose. In fact, the total dose is not necessarily a simple linear transformation of the daily dose because not all patients use opioids every day, instead it reflects the total amount of opioids available to a patient. Among 206,869 national HMO patients aged 18-64 with non-cancer pain filling at least 2 schedule II or III opioid analgesic prescriptions, the rate of overdose was 471 per 100,000 person-years. Over the study period of 3.5 years, risk of drug overdose was two to three times greater for patients with a daily dose >100 mg regardless of the total dose filled or a daily dose of 50-99 mg with a high total dose (>1830 mg) filled a six month interval (versus no opioids). The overdose risk was increased slightly for 50-99 mg per day with a lower total dose and not increased at all for daily doses under 20 mg regardless of the total dose. (more…)
Author Interviews, JAMA, Osteoporosis, Pharmacology, Testosterone / 03.12.2014

MedicalResearch.com Interview with: Shabbir M. H. Alibhai, MD, MSc and Husayn Gulamhusein, BHSc Department of Medicine, University Health Network Toronto, Ontario, Canada Medical Research: What is the background for this study? What are the main findings? MedicalResearch: In 2009, we published a research letter in JAMA which examined the rate of bone mineral density (BMD) testing in men starting androgen deprivation therapy (ADT) in the province of Ontario, Canada, between 1995 and 2008. Despite being recommended as a tool to better characterize fracture risk and optimize bone health, use of bone mineral density testing was low throughout the study period. This current study focuses on another aspect of bone health, which is the use of bisphosphonates among men undergoing androgen deprivation therapy for prostate cancer. Bisphosphonates are generally safe and effective medications that can reduce fracture risk particularly in those at higher risk of future fracture. Throughout the 17-year study period, we found that rates of new prescriptions for bisphosphonates remained low. Even when focusing on those men who should be receiving bisphosphonates as per Canadian guidelines due to their high risk for future fracture, i.e. those with a prior fragility fracture or prior diagnosis of osteoporosis, prescription rates remained low. Moreover, in all three groups, new bisphosphonate prescriptions dipped between the 2007-09 and 2010-12 time periods. This may be partly due to recent negative media attention regarding the association of bisphosphonates with rare but serious side effects (i.e. osteonecrosis of the jaw and atypical femoral fracture). (more…)
Antibiotic Resistance, Author Interviews, Pharmacology, Rheumatology / 19.11.2014

MedicalResearch.com Interview with: Dr. Daniel B Horton, MD Division of Pediatric Rheumatology Department of Pediatrics Nemours Dupont Pediatrics Wilmington, Delaware
Medical Research: What is the background for this study? What are the main findings? Dr. Horton: The reasons why children develop juvenile arthritis (JIA) are unclear. To date, genetic variation accounts for only a minority of disease incidence, and no environmental factor has consistently been associated with juvenile arthritis. There is growing understanding about the role of microbiome disturbance in the development of multiple diseases, including obesity, inflammatory bowel disease, and rheumatoid arthritis. Exposure to antibiotics, a known disruptor of the human microbiome, has been linked to pediatric conditions including inflammatory bowel disease, asthma, and obesity. We showed that antibiotic prescriptions are associated with the development of new JIA diagnosis in a large general pediatric population, after accounting for history of infection and other relevant factors. This association is stronger for those who have received multiple courses of antibiotics and appears specific for antibacterial antibiotics, such as penicillins and sulfa drugs. (more…)
Author Interviews, Kidney Disease, Pharmacology / 14.11.2014

MedicalResearch.com Interview with: Naoka Murakami MD PhD Mount Sinai Beth Israel Department of Medicine Medical Research: What is the background of the study? What are the main findings?  Dr. Murakami: Dialysis patients live in a complex sociomedical situation and are highly dependent on technologies to sustain their lives; such as transportation, electricity and water for the dialysis apparatus. Interruption of this infrastructure by a natural disaster can result in devastating outcomes. During triage of patients arriving at Mount Sinai Beth Israel in the immediate aftermath of hurricane Sandy, we observed that many dialysis patients did not know about their medications, their comorbid conditions nor their dialysis prescriptions. Therefore we conducted a cross-sectional follow-up study of 357 hemodialysis patients in five dialysis units in lower Manhattan, New York. Using checklists prepared by the National Kidney Foundation and the Department of Homeland Security, we found that 26.3% subjects missed dialysis sessions and 66.1% received dialysis at non-regular dialysis unit(s). We observed that the distribution of a “Dialysis emergency packet” significantly improved retention of medical records at home. Analysis showed that dialysis-specific preparedness, racial ethnicity (non-African American, Hispanic or Caucasian), reception of dialysis in affiliated units, and older age, were associated with a significant reduction in missed dialyses. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmacology / 27.09.2014

