Health Train Express

Tuesday, March 12, 2024

Surgeon Sex and Health Care Costs for Patients Undergoing Common Surgical Procedures

Women surgeons have lower health care costs, Why?

Surgeon Sex and Health Care Costs for Patients Undergoing Common Surgical Procedures | Surgery | JAMA Surgery | JAMA Network

Monday, March 11, 2024

Taking Z-drugs for Insomnia? Know the Risks | FDA

ZZZZZ. Remember sleeping through the night? Not lately?

If you’re lying awake night after night, unable to sleep, you may want to talk to your health care professional about it. They may prescribe insomnia medicines approved by the U.S. Food and Drug Administration, such as eszopiclone (Lunesta), zaleplon (Sonata) and zolpidem (Ambien, Ambien CR, Edluar, and Zolpimist). Sometimes known as “Z-drugs,” they might help you get a good night’s sleep. But as with any medicine, there are risks.

Prescription Z-drugs work by slowing activity in the brain. Used properly, they can help you sleep. Quality sleep can have a positive impact on physical and mental health. But the treatments also carry the risk – though rare – of serious injuries, and even death. Be aware of these risks.

In 2019, the FDA required the addition of the risks for complex sleep behaviors resulting in serious injuries or death to the labeling and Patient Medication Guides for all prescription Z-drugs.

What Are Complex Sleep Behaviors?

Complex sleep behaviors occur while you are not fully awake. Examples include sleepwalking, sleep driving, sleep cooking, or taking other medicines.

The FDA has received reports of people taking these insomnia medicines and accidentally overdosing, falling, being burned, shooting themselves, and wandering outside in extremely cold weather, among other incidents.

People might not remember these behaviors when they wake up the next morning. Moreover, they may experience these types of behaviors after their first dose of one of these Z-drugs, or after continued use.

Tips for Taking Medicines for Insomnia

If your health care professional prescribes a Z-drug to help you sleep, discuss with them the benefits and risks.

Be sure to read the Patient Medication Guide as soon as you get the prescription filled and before you start taking the medicine. If you have any questions or don’t understand something, ask your health care professional.

After taking the medicine, if you experience a complex sleep behavior, stop taking the drug and contact your health care professional immediately.

Complex sleep behaviors can occur at lower dosages, not just high doses. It’s important to carefully follow the dosing instructions as directed by your health care professional.

Don’t take these medicines with any other sleep drugs, including those you can buy over-the-counter without a prescription.

Don’t drink alcohol before or while taking these medicines; together they may be more likely to cause side effects.

You may still feel drowsy the day after taking one of these drugs. Keep in mind that all insomnia medicines can impair your ability to drive and activities that require alertness the morning after use.

For information on healthy sleep habits, visit Tips for Better Sleep and Insomnia: Relaxation techniques and sleeping habits.

Was this helpful?

Taking Z-drugs for Insomnia? Know the Risks | FDA

Credible Sources of Information on Health and Wellness

When seeking credible sources for health and wellness information to include on a website, it's essential to rely on reputable organizations and experts. Here are some sources that you can consider:

1. **Government Health Agencies:**

- Centers for Disease Control and Prevention (CDC): Provides comprehensive information on a wide range of health topics.

- World Health Organization (WHO): Offers global health information and guidelines.

2. **Medical Associations:**

- American Heart Association (AHA): Trusted source for cardiovascular health information.

- American Cancer Society (ACS): Provides reliable information on cancer prevention and treatment.

- National Institutes of Health (NIH): Comprises various institutes, each focusing on specific health aspects.

3. **Educational Institutions:**

- Mayo Clinic: Known for its expertise in medical research and patient care.

- Harvard Health Blog: Offers insights and advice from Harvard Medical School experts.

4. **Nonprofit Organizations:**

- WebMD: Provides health information with input from medical experts.

- Mayo Clinic: Offers reliable health information and tools for self-care.

5. **Professional Health Journals:**

- The New England Journal of Medicine: Publishes peer-reviewed articles on a wide range of medical topics.

- JAMA (Journal of the American Medical Association): Covers various medical specialties.

6. **Nutrition and Diet:**

- Academy of Nutrition and Dietetics: Offers evidence-based information on nutrition.

- Nutrition.gov: A government resource providing information on healthy eating.

7. **Mental Health:**

- National Institute of Mental Health (NIMH): Focuses on mental health research and education.

- Mental Health America: Provides information and resources for mental health.

8. **Alternative Medicine:**

- National Center for Complementary and Integrative Health (NCCIH): Focuses on complementary and alternative medicine.

9. **Fitness and Exercise:**

- American Council on Exercise (ACE): Offers resources on fitness and exercise.

- National Institute on Aging (Exercise and Physical Activity): Tailored for older adults, providing exercise guidelines.

When curating information, it's crucial to cross-reference from multiple sources to ensure accuracy. Additionally, be cautious of websites that lack clear authorship or those promoting unsubstantiated claims. Always prioritize peer-reviewed journals, established health organizations, and government agencies for the most reliable information.

