Access 2020-2021 OTC Guide Survey Results

The Year's Top Pharmacist-Recommended Health Products

A diet rich in flavan-3-ols, more commonly referred to as flavanols, includes food and beverages such as tea, apples, and berries. According to the European Prospective Investigation into Cancer (EPIC) Norfolk study published in 

, this type of diet may lower blood pressure, indicating its ability to support the maintenance of cardiovascular (CVD) health on a population scale.

Flavanols are a group of bioactive compounds that have demonstrated an ability to help vascular function in prior intervention studies. For this reason, the researchers were interested in investigating flavanols as dietary support in the prevention of CVD diseases due to a lack of reliable data from observational studies on the subject. They noted that such a lack may be in part because of the high variability in the flavanol content of food, making estimates of actual intake difficult without nutritional biomarkers.

The researchers assessed the biomarker-estimated flavanol intake of 25,618 citizens of Norfolk in the United Kingdom in relation to their blood pressure and other CVD risk markers, as well as longitudinal associations with CVD risk. However, the researchers strayed from common practice in studies of this kind by not relying on the reported diets of participants, and instead measured flavanol intake through nutritional biomarkers, such as indicators of dietary intake, metabolism, or nutritional status present in the blood.

"Previous studies of large populations have always relied on self-reported data to draw conclusions, but this is the first epidemiological study of this scale to objectively investigate the association between a specific bioactive compound and health,” said lead author Gunter Kuhnle, PhD, a professor of nutrition at the University of Reading, in a press release.

The results demonstrated that participants with the lowest 10% of flavanol intake and participants with the highest 10% of intake had a difference in blood pressure between 2 and 4 mmHg. Such significant changes in blood pressure are comparable to those with a Mediterranean diet or moderate salt reduction.

"What this study gives us is an objective finding about the association between flavanols—found in tea and some fruits—and blood pressure. This research confirms the results from previous dietary intervention studies and shows that the same results can be achieved with a habitual diet rich in flavanols. In the British diet, the main sources are tea, cocoa, apples and berries,” Kuhnle said.

Kuhnle explained that the methodology of the study was also of importance in their research.

“This is one of the largest ever studies to use nutritional biomarkers to investigate bioactive compounds. Using nutritional biomarkers to estimate intake of bioactive food compounds has long been seen as the gold standard for research, as it allows intake to be measured objectively. The development, validation and application of the biomarker was only possible because of the long-term commitment of all collaborators. In contrast to self-reported dietary data, nutritional biomarkers can address the huge variability in food composition. We can therefore confidently attribute the associations we observed to flavanol intake," Kuhnle said.

Following this study, researchers from the University of Reading; Cambridge University; University of California, Davis; and Mars, Incorporated assessed the data of the participants from the EPIC Norfolk study and observed that the greatest change in blood pressure due to diet was observed in participants with the highest blood pressure.

The researchers noted this finding suggests that an increase in flavanol intake among the general public could result in an overall reduction in CVD disease incidence.

"This study adds key insights to a growing body of evidence supporting the benefits of dietary flavanols in health and nutrition,” said Hagen Schroeter, PhD, chief science officer at Mars Edge, in a press release. “But, perhaps even more exciting was the opportunity to apply objective biomarkers of flavanol intake at a large scale. This enabled the team to avoid the significant limitations that come with past approaches which rely on estimating intake based on self-reported food consumption data and the shortcomings of current food composition databases."

Ottaviani JI, Britten A, Lucarelli D, et al. Biomarker-estimated flavan-3-ol intake is associated with lower blood pressure in cross-sectional analysis in EPIC Norfolk. 

. 10,17964(2020). doi: 10.1038/s41598-020-74863-7.

High flavanol diet may lead to lower blood pressure. Reading, UK: University of Reading; October 21, 2020. eurekalert.org/pub_releases/2020-10/uor-hfd101620.php. Accessed October 28, 2020.

Articles

According to a recent study, a flavanol-rich diet may lower blood pressure, indicating its ability to support the maintenance of cardiovascular (CVD) health on a population scale.

Flavanol-rich Diet May Lower Blood Pressure

The FDA has approved invermectin 0.5% (Sklice, Sanofi Pasteur Inc), a lotion for the treatment of head lice, for OTC use.

Invermectin 0.5% was initially approved for prescription use in patients 6 months of age and older in February 2012. Every year, an estimated 6 to 12 million cases of head lice infestation occurs in children 3 to 11 years of age, according to an FDA press release. Lice are most common among children in preschool, elementary school, and among members of a household in which children have lice.