Dr. Song Hee Hong PhD Associate Professor, Health Outcomes and Policy Research Dept. Clinical Pharmacy University of Tennessee Health Science Center Memphis, TN 38163MedicalResearch.com Interview with: Dr. Song Hee Hong PhD Associate Professor, Health Outcomes and Policy Research Dept. Clinical Pharmacy University of Tennessee Health Science Center Memphis, TN 38163 Medical Research: What are the main findings of the study? Dr. Hong: Use of GDDP (generic drug discount programs) increased to 23.1% in 2010 from 3.6% of patients receiving any prescription drugs in 2007. Generic drug discount programs were more valued among the elderly, sicker and uninsured populations. The lower use of Generic drug discount programs among racial/ethnic minorities observed when the program was deployed no longer existed when the program matured. (more…)
Author Interviews, Diabetes, Diabetes Care, Heart Disease, Pharmacology / 27.08.2014

Dr. Frank B. Hu Department of Nutrition Harvard School of Public Health Boston, MAMedicalResearch.com Interview with: Dr. Frank B. Hu Department of Nutrition Harvard School of Public Health Boston, MA Medical Research: What are the main findings of the study? Dr. Hu: in this study among approximately 5000 patients with type 2 diabetes followed for up to 10 years, longer duration of sulfonylurea therapy was associated with a higher risk of coronary heart disease. The continuous sulfonylurea therapy for 10 years was associated with almost two times greater risk of coronary heart disease compared with nonusers. However, given the observational nature of the study, we cannot make causal inference from these findings. (more…)
Author Interviews, Gender Differences, Heart Disease, Pharmacology / 21.07.2014

Lisa A. McDonnell Program Manager, Prevention & Wellness Centre, Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.MedicalResearch.com Interview with: Lisa A. McDonnell Program Manager, Prevention & Wellness Centre, Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Medical Research: What are the main findings of the study? Answer: The analysis focuses on a comparison of women’s perceptions of their heart disease knowledge and heart health risk with their self‐reported knowledge and heart health risk status. In summary, it gives insight into the Perceptions vs Reality when it comes to women and their heart health. Heart disease knowledge: For the purposes of measuring knowledge related to heart health, a scoring index was created on which women responding to the survey could score as low as 0 or as high as 40. The overall mean score among women in the survey was 15.0, which is fairly modest given the maximum of 40. In a comparison of actual and perceived heart disease knowledge, 80% of respondents with a low knowledge score perceived that they were moderately or well informed. The risk factors that Canadian women most commonly associate with heart disease are being overweight/having abdominal obesity (ov/ob), physical inactivity, smoking, and lacking fruits/vegetables. Smoking, diabetes and high blood pressure account for up to 53% of MI’s, followed by Ov/Ob, psychosocial factors, a lack of physical activity, and a lack of fruits/vegetables. The limited awareness of high blood pressure, high cholesterol and diabetes as key risk factors is particularly surprising, given that these are key determinants of heart disease. Low awareness of symptomology among women in our survey were noted when comparing the occurrence of symptoms versus their recognition of these symptoms as possibly being related to their heart. Only 4 in 10 women could name chest pain as a symptom of heart disease, and a smaller proportion could identify symptoms including dyspnea, radiating pain, or typical prodromal symptoms. Such shortcomings might contribute to the greater number of unrecognized myocardial infarctions in women than in men, not to mention inappropriate treatment of acute events and premature discharge from emergency care. (more…)
Addiction, Author Interviews, Opiods, Pharmacology / 10.07.2014