Feel free to ask if you have specific health topics in mind, and I can provide more tailored recommendations.

Sunday, March 10, 2024

OpenEvidence - NY Times finally reports some Truth

The prevalence of Long COVID, defined as the persistence of symptoms beyond 4 weeks from the onset of acute COVID-19, varies across different age groups. In the general adult population, estimates suggest that around 7.3% of all respondents reported long COVID.[1] However, the prevalence of long COVID was found to be higher among respondents who were female, had comorbidities, or were not vaccinated.[1]

In a nationwide population cohort study of Scottish adults, the adjusted prevalence of symptoms attributable to SARS-CoV-2 infection was 6.6%, 6.5%, and 10.4% at 6, 12, and 18 months respectively.[2]

In children and adolescents, the prevalence of long COVID is reported to be around 25.24%, with another study reporting a similar prevalence of 23.36%.[3-4] The most prevalent clinical manifestations in this age group were mood symptoms, fatigue, and sleep disorders.[3]

Risk factors for long COVID in children and adolescents include chronic conditions, obesity, and being in the adolescent age group.[5] In the general population, risk factors include increasing age, female sex, white ethnicity, poor pre-pandemic general and mental health, overweight/obesity, and asthma.[6]

It's important to note that these estimates may vary due to differences in study design, population characteristics, and definitions of long COVID. Further research is needed to better understand the prevalence and risk factors of long COVID across different age groups.

OpenEvidence - What's the prevalence of Long COVID in different age groups?

Saturday, March 2, 2024

Calculators for your Health Needs

Friday, March 1, 2024

$15 billion win for physicians on prior authorization | American Medical Association

The time-consuming process for prior authorization to be incorporated into Electronic Health Record.

$15 billion win for physicians on prior authorization | American Medical Association

What’s at stake

Prior authorization is a health plan cost-control process that AMA survey research shows leads to delayed and abandoned care, negatively affecting patient outcomes. The average physician practice completes 45 prior authorizations per physician, per week, and doctors and their staff spend nearly two business days a week completing such authorizations.

More than nine in 10 physicians (94%) report care delays while waiting for insurers to authorize necessary care, and 80% say prior authorization can lead to treatment abandonment.

One-third (33%) of physicians report that prior authorization has led to a serious adverse event. This includes hospitalization (25%) or disability or even death (9%) for a patient in their care.

Meanwhile, 31% of physicians report that prior authorization criteria are rarely or never evidence-based, with 89% saying prior authorization harms patients’ clinical outcomes.

Prior authorization is overused, costly, inefficient, opaque, and responsible for patient care delays. That’s why we’re standing up to insurance companies to eliminate care delays, patient harm and practice hassles, and why fixing prior authorization is a critical component of the AMA Recovery Plan for America’s Physicians.

Prior authorization is overused, costly, inefficient, opaque, and responsible for patient care delays. That’s why we’re standing up to insurance companies to eliminate care delays, patient harm, and practice hassles, and why fixing prior authorization is a critical component of the AMA Recovery Plan for America’s Physicians.

Centers for Medicare & Medicaid Services (CMS) has released a final rule making important reforms to prior authorization to cut patient care delays and electronically streamline the process for physicians. Together, the changes will save physician practices an estimated $15 billion over 10 years, according to the U.S. Department of Health and Human Services (HHS).

The rule addresses prior authorization for medical services in these government-regulated health plans:

Medicare Advantage.

State Medicaid and Children’s Health Insurance Program (CHIP) fee-for-service programs.

Medicaid-managed care plans and CHIP-managed care entities.

Qualified health plan issuers on the federally facilitated exchanges.

In addition, CMS is mandating shortened processing time frames and also requiring that payers give physicians and patients more prior authorization-related information. Notably, the $15 billion savings estimate does not account for lower patient costs attributable to timelier delivery of physician-ordered care.

Enforcement of these policies, particularly around Medicare Advantage payers, can include CMS sanctions and civil monetary penalties. Starting in 2026, affected payers will have to send prior authorization decisions within 72 hours for urgent requests and within a week for nonurgent requests. For some payers, CMS noted, that would represent a 50% improvement. The AMA strongly advocated faster time frames (PDF) of 24 hours for urgent requests and 48 hours for standard requests. CMS said it will consider updating its policies in future rulemaking.

Why it’s important: While payers claim that prior authorization requirements are used for cost and quality control, a vast majority of physicians report that the protocols lead to unnecessary waste and avoidable patient harm. One-third of the 1,001 physicians surveyed (PDF) by the AMA reported that prior authorization has led to a serious adverse event for a patient in their care.

More specifically, the AMA survey found that these shares of the physician respondents reported that prior authorization led to:

A patient’s hospitalization—25%.

A life-threatening event or one that required intervention to prevent permanent impairment or damage—19%.

A patient’s disability or permanent bodily damage, congenital anomaly or birth defect, or death—9%.