The nonprescription designation was changed in a process known as prescription (RX)-to-OTC switch. This process is usually initiated by the manufacturer, which must prove that the drug is safe and effective when used as directed in the proposed labeling in order to be successful.

Invermectin 0.5% is a lotion for external use only and should be used on the scalp or dry hair in accordance with label instructions only. The lotion is not approved for any other use, according to the FDA.

“The Rx-to-OTC switch process aims to promote public health by increasing consumer access to drugs that would otherwise only be available by prescription,” Theresa Michele, MD, acting director of the Office of Nonprescription Drugs in the FDA’s Center for Drug Evaluation and Research, said in a press release. “Today’s approval expands access to another effective topical treatment for the thousands of people with head lice.”

The lotion will be marketed as a nonprescription drug and will no longer require a prescription drug. Those who are currently using a prescription version of the product should consult their health care professional, according to the FDA.

FDA Approves Lotion for Nonprescription Use to Treat Head Lice [News Release] October 27, 2020; White Oak, MD. 

https://www.fda.gov/news-events/press-announcements/fda-approves-lotion-nonprescription-use-treat-head-lice?utm_medium=email&utm_source=govdelivery

Invermectin 0.5% is a topical lotion available OTC to treat head lice. 

FDA Approves Invermectin Lotion for Head Lice 

A new study from researchers at the University of Maryland School of Medicine (UMSOM) found that hospitalized patients with coronavirus disease 2019 (COVID-19) who were taking a daily low-dose aspirin to protect against cardiovascular disease had a significantly lower risk of complications and death compared with those who were not taking aspirin.

Further, aspirin takers were less likely to be placed in the ICU or hooked up to a mechanical ventilator and were more likely to survive the infection compared with hospitalized patients who were not taking aspirin.

"This is a critical finding that needs to be confirmed through a randomized clinical trial," said study leader Jonathan Chow, MD, assistant professor of Anesthesiology at UMSOM in a press release. "If our finding is confirmed, it would make aspirin the first widely available, over-the-counter medication to reduce mortality in COVID-19 patients."

Chow and his colleagues went through medical records of 412 COVID-19 patients with an average age of 55 years who were hospitalized over the past few months due to complications of their infection. The patients were treated at the University of Maryland Medical Center in Baltimore and 3 other hospitals along the East Coast. Approximately one-quarter of the patients taking a daily low-dose aspirin before they were admitted or right after admission to manage their cardiovascular disease.

The researchers found aspirin use was associated with a 44% reduction in the risk of being put on a mechanical ventilator, a 43% decrease in the risk of ICU admission, and a 47% decrease in the risk of dying in the hospital compared with those who were not taking aspirin. The patients in the aspirin group did not experience a significant increase in adverse events, such as major bleeding while hospitalized, according to the study.

Several factors may have contributed to the patients’ prognosis, including age, gender, body mass index, race, hypertension, and diabetes, also accounting for heart disease, kidney disease, liver disease, and the use of beta blockers to control blood pressure.

Although physicians often recommend a daily low-dose aspirin for patients who have previously had a heart attack or stroke caused by a blood clot to prevent future blood clots, daily use can increase the risk of major bleeding or peptic ulcer disease, according to the study.

"We believe that the blood thinning effects of aspirin provides benefits for COVID-19 patients by preventing microclot formation," said study co-author Michael A. Mazzeffi, MD, associate professor of anesthesiology at UMSOM, in a press release. "Patients diagnosed with COVID-19 may want to consider taking a daily aspirin as long as they check with their doctor first.”

Further studies are needed to prove that aspirin use leads to better outcomes in COVID-19, but the evidence from this study suggests that patients may want to discuss with their physician whether it is safe for them to take aspirin to manage potentially prevent serious complications, according to the study authors.

New study: aspirin use reduces risk of death in hospitalized patients. EurekAlert! Published October 22, 2020. Accessed October 23, 2020.

Aspirin takers were less likely to be placed in the ICU or hooked up to a mechanical ventilator and were more likely to survive the infection compared with hospitalized patients who were not taking aspirin.

Study: Aspirin Use Reduces Risk of Death in Hospitalized COVID-19 Patients 

New research suggests that CBD can reduce inflammation and reduce the cytokine storm that causes lung damage and death in many patients with coronavirus disease 2019 (COVID-19).

Investigators at the Dental College of Georgia and Medical College of Georgia had previously found that CBD improves oxygen levels and reduces inflammation and physical lung damage in their model of adult respiratory distress syndrome (ARDS). In their new study, the team found that apelin levels significantly decrease during COVID-19, but that CBD quickly helps normalize those levels.

