April 06, 2007
Woes for Canadians with Spinal Difficulties
Source: Canadian Television News, Toronto, Feb 24/07
Description of Issue:
There is troubling news regarding another dimension of the Canadian Health Care System. The Canadian Spinal Association is reporting exceptionally long wait times for a referral to a specialist. Many physicians, specializing in spinal related problems are refusing to see new patients although many of these patients may require surgery. In fact, the physicians readily admit that some of the patients on the waiting lists are more in need of care than patients undergoing treatment. Many Canadian patients are now traveling to Germany and India where diagnosis and if required, surgery can sometimes be completed in one week! As a number of patients interviewed stated, “this shouldn’t be the case in Canada’s publicly funded health care system.” Unfortunately, spinal related matters are not one of the current priorities in Canada’s health care system.
Implication for Pharmacy:
Pharmacists need to monitor and assist in the pain management and medication management as patients wait to see a specialist. In addition, there is the issue of collaboration with health professionals in other areas when patients elect to leave Canada to seek treatment in another country.
Posted by mmacneil at 06:24 PM | Comments (0)
April 03, 2007
Artificial Intelligence Systems to Support Independent Living
Source: Cape Breton Post. Sydney, Nova Scotia, Feb 20, 2007
Description of Issue:
For most of us, washing our hands, taking a pill or using the washroom are things we do without much conscious thought. But for people with dementia and their caregivers, these simple second-long tasks can stretch into minutes and become exercises in frustration. Researchers at the Toronto Rehabilitation Institute are working on artificial intelligence systems, including a “smart bathroom”, that they hope will one day help people with Alzheimer’s and other forms of dementia live more independent lives in their own homes. Dr. Alex Mihailidis, a biomedical engineer has developed a prototype interactive “talking bathroom” which assists people with dementia through the process of hand washing by giving them verbal and visual cues if they become confused about the correct sequence of steps. The system is designed to be sensitive to a patient’s needs. Initial research on a small sample shows a 25% increase in the number of hand washings (patients) were able to complete without having a human caregiver present.
Implication for Pharmacy:
Further research may focus on designing prototype technology that would be sensitive to patients requiring assistance from a pharmacist in terms of taking pills or other issues around medication. This technology would fit nicely in the expanding area of home infusion as more elderly patients choose to live independently in their own home.
Posted by mmacneil at 08:55 PM | Comments (0)
March 30, 2007
Canada Invests in Vaccine Development
Source: Globe and Mail, Tuesday, Feb 27/07
Description of Issue:
Vaccination has been clearly shown to be one of the most effective ways to fight infectious diseases around the globe. On Feb 9, 2007, the Canadian government announced a $200 million US contribution to the Advance Market Commitment (AMC) to create a pneumococcal vaccine. The initiative is part of a joint project, funded by Canada, Italy, Norway, Russia, Britain and the Bill and Melinda Gates Foundation. The project is aimed at developing a vaccine that will prevent the strains of the disease most common in the world’s poorest nations. It is estimated that the project could prevent between 500,000 and 700,000 deaths over a ten-year period. It is anticipated that the first vaccine purchases will occur in 2010 and will continue for approximately ten years. More than 1.6 million people, including 700,000 children, currently die each year of pneumococcal meningitis and pneumonia, prominently in South Asia and Sub-Saharan Africa.
Implication For Pharmacy:
Continuing investment in front-line, preventative health care is expected to result in further, significant reduction in health-care costs and save untold lives. This vaccine initiative has the potential to save millions of lives. While the research and development of new medicines is both expensive and risky for patients overall, the health outcomes are immeasurable. For governments, medicines and vaccines are an effective way in helping save valuable health-care dollars.