Tara Gomes St Michael's Hospital Toronto, ON, CanadaMedicalResearch.com Interview with: Tara Gomes St Michael's Hospital Toronto, ON, Canada Medical Research: What are the main findings of the study? Tara Gomes: We found that rates of opioid overdose in Ontario have increased more than 3-fold over the past 2 decades. Furthermore, these deaths are clustered among younger Ontarians; in 2010, 1 in 8 deaths among those aged 25 to 34 years were related to opioids. This has led to considerable burden due to loss of life. (more…)
Accidents & Violence, Author Interviews, Global Health, Lancet, Pharmacology / 03.07.2014

MedicalResearch.com Interview with: Tamara Haegerich, PhD Deputy Associate Director for Science Division of Unintentional Injury Prevention CDC - National Center for Injury Prevention and ControlMedicalResearch.com Interview with: Tamara Haegerich, PhD Deputy Associate Director for Science Division of Unintentional Injury Prevention CDC - National Center for Injury Prevention and Control MedicalResearch: What are the main findings of the study? Dr. Haegerich: In the first three decades of life, more people in the US die from injuries and violence than from any other cause. Approximately 60% of fatal injuries are unintentional (for example, from motor vehicle crashes, drug overdose, and falls), 20% are due to suicide, and 20% are due to homicide. Injuries and violence have been linked to a wide range of physical, mental health, and reproductive health problems, and chronic diseases. They take an enormous economic toll, including the cost of medical care and lost productivity. Importantly, injuries and violence are preventable through education, behavior change, policy, engineering, and environmental supports. For example, laws that promote the use of seat belts and child safety seats, and prevent drunk driving, can reduce motor-vehicle-related injuries. Early childhood home visitation, school-based programs, and therapeutic foster care are examples of evidence-based approaches to preventing violence. Improving proper prescribing of painkillers and access to treatment for substance misuse could prevent prescription drug overdoses. Improvements are possible by framing injuries and violence as preventable, identifying interventions that are cost-effective and based on research, providing information to decision makers, and strengthening the capacity of the health care system. (more…)
Author Interviews, Heart Disease, Pharmacology, Testosterone / 03.07.2014

Jacques Baillargeon, PhD Director, Epidemiology Division Associate Professor Department of Preventive Medicine and Community Health University of Texas Medical Branch MedicalResearch.com Interview with: Jacques Baillargeon, PhD Director, Epidemiology Division Associate Professor Department of Preventive Medicine and Community Health University of Texas Medical Branch MedicalResearch: What are the main findings of the study? Dr. Baillargeon: The main findings of the study were that older men who were treated with testosterone did not appear to have an increased risk of Myocardial Infarction.  For men with high MI risk, testosterone use appeared to be modestly protective against MI. (more…)
Author Interviews, CMAJ, Compliance, Pharmacology, Statins / 25.06.2014

Dr. Heli Halava: Departments of Public Health and Pharmacology, Turku, FinlandMedicalResearch.com Interview with: Dr. Heli Halava: Departments of Public Health and Pharmacology, Turku, Finland MedicalResearch: What are the main findings of the study? Dr. Halava: The associations between lifestyle factors and nonadherence to statin therapy varied by cardiovascular comorbidity status. Of the participants without cardiovascular comorbidities (n = 6458), 3171 (49.1%) were nonadherent with their statin therapy. Of the participants with cardiovascular comorbidities (n = 2827), 1155 (40.9%) were nonadherent. People with cardiovascular comorbidities who had risky drinking behaviours or a cluster of lifestyle risks were at increased risk of nonadherence. (more…)
Author Interviews, Opiods, Pharmacology / 19.06.2014

Nicholas B. King, PhD, Biomedical Ethics Unit McGill University Montreal QC CanadaMedicalResearch.com Interview with: Nicholas B. King, PhD, Biomedical Ethics Unit McGill University Montreal QC Canada MedicalResearch: What are the main findings of the study? Dr. King: Unintentional overdoses from prescription opioid painkillers have been rising sharply in the US and Canada during the past two decades, killing thousands of people every year. A lot has been written about the subject in both popular media and scholarly literature, but we still don't have a very good idea of why this has happened. So we tried to objectively and systematically assess evidence for what has contributed to increasing mortality. We found the following: (1) The evidence base for why mortality has increased is very thin, and more research is urgently required. (2) We found evidence for at least 17 different causes of increased mortality. We found the most evidence for the following factors: dramatically increased prescription and sales of opioids; increased use of strong, long-acting opioids like oxycodone and methadone; combined use of opioids and other (licit and illicit) drugs and alcohol; and social and demographic characteristics. We found little evidence that internet sales of pharmaceuticals and errors by doctors and patients--factors commonly cited in the media--have played a significant role. (more…)
Author Interviews, BMJ, Heart Disease, Pharmacology / 17.06.2014