“CBD almost brought [apelin] back to a normal level,” said co-author Jack Yu, MD, in a press release.

COVID-19 enters human cells via the angiotensin-converting enzyme 2 (ACE2) receptor, which typically works with apelin to control blood pressure. The authors hypothesized that an upregulation of both ACE2 and apelin may be helpful in cardiovascular disease by decreasing blood pressure and increasing the heart’s ability to pump.

Similar to other diseases, however, the investigators said COVID-19 appears to upset the partnership between apelin and ACE2. The binding of the virus to ACE2 has been shown to decrease the receptor’s levels and increase levels of angiotensin II, because angiotensin II is degraded and fewer vasodilators are produced.

In the researchers’ ARDS models, blood levels of apelin dropped close to zero but quickly increased 20 times over with CBD, according to the study published in the 

Journal of Cellular and Molecular Medicine.

 Apelin—a pervasive peptide created by cells in the heart, lungs, brain, fat tissue, and blood—is essential in regulating both blood pressure and inflammation.

When blood pressure increases, the investigators said apelin levels should grow in the correct place to help bring it down. It should also increase in order to normalize significant spikes in lung inflammation and related breathing difficulties associated with ARDS.

“Ideally, with ARDS it would increase in areas of the lungs where it’s needed to improve blood and oxygen flow to compensate and to protect,” said Babak Baban, PhD, the study’s corresponding author.

However, Baban added that this did not prove to be true in their ARDS model, with apelin decreasing in both the lung tissue itself and the general circulation.

Although the investigators did not attribute all of CBD’s benefits to apelin levels, they said the peptide does play an important role. More research is needed in order to understand whether COVID-19 or CBD have a direct impact on apelin or if these are downstream consequences.

“It is an association; we don’t know yet about causative, but it is a very good indicator of the disease,” Baban said.

CBD helps reduce lung damage from COVID by increasing levels of protective peptide [news release]. EurekAlert!; October 19, 2020. 

https://www.eurekalert.org/pub_releases/2020-10/mcog-chr101620.php

Although the investigators did not attribute all of CBD’s benefits to apelin levels, they said the peptide does play an important role.

Study: CBD Increases Levels of Protective Peptide, Reducing COVID-19 Lung Damage

Investigators at MIT and the Ragon Institute of MIT, MGH, and Harvard have designed a vaccine that triggers an immune response against an influenza protein segment that rarely mutates, but is not normally targeted by the immune system, according to a study published in 

 According to the authors, this vaccine marks one step closer towards the development of a universal flu vaccine.

The flu vaccine has to be redesigned annually in order to account for mutations that the virus accumulates. However, even with the yearly redesign, the vaccine often does not fully protect everyone.

The vaccine candidate offers nanoparticles coated with flu proteins that teach the immune system to create desired antibodies. In testing with mice, the vaccine elicited an antibody response targeted the protein segment. This means that the vaccine could potentially be effective against any flu strain.

According to the study, the immune system targets the head of the HA Protein and not the stem. The head of the protein tends to mutate rapidly, but the HA stem very rarely mutates. This makes the stem a prime target for a universal flu vaccine.

"We don't understand the complete picture yet, but for many reasons, the immune system is intrinsically not good at seeing the conserved parts of these proteins, which if effectively targeted would elicit an antibody response that would neutralize multiple influenza types," said Daniel Lingwood, PhD of Harvard Medical School, in a prepared statement.

According to study authors, developing a universal flu vaccine can help minimize pandemic threats. Refocusing immunity can help in its development.

"When there's a refocusing event, that means we can swing the antibody response against that target, which under other conditions is simply not seen. We have shown in previous studies that when you're able to elicit this kind of response, it's protective against flu strains that mimic pandemic threats,” Lingwood said.

Trafton A. A step toward a universal flu vaccine. MIT News. Published October 7, 2002. Accessed October 23, 2020. https://news.mit.edu/2020/universal-flu-vaccine-1007

Targeting the virus’s stem, not the head, could be the answer. 

Steps Made Towards Universal Flu Vaccine

The National Association of Pediatric Nurse Practitioners (NAPNAP) has revised its position statement on the integration of mental health care in primary care settings. The change was made because of the rise of mental health in the public health realm, according to the organization.

The revised position statement confirms that the holistic, family-centered, longitudinal approach of care delivered at the pediatric primary care level can lead to early identification of mental health issues and behavioral factors contributing to mental health issues of children. Further, pediatric-focused advanced practice registered nurses have the education and skills to meet the increasing demand for pediatric mental health care integration in primary care settings.