Posted by mmacneil at 10:13 PM | Comments (0)
March 25, 2007
Cancer-Drug Funding is Top Priority
Source: The Halifax Daily News, Feb.6/07, p.5
Description of the issue:
The Cancer Advocacy Coalition of Canada has issued its latest Report Card on cancer in Canada. The coalition studied access to a selection of 24 drugs. According to the report Nova Scotia's score in funding such drugs is close to the bottom of the 24 drugs studied. Nova Scotia supplied access and funding to only four of the 24 drugs at the end of last year. In contrast, British Columbia funded 20. Nova Scotia does, however, fund 13 additional drugs. One positive step is a process introduced in Nova Scotia for evaluating new drugs. The process utilizes scientific evidence, a pharmacoeconomic analyses and ethical framework. Nova Scotia is taking small steps toward making more drugs available that would extend the lives of cancer patients. But others, such as Newfoundland and Labrador are taking larger strides, for example, by funding Avastin (for colorectal caner) while this drug is not covered in Nova Scotia. The doctors behind the Cancer Advocacy Coalition believe an important part of the solution is to set up a national "catastrophic drug costs" program that gives all Canadians similar access to proven cancer drugs.
Implications of this issue to Pharmacy:
In Canada, we don't want to have a situation where an individual's likelihood of survival is dependent on the province in which they live. A common formulary for listing approved drugs and lobbying governments for a national pharmacare programs are advocacy actions where pharmacists could be involved. Pharmacists could be involved in the research needed to find the "biomarkers" that identify patients most likely to benefit from a particular drug. If certain drugs are found to be helpful they should be available to everyone who need them regardless of where they live.
Posted by mmacneil at 01:33 PM | Comments (0)
March 12, 2007
No More Munchies
Source- Halifax Chronicle Herald, Feb 6, 07. F1, F2
Description of the issue:
Diabetes is a serious health issue in Canada. Two and a half million Canadians, including 80,000 Nova Scotians, have Diabetes; one in seven health dollars goes to the care of diabetes and its complications; 80 % of diabetics die of heart attacks and strokes. It is a huge medical burden, Dr. Ehud Ur, a Nova Scotia diabetes and obesity expert, indicates. Dr Ur notes that 90 % of diabetics have type 2 and in 95% of cases with type 2, weight underlies the problem. Dr. Ur, Professor of Medicine, at Dalhousie University, is the principal investigator for the Halifax, Nova Scotia part of an international clinical trial by Pfizer. Researchers have known for years that cannabis triggers food cravings in a pleasure area of the brain identified as the cannabinoid system. A new classification of drugs known as cannabinoid receptor antagonists are believed to suppress appetite and lower blood sugar and cholesterol. A 900 - person study of the experimental drug (CP945,598) is taking place at 65 sites in 11 countries over the next year. The QEH hospital in Halifax wants to recruit 15 overweight diabetics. Their body mass index must be above 27, which translates to roughly 10 to 15 pounds overweight, an amount Dr. Ur believes is far too common.
Implications of Issue to Pharmacy:
The devastating health effects of diabetes accompanied by obesity makes this study so appealing. Health Professionals such as physicians and pharmacists are always looking for better, more effective and safer means of treatment. There's evidence the cannabinoid receptor has health benefits and a substantial effect on weight loss. It is important to emphasize that this is not a cosmetic treatment for overweight people. These drugs are targeting diabetics who are at risk from the complications of obesity.
Posted by mmacneil at 10:35 PM | Comments (0)
March 04, 2007
Canada Inches Closer to Private Health Options
Source: MacLean's, Vol.119, No.18, May 1, 2006
Description of Issue:
Canadians are forced out of necessity, to investigate medical treatment options outside the publicly funded health insurance system. With an estimated 800,000 people on wait lists, more and more Canadians are looking beyond the Medicare system. While strongly supportive of universal public health care, a growing number of Canadians favor the creation of a Parallel Private System to augment the public health care system. However, Canada needs to get a handle on the massive implications and opportunities related to private medical care. One outcome has been for two American hospitals to branch into the Canadian market: 1) Ohio based Cleveland Clinic; 2) Texas based M.D. Anderson Cancer Center. The United States options are now easier for Canadians to access treatment rather than traveling outside the country.
Implications for Pharmacy:
One clear implication for Pharmacy is that the United States leads Canada by several years in drug availability for Cancers. Patients now treated by a U.S. doctor will follow a treatment plan in Canada. If patients need drugs not available in the Canadian public system, arrangements can be made. However, there will need to be collaboration between U.S. health professionals and Pharmacists/Physicians in Canada. A challenge for Canadian health advocates is getting Canadian health insurance to pay the bill.