MedicalResearch.com Interview with: Professor June-Hong Kim, Division of Cardiology Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital Yangsan, South Korea; MedicalResearch: What are the main findings of the study? Dr. Kim: In vasospastic angina, the cilostazol group significantly reduced relative ireduction of of weekly incidence of chest pain compared with placebo group (−66.5±88.6% vs −17.6±140.1%, respectively, p=0.009).. Other clinical parameters such as a change in the frequency of chest pain (−3.7±0.5 vs −1.9±0.6, respectively, p=0.029), a change in the chest pain severity scale (−2.8±0.4 vs −1.1±0.4, respectively, p=0.003), and the proportion of chest pain-free patients (76.0% vs 33.3%, respectively, p=0.003) also significantly favored cilostazol. (more…)
Diabetes, Pharmacology / 16.06.2014

MedicalResearch.com Interview with: Peter Stein, M.D. Vice president, Clinical Research for Diabetes and Dndocrinology Merck Research Laboratories. MedicalResearch: What are the main findings of the study? Dr. Stein: This late-breaking observational study assessed the differences in time to initiation of insulin use and the proportion of the population initiating insulin among patients with type 2 diabetes taking the combination of JANUVIA® (sitagliptin) and metformin, and patients taking the combination of a sulfonylurea and metformin.  In this study, patients treated with a combination of JANUVIA and metformin initiated insulin therapy at a slower rate during the period of observation than patients treated with a combination of sulfonylurea and metformin. In this study, the percentages of patients initiating insulin by years one through six were 3.6, 8.4, 12.9, 17.7, 22.4, 26.6 for patients taking JANUVIA; and 4.1, 9.4, 14.6, 21.0, 27.1, 34.1 for patients taking a sulfonylurea. An analysis of the data overall (Kaplan-Meier method) showed that patients taking JANUVIA progressed more slowly to insulin use than patients taking a sulfonylurea (p=0.0034). The Cox proportional hazard regression analysis indicated that by year six, patients in the JANUVIA group were 24 percent less likely to initiate insulin during the period of observation compared to patients taking a sulfonylurea (HR = 0.76; p = 0.0011). Similar results were observed in the sub-group of patients with a baseline A1C of less than 9 percent (HR = 0.77; p = 0.0128]; however there was no statistically significant difference in time to insulin initiation in the sub-group with a baseline A1C of greater than or equal to 9 percent (HR = 0.75; p = 0.1818). (more…)
Author Interviews, Cost of Health Care, Pharmacology, University of Pittsburgh / 09.06.2014

MedicalResearch.com Interview with: Yuting Zhang, Ph.D. Associate professor Graduate School of Public Health Department of Health Policy and Management. University of Pittsburgh MedicalResearch: What are the main findings of the study? Dr. Zhang: Since 2006, the government has randomly assigned low-income enrollees to stand-alone Part D plans, based upon the region in which they live. If low-income Medicare Part D enrollees were assigned to the least expensive plan instead of a random plan, the government and beneficiaries could save more than $5 billion in the first year. (more…)
Addiction, Author Interviews, JAMA, Pharmacology / 31.05.2014

Theodore J. Cicero, PhD Professor, Vice Chairman for Research Department of Psychiatry Washington University in St Louis St Louis, MissouriMedicalResearch.com Interview with: Theodore J. Cicero, PhD Professor, Vice Chairman for Research Department of Psychiatry Washington University in St Louis St Louis, Missouri MedicalResearch: What are the main findings of the study? Dr. Cicero: Heroin users nowadays are predominantly white men and women in their late 20s living outside large urban areas who were first introduced to opioids through prescription drugs compared to the 1960s when heroin users tended to be young urban men whose opioid abuse started with heroin. (more…)
Author Interviews, Diabetes, Diabetes Care, Pharmacology / 29.05.2014