“There is a stigma associated with mental health that leads to a reluctance by families to talk to primary care providers about these concerns,” said NAPNAP president Jessica Peck, DNP, APRN, CPNP-PC, CNE, CNL, FAANP, in a prepared statement. “Nurse practitioners in pediatric primary care need to treat every visit as an opportunity to screen a child’s mental health and provide families with the information and resources they need.”

In order to provide comprehensive mental and behavioral health services to all children and adolescents, pediatric-focused nurse practitioners should be guided by the position statement, according to NAPNAP, which recommends practices as follows:

Using a lifespan approach to provide mental and behavioral health promotion

Integrating research findings that optimize physical and mental health in childhood and adolescence, laying the foundation for physical and mental well-being in adulthood

Educating children and families about the early signs and symptoms of mental and behavioral health problems in primary care

Advocating for reimbursement policies that support parity for mental health services provided to children in primary care settings

Educating the public about pediatric mental health conditions and support legislative and other interdisciplinary efforts that aim to bolster children’s mental and behavioral health needs at the local, state, and federal levels

NAPNAP revises position statement on integration of mental health care in primary care settings. NAPNAP [email]. Sent October 21, 2020. Accessed October 21, 2020.

The revised position statement confirms that the holistic, family-centered, longitudinal approach of care delivered at the pediatric primary care level can lead to early identification of mental health issues and behavioral factors contributing to mental health issues of children. 

NAPNAP Revises Position Statement on Integration of Mental Health Care in Primary Care Settings

Columbia University School of Nursing has announced the establishment of the Center for Research on People of Color (CRPC). The center aims to provide multidisciplinary resources for research and educational programming designed to address injustices in health care that disproportionately affect communities of color, according to Columbia University.

The CRPC’s goals are to promote and expand the body of scholarly research related to people of color and to provide consultation and mentoring for researchers. In addition, the CRPC’s body of research will focus on conditions and diseases that disproportionately affect minority populations, such as hypertension, obesity, diabetes, maternal/child health and poor birth outcomes, LGBTQ health, and genomics of health and disease.

“For too long, people of color have not been sufficiently represented in health research, which has perpetuated injustice across the field and broader society,” said Jacquelyn Y. Taylor, PhD, founding director of the center in a prepared statement. “The CRPC seeks to promote health equity and justice through high-quality studies, mentorship for early career researchers, and learning opportunities open to all.”

The CRPC aims to support pilot investigators in conducting research and generating preliminary findings, and it will provide resources for research projects involving people of color, including project databases, access to biological samples located in the CRPC, data management consultation, and support for junior investigators on career development in health equity research.

With the emergence of the coronavirus disease 2019 (COVID-19), the CRPC will examine the interaction between the biological sciences and diverse social factors that contribute to health disparities, such as how COVID-19 is disproportionately affecting the nation’s most vulnerable populations.

“We are excited to launch this important interdisciplinary work and look forward to seeing the CRPC grow and thrive in the years to come” said Lorraine Frazier, PhD, dean of Columbia University School of Nursing and senior vice president, Columbia University Irving Medical Center in a prepared statement. “Under Dr. Taylor’s leadership, the center will be a focal point for important research and for supporting investigators in areas that have not been fully addressed before.”

Columbia University School of Nursing Launches Center for Research on People of Color (CRPC). Columbia School of Nursing. 

https://www.nursing.columbia.edu/news/columbia-university-school-nursing-launches-center-research-people-color-crpc

. Published October 15, 2020. Accessed October 20, 2020.

The CRPC’s goals are to promote and expand the body of scholarly research related to people of color and to provide consultation and mentoring for researchers.

Columbia University School of Nursing Launches Center for Research on People of Color

Telemedicine can help limit the time spent in the emergency department (ED) and help hospitals with demand surges, according to a new study published in 

The coronavirus disease 2019 (COVID-19) pandemic has limited doctors’ offices and hospital visits to help ensure patient and care provider safety. Telemedicine can help bridge the gap rather than diminish the quality of care, according to the study. Additionally, overcrowding in EDs are a common problem in general, which can be costly for hospitals and impact patient experience.

Investigators looked at ED visits in New York from 2010 to 2014, comparing visits that utilized telemedicine versus those that did not.

Investigators found that telemedicine significantly reduces average length of stay. According to the study, this finding is partially driven by flexible resource allocation. Using telemedicine during ED surges can also reduce hospital stays and reduce patient wait times.

The majority (76%), of United States hospitals are already using telemedicine technologies.