Posted by mmacneil at 10:37 AM | Comments (0)
March 02, 2007
Bottleneck in Canada’s Health-Care System
Source: Toronto Globe and Mail- January31/07
Description of Issue:
The issue concerns the commitment of the Federal Conservative Party to "fix" the waiting-time problem in health care. The Canadian Medical Association on behalf of the country's doctors indicated that the wait-line problem is still pressing. The 2004 Canadian Health Accord identified 5 priority areas: Cardiac Care /Cancer /Joint Replacement /Cataracts and /Diagnostic Imagery. Dr. Louise Cloutier, a physician from Halifax, Nova Scotia noted that the focus on some types of care is making waits for other medical interventions longer. In addition, emergency department waits are linked to bottlenecks in other parts of the health care system. Benchmarks for a broad range of procedures back by resources are required to improve Canada’s health care system.
Implication for Pharmacy:
Canada prides itself in being one of the best countries in the world to live. Yet, there are many patients who do not get what would be considered adequate management or standard of care. It is very challenging for pharmacists to support, monitor and follow-up with their patients in the absence of initial proper and adequate care. In addition, pharmacists often have to wait to see patients whose medical issues don't fall into the priority areas.
Posted by mmacneil at 06:40 PM | Comments (0)
February 26, 2007
Advocating for Children’s Health and Well-Being
Source of Information- CTV National News-Jan.27/07
Description of Issue:
The Ontario Medical Association is supporting a ban on cigarette smoking in cars when children 18 years and younger are in the vehicle. This follows the recent news announcement that the City of Bangor, Maine has enacted such legislation. The Ontario Medical Association has supported the cigarette ban for the last 3 years. A recent public opinion poll in Ontario showed 78% support for the cigarette ban in cars containing children. Health evidence has demonstrated that second hand smoke in cars is significantly more toxic for children than in other environments (i.e. home).
Implication for Pharmacy:
Pharmacists and other health practioners in Canada are concerned about the alarmingly high asthma rate in children. Exposure to cigarette smoke is considered one of the factors accounting for the high asthma rate in this country. In addition, pharmacists as health advocates must take the time and have the inclination to lobby for legislation that will ensure the health and well-being of children and youth. The cigarette ban is one such example.
Posted by mmacneil at 04:56 PM | Comments (0)
February 13, 2007
Health Literacy an Important Issue for the Health Professional
Source: Canada West News Srvice-Jan/07
Description of Issue:
An article by Sharon Dirkey discusses a new Canadian report of literacy skills. One aspect of the national study addressed Health Literacy, meaning the ability to understand all of those things, which allow you to maintain control of your health. One disturbing finding was that more than half of Canadians have trouble understanding what "take two tablets twice daily for seven days" means. In addition, nearly 90% of senior’s -the biggest users of health services in the country- lack the literacy skills needed to deal with health information.
Implications to Pharmacy:
Low health literacy can lead to dosing errors. Diabetics, for example, may have problems interpreting blood glucose scores. People are more likely to ignore warning labels.
Pharmacists must have concerns about health literacy. Health Professionals must take the time to ensure that complex medical information/instructions are put in terms that people with lower levels of literacy skills can understand.
Posted by mmacneil at 09:18 PM | Comments (0)
February 06, 2007
Pharmacy Across Borders
Source: Toronto Globe and Mail- January/07
Description of Issue:
A Danish study has found some drug manufacturers have suppressed negative data and modified results to put their product in a positive light. A team of European and Canadian researchers investigated 44 trials carried out in Denmark in the 1990's. They discovered that drug company employees were directly involved in 33 of these trials, but their names did not appear in the list of authors, or contributors when the studies were published. In effect, company employees were "ghost authors" of many studies. An-Wen Chan (U. Toronto) believes keeping names secret provides a misleading impression of who really conducted and interpreted the study.
Implications to Pharmacy/Practice:
Although researchers for this study looked at only Danish trials, they believe ghost authorship is a global research problem. Some would argue that you could come to just about any conclusion you want from a particular study. And, for that reason, it is important to know who is doing the analyses- and if that person has a hidden agenda. In Pharmacy research, there is an assumption of pharmacy companies maintaining an arm's length relationship with researchers to ensure findings are free of bias.
Posted by mmacneil at 08:19 PM | Comments (0)
January 23, 2007
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Posted by mmacneil at 02:59 PM | Comments (0)