MedicalResearch Interview with: Dr. Valeria Pechtner Medical Advisor, Lilly Diabetes MedicalResearch: What are the main findings of the study? Dr. Pechtner: Used as monotherapy, once-weekly dulaglutide resulted in significant, sustained glycemic lowering, as measured by HbA1c change from baseline. Both the 1.5 mg and the 0.75 mg dose were superior to metformin at the primary endpoint of 26 weeks. At 52 weeks, dulaglutide 1.5 mg continued to demonstrate superiority to metformin, with dulaglutide 0.75 mg showing non-inferiority. In addition, a majority of patients in all arms achieved the American Diabetes Association’s recommended HbA1c target of less than 7 percent, with more patients achieving this goal in the dulaglutide groups at the 26-week endpoint, and more patients achieving the target in the dulaglutide 1.5 mg group at the 52 week timepoint. Additionally, dulaglutide 1.5 mg and metformin resulted in similar weight loss. The tolerability and safety profile was comparable for both medications. (more…)
Author Interviews, Compliance, JAMA, Pharmacology, Schizophrenia / 23.05.2014

Scott Stroup, MD, MPH Professor of Psychiatry Director, Program for Intervention Effectiveness Research, Associate Director for Adult Services, Division of Mental Health Services and Policy Research, New York State Psychiatric Institute Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New YorkMedicalResearch.com Interview with: Scott Stroup, MD, MPH Professor of Psychiatry Director, Program for Intervention Effectiveness Research, Associate Director for Adult Services, Division of Mental Health Services and Policy Research,  New York State Psychiatric Institute Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York MedicalResearch: What are the main findings of the study? Dr. Stroup: We conducted a study sponsored by the National Institute of Mental Health that compared long-acting injectable antipsychotics for people with schizophrenia. Long-acting injectable antipsychotics, also known as depot antipsychotics, are used to promote treatment adherence.  We compared a newer injectable antipsychotic, paliperidone palmitate, to an older one, haloperidol decanoate.  We did not find an advantage for the newer drug in overall effectiveness.  The drugs performed very similarly, and were tolerated about the same. (more…)
Breast Cancer, Mayo Clinic, Pain Research, Pharmacology / 06.05.2014

Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn.MedicalResearch.com Interview with: Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn. MedicalResearch.com: What are the main findings of the study? Dr. Boughey: Use of paravertebral block (a form of regional anesthesia) in women undergoing mastectomy results in less need for opioid medications and less frequent use of anti-nausea medication after surgery. (more…)
Annals Thoracic Surgery, Author Interviews, Cost of Health Care, Hospital Readmissions, Pharmacology / 02.05.2014

Michael H. Hall, MD North Shore-LIJ Health SystemMedicalResearch.com Interview with: Michael H. Hall, MD North Shore-LIJ Health System MedicalResearch: What are the key points of your research? Dr. Hall: Our study was designed to improve care transition from the hospital to home after coronary bypass surgery. The innovative program (Follow Your Heart), implemented at one of our system hospitals, involves sending cardiac surgery nurse practitioners (NPs) who cared for the patients in the hospital to the homes of discharged patients for at least two visits in the first two weeks after discharge. Their goal is to provide continuity of care for patients that they know from the hospital setting and to provide robust medication management, coordinate community services, and be a communications hub for hospital and community providers (primary care, cardiology, and community nurse home visit services). The  nurse practitioners interact with community resources to ensure understanding and satisfaction of the patients’ needs prior to hand-off to those resources after two weeks. Our  nurse practitioners utilize encrypted smart phones to provide reports to all appropriate providers and can even send pictures of incisions to the surgeon when necessary. (more…)
Addiction, Frailty, Geriatrics, JAMA, Pharmacology / 15.04.2014