"The current pandemic has shown hospitals the great promise of telemedicine application and hopefully the unexpected enrollment of such policies, alongside this research, can help get the process underway to help more health care facilities utilize this technology in [Eds] and elsewhere," study author Susan Lu, PhD said in a prepared statement.

"Policymakers can play a role as well by reducing regulatory barriers that inhibit more expansive use of telemedicine and by creating incentives that encourage hospitals to more broadly adopt telemedicine in emergency rooms,” said Lu.

Adopting telemedicine during ED surges would not increase costs, study authors say, nor would it increase the expense of care quality.

Utilizing telemedicine in the ER can reduce wait times and patient length of stay [News Release] October 16, 2020; West Lafayette, Indiana. 

https://www.eurekalert.org/pub_releases/2020-10/ifor-uti101620.php

Investigators found that using telemedicine can improve patient experience. 

Study: Telemedicine Can Reduce Emergency Department Backlog, Wait Times

Halloween will likely look different this year as the coronavirus disease 2019 (COVID-19) pandemic persists throughout the United States. Many families look forward to Halloween festivities, and there are a variety of creative and safe ways to celebrate while reducing the spread of COVID-19.

This is a great time for health care professionals to educate the public and remind everyone about the importance of masks, physical distancing (staying at least 6 feet apart), and frequent hand washing. Individuals should not let their guard down during Halloween, as it is critical to prevent the spread of COVID-19. It is also an important time to remind the community that everyone’s actions have a direct impact on the health of others.

Both the CDC and American Academy of Pediatrics (AAP) have issued guidance on Halloween activities, and health and safety measures.

 “The decisions we make on this 1 day can have a ripple effect on our family members.We can find safe ways to celebrate and create magical memories,” said Shelly Vaziri Flais, MD, FAAP, pediatrician and AAP spokesperson in a prepares statement.

Evidence demonstrates that even small family gatherings can lead to COVID-19 spread when appropriate safety measures are not followed.

Hosting a virtual costume party is a great way to stay connected with family and friends.2 Pumpkin carving, decorating, and a Halloween movie night with members of the same household can be fun for all ages. Creating a Halloween themed scavenger hunt by hiding treats around the house is also sure to be a big hit.

Outdoor activities with family and friends that are not in the same household should involve physical distancing, mask wearing, and frequent hand washing.

 Drive through events are being advertised on social media as a safe way to experience Halloween without getting out of the car, and may even have curbside treats and pumpkins. Attending an outdoor costume parade can be a fun way to celebrate Halloween, as long as all health and safety measures are followed.

 If visiting a pumpkin patch, it’s important to wash hands or use hand sanitizer with at least 60% alcohol after touching surfaces and pumpkins.

 Crowds should be avoided, and individuals should not attend indoor events such as haunted houses, as these can increase the spread of COVID-19.

Individuals should avoid traditional trick-or-treating, and residents should sit outdoors wearing face coverings if they would like to hand out individually packaged treats.

 Families should bring hand sanitizer and use frequently while trick-or-treating, and wash their hands after returning home. All individuals aged 2 years and older should wear adequate face coverings, as costume masks are not sufficient against COVID-19 transmission, if trick-or-treating.

It also is important to offer non-candy options for children with food allergies, and in doing so, households can participate in the Teal Pumpkin Project.

 All families should wipe down treat bags and keep candy in quarantine for a few days as an extra precaution.

CDC. Coronavirus disease 2019 (COVID-19): Trick or treating and other Halloween activities. Updated October 9, 2020. Accessed October 14, 2020. 

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays/halloween.html

AAP. American Academy of Pediatrics offers tips for a safe Halloween during pandemic. Published September 22, 2020. Accessed October 14, 2020. 

https://services.aap.org/en/news-room/news-releases/health--safety-tips/american-academy-of-pediatrics-offers-tips-for-a-safe-halloween-during-pandemic/

Schwartz NG, Moorman AC, Makaretz A, et al. Adolescent with COVID-19 as the Source of an Outbreak at a 3-Week Family Gathering — Four States, June–July 2020. 

Many families look forward to Halloween festivities, and there are a variety of creative and safe ways to celebrate while reducing the spread of COVID-19. 

Halloween Activity Health Tips During the COVID-19 Pandemic

Lower doses of zinc are just as effective in treating childhood diarrhea while decreasing vomiting, according to a recent study published in 

While there has been a 90% decline in diarrhea-related deaths since 1980, approximately half a million children died of diarrhea in 2018. The World Health Organization currently recommends 20 mg of zinc for 10 to 14 days for children with acute diarrhea. Previous trials found that while this dosage decreases diarrhea, it increases vomiting, according to the study.

The randomized, multicenter study focused on 4500 children in Indian and Tanzania who were aged 6-59 months and had acute diarrhea. Each child was assigned 5 mg, 10 mg, or 20 mg of zinc sulfate for 14 days. According to the study, the 3 primary outcomes were a diarrhea duration of more than 5 days, the number of stools, and the number of vomiting within 30 minutes after zinc administration.

Children with diarrhea for more than 5 days was 6.5% in the 20 mg group, 7.7% in 10 mg group, and 7.2% in the 5 mg group, according to the study. The mean number of diarrheal stools was similar across all 3 groups. For the 20 mg group, the mean number of stools was 10.7, for the 10 mg group it was 10.9, and 10.8 in the 5 mg group. However, as the dosage of zinc decreased, so did the rate of vomiting within 30 minutes after administration. In the 20 mg group, 19.3% experienced vomiting within 30 minutes. For the 10 mg group, 15.6% had this adverse effect, and 13.7% of the 5 mg group experienced vomiting after administration.

“In our trial, we found that children with acute diarrhea receiving 5 mg or 10 mg per day of supplemental zinc had diarrhea outcomes similar to those in children receiving 20 mg but had less vomiting,” study authors wrote.

Investigators found that children in India appeared to benefit more from lower zinc doses with respect to vomiting than children in Tanzania. This may be due to several unmeasured factors, according to the study. For example, the Tanzanian children tended to be younger and more well-nourished compared to the Indian children in the study.

Dhingra, Usha, MA, MCA et al. Lower-Dose Zinc for Childhood Diarrhea — A Randomized, Multicenter Trial [Journal Article] The New England Journal of Medicine; September 24, 2020. DOI: 10.1056/NEJMoa1915905. Accessed September 24, 2020.

Lower doses of zinc provide similar results while reducing vomiting. 

Study: Lower Zinc Doses Effective For Childhood Diarrhea

Every year on October 12, the observance of World Arthritis Day calls global attention to the complex, multifaceted disease that causes both physical and emotional impacts, yet is still called the ‘invisible disease.’1

Many people with arthritis are more vulnerable to the coronavirus disease 2019 (COVID-19) due to their age or a compromised immune system. Taking action and spreading awareness about the seriousness of arthritis can help make health care more accessible and affordable for chronic diseases and finding a cure.

There are multiple ways that the public can advocate for the cause and spread the word about World Arthritis Day. For example, the Arthritis Foundation is asking the public to take part in the 

 study and sharing the results with policymakers, medical experts, and product manufacturers to bring about major changes.

Additionally, on October 14, 2020, there is an opportunity to be an advocate for World Arthritis Day by participating in the roundtable discussion, “Policy Prescription: Improving Pain Management Through Research, Innovation, & Access” which will talk about the challenges arthritis patients face and potential solutions to improve care and outcomes.

In recognition of World Arthritis Day, PainBloc24 is matching 

s to the Arthritis Foundation for up to $25,000. The donation match is occurring for 1 day.

World Arthritis Day 2020. Arthritis Foundation. Published October 5, 2020. Accessed October 12, 2020. 

http://blog.arthritis.org/living-with-arthritis/world-arthritis-day-2020/?_ga=2.44939812.187298419.1602514455-1418080035.1602514455&_gac=1.255058650.1602514455.cjwkcajw_y_8brbieiwa5mcbjvltulvviyid2zduptck5gtzqoo0oojj445b_bcvxjbmurj9fpefhxoc6z0qavd_bwe

Every year on October 12, the observance of World Arthritis Day calls global attention to the complex, multifaceted disease that causes both physical and emotional impacts, yet is still called the ‘invisible disease.

Bringing Attention to the ‘Invisible Disease’ on World Arthritis Day 2020

New community-focused pharmacy and health care initiatives are being implemented by Walgreens in Chicago, Illinois, to address health disparities and improve outcomes beginning in underserved neighborhoods on the South Side.

“Improving the health and well-being of the communities we serve guides everything we do, and we know there is great need, as well as opportunity, to assist the patients we serve on their journey to better health,” said John Standley, Walgreens president, in a press release. “By learning more about the particular health needs in these areas and tailoring our pharmacy services to help address them, we can continue to make an impact as part of our commitment to Chicago, and with pharmacists our customers know and trust.”

Walgreens is working to expand access to affordable care and educational outreach to further support the city of Chicago’s health equity objectives, according to the press release.