Cara Tannenbaum, MD, MSc The Michel Saucier Endowed Chair in Geriatric Pharmacology, Health and Aging La Chaire pharmaceutique Michel-Saucier en santé et vieillissement Professor of Medicine and Pharmacy University of Montreal Centre de Recherche Institut Universitaire de Gériatrie de Montréal Montreal, QC MedicalResearch.com Interview with: Cara Tannenbaum, MD, MSc The Michel Saucier Endowed Chair in Geriatric Pharmacology, Health and Aging,Professor of Medicine and Pharmacy University of Montreal Centre de Recherche Institut Universitaire de Gériatrie de Montréal Montreal, QC MedicalResearch.com: What are the main findings of the study? Dr. Tannenbaum: The EMPOWER study showed that providing older patients with information about the harms of sleeping pill use led to discontinuation or dose reduction in 1-in-every 4 patients with longstanding use of benzodiazepines. Receipt of evidence-based information about drug harms resulted in a 8-fold higher likelihood of benzodiazepine cessation. Many physicians think that patients become too dependent on sedative-hypnotics to successfully discontinue. Regardless of age, sex, and duration of use, 27% of patients aged 65-95 in this study successfully completed the recommended 20-week tapering protocol during a 6-month time period and another 11% were in the process of tapering. EMPOWERing patients with evidence-based information therefore results in appropriate risk reduction. (more…)
Annals Internal Medicine, Author Interviews, Compliance, Cost of Health Care, McGill, Pharmacology / 09.04.2014

Robyn Tamblyn BScN Msc PhD James McGill Chair Departments of Medicine and Epidemiology and Biostatistics McGill University Scientific Director Institute of Health Services and Policy Research Canadian Institutes of Health Research MedicalResearch.com Interview with: Robyn Tamblyn BScN Msc PhD James McGill Chair Departments of Medicine and Epidemiology and Biostatistics McGill University and Scientific Director Institute of Health Services and Policy Research Canadian Institutes of Health Research MedicalResearch.com: What are the main findings of the study? Dr. Tamblyn: Higher drug costs are associated with a higher probability of primary non-adherence, whereas better follow-up by the prescribing physician, and a policy to provide medication at no cost for the very poor increase the likelihood of adherence (more…)
Author Interviews, Diabetes, Diabetes Care, FDA, Pharmacology / 20.03.2014

Christian Hampp PhD Senior Staff Fellow/Epidemiologist at FDA Division of Epidemiology-I, Office of Pharmacovigilance and Epidemiology, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MDMedicalResearch.com Interview with: Christian Hampp PhD Senior Staff Fellow/Epidemiologist at FDA Office of Pharmacovigilance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD MedicalResearch.com: What are the main findings of the study? Dr. Hampp: Our study described U.S. market trends for antidiabetic drugs, focusing on newly approved drugs, concomitant use of antidiabetic drugs, and effects of safety concerns and restrictions on thiazolidinedione use. We found that since 2003, the number of adult antidiabetic drug users increased by approximately 43% to 18.8 million in 2012.  During 2012, 154.5 million prescriptions for antidiabetic drugs were filled in outpatient retail pharmacies.  Since 2003, metformin use increased by 97% to 60.4 million prescriptions dispensed in 2012.  Among antidiabetic drugs newly approved for marketing between 2003 and 2012, the dipeptidyl-peptidase-4 (DPP-4) inhibitor sitagliptin had the largest share with 10.5 million prescriptions in 2012. Possibly triggered by safety concerns, the use of pioglitazone declined in 2012 to approximately 52% of its peak in 2008, when 14.2 million prescriptions were dispensed in outpatient retail pharmacies and the use of rosiglitazone use decreased to fewer than 13,000 prescriptions dispensed in retail or mail-order pharmacies in 2012. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Pharmacology, Psychological Science / 19.03.2014

Dr. Christian Fynbo Christiansen Clinical Associate Professor Department of Clinical Epidemiology Aarhus University HospitalMedicalResearch.com Interview Invitation Dr. Christian Fynbo Christiansen Clinical Associate Professor Department of Clinical Epidemiology Aarhus University Hospital MedicalResearch.com: What are the main findings of the study? Dr. Christiansen:  We included 24,179 critically ill nonsurgical patients receiving mechanical ventilation in intensive care units in Denmark, and matched comparison groups of hospitalized patients and the general population. We assessed psychiatric diagnoses and medication prescriptions before and after critical illness. We found an increased prevalence of psychiatric diagnoses in the 5 year period before critical illness, compared to both other hospitalized patients and the general population. (more…)
Author Interviews, Cost of Health Care, JAMA, Pain Research, Pharmacology, Radiology, University of Michigan / 17.03.2014