Further, Walgreens has started to bring health service offerings to Chatham on the South Side of the city, including the following initiatives:

, where pharmacists are prioritizing high-touch consultations for those living with diabetes to personalize solutions, address any barriers to taking medications and making recommendations for health screenings and immunizations.

, where pharmacists are conducting outreach to parents and guardians of children with asthma to provide education on the importance and proper use of asthma medications, review adverse effects, discuss asthma triggers, and provide action plans in collaboration with health care providers as needed.

, with flu shots provided at no cost through initiatives with health insurers, the Illinois Department of Public Health, local community groups and churches in Little Village, Chatham, Gresham, Englewood, Bronzeville, Austin, and Roseland.

, sponsored by the First Ladies Health Initiative, working with African American church leaders and pastors’ wives to provide thousands of free health screenings, including blood pressure, blood glucose, HIV screenings, and immunizations.

where Walgreens is supporting the American Heart Association’s efforts to eliminate health disparities and the life expectancy gap between Chicago neighborhoods.

through the expansion of the Walgreens Prescription Savings Club, which provides savings up to 80% off of more than 8000 medicines to members.

In addition to these new initiatives, Walgreens has extended its offering of free prescription delivery for 1- to 2-day deliveries through the end of 2020.

Walgreens addressing health disparities in Chicago’s Underserved Communities with New Pharmacy and Healthcare Initiatives. Walgreens Newsroom. 

https://news.walgreens.com/covid-19/press-releases-1/walgreens-addressing-health-disparities-in-chicagos-underserved-communities-with-new-pharmacy-and-healthcare-initiatives.htm?view_id=8541

. Published October 7, 2020. Accessed October 9, 2020.

Walgreens Addressing Health Disparities in Underserved Chicago Communities

Data science can be effectively used to predict patient outcomes for areas such as medication utilization and readmission rates to hospitals, according to a session on applying data science at the DHX Virtual conference. These predictions can help the users of data science tools to support the delivery of optimal patient care.

Data science uses the scientific method, processes, algorithms, and systems to extract applicable knowledge from structural and unstructured data, explained speaker Dalton Fabian, PharmD, RPh, a data science analyst at UnityPoint Health, during the session.

The field is comprised of different disciplines in order to tap into their skillsets, including math and statistics, business knowledge, and computer science, according to Fabian. Each of these disciplines then fits in uniquely to the function of data science in pharmacy.

For the use of math and statistics, data science analysts apply these skills when using data from the past to predict the future, such as the likelihood of whether someone will be readmitted to the hospital within 30 days of discharge.

Business knowledge, on the other hand, is used by data science analysts to communicate with nurses regarding the tools that the analysts have made. This communication helps analysts confirm that the nurses have a full understanding of the tools they are using, according to Fabian.

“As pharmacists, we understand the intricacies of health care, like how to read lab descriptions and how to interpret lab values using those types of skills in our data work,” Fabian explained.

Additionally, Fabian noted that data scientists use computer science skills when writing sequel queries to obtain or analyze data implementing models and programming languages, such as R and Python, as well as visualizing data with platforms such as tableau.

David Berkowitz, PharmD, an Omnicell One field strategist and director of the Omnicell fellowships in data analytics and automation research, said during the session that obtaining data is always the first step to commencing work as a data science analyst.

“First, you need data,” Berkowitz said. “The standard nomenclature is ETL—extract, transform, and load. And that’s getting data from your source system, whether it would be an electronic health record, laboratory system, IOT device, blood pressure cuff, etc.”

The next step is to transform these data into a format that is usable, such as Epic, which is written using Massachusetts General Hospital Utility Multi-Programming System (MUMPS). MUMPS, a programming code that was developed in the late 1960s, is a language that is effective for fast operations, which allows users to click a lab result and find the necessary information quickly.

“That’s why when you build, say, a workbench report, it’ll sort of crap out after looking back 14 days, because that type of search is not meant for querying, doing research, and doing data analysis—it’s meant for operations,” Berkowitz said.

By moving the data and encoding it into a different format, which is usually structured query language (SQL) in health care, data science analysts are able to store the data. The databases available to for storage are generally SQL, No-SQL, and cloud storage; however, not all providers use these databases when storing data.

“There are still a lot of folks in health care, probably actually a majority, that store their data on premises, or you’ll hear ‘on prem,’ which can make it a little harder to do data science because you have to sort of, when doing a specific analysis, enrich data with different sources,” Berkowitz said. “It’s harder to do that on prem in real time because of connections. So, cloud first is my motto.”

At Omnicell, Berkowitz noted that his team uses almost exclusively SQL. However, other employees at Omnicell will code using Python, R, or Scala, although the language used is often dependent on the specific problem the analyst is trying to solve.