Dr. Brian C. Callaghan MD Department of Neurology University of Michigan Health System, Ann ArborMedicalResearch.com Interview Invitation with: Dr. Brian C. Callaghan MD Department of Neurology University of Michigan Health System, Ann Arbor MedicalResearch.com: What are the main findings of the study? Dr. Callaghan:  The main findings are that we order headache neuroimaging (MRIs and CTs) frequently, this accounts for approximately $1 billion dollars annually, and the number of tests ordered is only increasing with time. (more…)
Addiction, Author Interviews, Emergency Care, Pain Research, Pharmacology / 16.03.2014

Maryann Mazer-Amirshahi PharmD, MD1MedicalResearch.com Interview with: Maryann Mazer-Amirshahi PharmD, MD The Department of Emergency Medicine, The George Washington University The Department of Clinical Pharmacology, Children's National Medical Center, Washington, DC MedicalResearch.com: What are the main findings of the study? Answer: We found a significant increase in the prescribing of opioid pain medications in the emergency department. At the same time, this was not accounted for by a similar increase in pain-related visits and prescribing patterns of non-opioid analgesics did not change. (more…)
Addiction, Opiods, Orthopedics, Pharmacology, Surgical Research / 11.03.2014

Brent J. Morris, M.D. Shoulder and Elbow Surgery Fellowship Texas Orthopaedic Hospital in affiliation with the University of Texas Houston Health Science Center, Houston, TexasMedicalResearch.com Interview with: Brent J. Morris, M.D. Shoulder and Elbow Surgery Fellowship Texas Orthopaedic Hospital in affiliation with the University of Texas Houston Health Science Center, Houston, Texas MedicalResearch.com: What are the main findings of the study?

 Dr. Morris: There are concerns that an increasing percentage of patients are receiving narcotics by “doctor shopping” or seeking narcotics from multiple providers. One in five of our postoperative orthopedic trauma patients received narcotics from one or more additional providers other than the treating surgeon. Patients that doctor-shopped postoperatively had a significant increase in narcotic prescriptions, duration of narcotics, and morphine equivalent dose per day. (more…)
Author Interviews, Infections, Outcomes & Safety, Pharmacology, Urinary Tract Infections / 28.02.2014

Dr. Jerome A. Leis, MD, MSc Sunnybrook Health Sciences Centre Toronto, ON, M4N 3M5, CanadaMedicalResearch.com Interview with: Dr. Jerome A. Leis, MD, MSc Sunnybrook Health Sciences Centre Toronto, ON, M4N 3M5, Canada MedicalResearch.com: What are the main findings of the study? Dr. Leis: We know that positive urine cultures from patients who lack signs and symptoms of urinary tract infection are a trigger FOR unnecessary antibiotic prescriptions in hospitals. This problem has not improved despite many educational initiatives.  We identified a subset of patients in our hospital where only 2% of all urine specimens sent to the laboratory were associated with symptomatic infection and decided to no longer routinely report positive results from these specimens on the electronic medical record, unless a special telephone request was made.  We found that with this simple change, unnecessary antibiotic prescriptions declined markedly and this did not require any education of care providers. Most importantly, based on our safety audits, patients who had a urinary tract infection all received appropriate treatment. (more…)
Author Interviews, JAMA, Opiods, Pharmacology, Weight Research / 02.10.2013

Marsha A. Raebel, PharmD, BCPS, FCCP Investigator in Pharmacotherapy Institute for Health Research 10065 E. Harvard Ave Suite 300 Denver, CO 80231.MedicalResearch.com Interview with: Marsha A. Raebel, PharmD, BCPS, FCCP Investigator in Pharmacotherapy Institute for Health Research 10065 E. Harvard Ave Suite 300 Denver, CO 80231. MedicalResearch.com: What are the main findings of the study? Answer: We found that in a group of patients who took chronic opioids for non-cancer pain and who underwent bariatric surgery there was greater chronic use of opioids after surgery compared with before surgery, findings that suggest the need for proactive management of chronic pain in these patients after surgery. (more…)