For data visualization, analysts commonly use Qlik, Power-BI, Tableau, or R-Studio in order to communicate data more effectively and support business intelligence and predictions, Berkowitz explained.

At UnityPoint Health, Fabian noted that they have used these different elements of ETL to create a tool called Population Health, which is primarily used by care managers to enroll patients in care management services. This tool can help to lower costs for high-risk patients by decreasing utilization and increasing the frequency of patients’ meetings with care managers. This helps to catch issues before they become critical and require a hospital visit.

“What we did, as a data science team, is develop a machine learning model that predicts the likelihood that a patient is going to go to the hospital or the ED in the next 12 months, and that’s how we determine high risk,” Fabian said.

Fabian noted that this tool helps to allow care managers to spend more time taking care of patients rather than needing to focus on administrative tasks that they were doing previously to figure out whom to enroll.

Another tool created by UnityPoint Health is the Readmission Heat Map, which is used to decrease 30-day admission rates. This tool allows for the prediction of whether patients will readmit to the hospital within 30 days of discharge, down to the day.

“In this tool, we’re taking all of the data we have access to in Epic, like disease states, medication, and the fact that people are in the hospital, and pairing that with a predictive model to help those nurses make better decisions about the care that a patient is going to need once they get out of the hospital,” Fabian said. “Anything over a 20% likelihood, and nurses will take heed and intervene on behalf of those patients.”

Berkowitz noted that by applying these same types of data science tools to medication utilization, analysts are able to help pharmacists visualize data from their pharmacy in a chart. For example, this could be applied to visualizing the effects of the pandemic on medication utilization at a pharmacy.

“I took a look at vaccination rates since January 2020 to see how COVID-19 has affected vaccination rates,” Berkowitz said. “Basically, it went down to nothing. This kind of tells me that either folks weren’t stepping on nails or they weren’t getting care and going to their pharmacies.”

Fabian D, Berkowitz D. Applying Data Science. Presented at: DHX Virtual 2020; October 2, 2020; virtual. cpha.com/event/dhx-virtual/. Accessed October 2, 2020.

Data science can help to predict patient outcomes for areas such as medication utilization and readmission rates to hospitals. 

Data Science Can Predict Patient Outcomes to Optimize Care

Contemporary Clinic spoke with Gregg Sylvester, chief medical officer at Seqirus, about the new trivalent influenza vaccine, aTIV, and its implications for practitioners.

Sylvester emphasized that vaccines are very important in preventing disease, beyond just influenza. However, if we focus on just influenza, they have evolved and improved over time. 

"This adjuvanted trivalent influenza vaccine that we're talking about now was shown in 2017/2018 to actually reduce office visits and hospitalizations compared to the standard flu vaccine," Sylvester said. 

Sylvester also discussed the importance of this data for vulnerable populations, implications for practitioners and other health care professionals, and what he hopes to see for the future of aTIV and other vaccines. 

Videos

New Trivalent Influenza Vaccine and Implications for Practitioners

Many elective medical screenings, including cancer screenings, were put on hold at the start of the coronavirus disease 2019 (COVID-19) pandemic to prioritize urgent needs and reduce the risk of spreading the virus in health care settings.

Many health care facilities are offering elective procedures again as more states re-open businesses and ease restrictions. When it comes down to restarting cancer screening, this procedure requires careful consideration of the risks and benefits of screening, along with ensuring safety for both patients and health care personnel.

The decisions on cancer screening will depend on certain factors and varies between each person and community, according to the American Cancer Society.

Patients should talk to their health care team about when to reschedule a postponed or cancelled screening appointment. Further, providers can discuss the risks and benefits of being screened now or at a later date, including the consideration of the patient’s personal and family history, other risk factors, and timing of the last screening test.

"Finding breast cancer early and getting high-quality cancer treatment are the most important strategies to prevent deaths from breast cancer. Getting regular screening tests is a critically important part of finding breast cancer early," said Laura Makaroff, MD, senior vice president of Prevention and Early Detection for the American Cancer Society, in a prepared statement.

Makaroff added that breast cancer screening disparities are already evident and will likely increase as a result of the COVID-19 pandemic if not given focused attention.

“Efforts to promote breast cancer screening and overcome barriers for populations with low screening prevalence must be at the forefront of our focus," Makaroff said.

Although many women get an annual mammogram for breast cancer screening, leading organizations have issued screening guidelines that recommend women at average risk aged 55 years and older can be screened every 2 years. Similarly, women who are aged 55 years and older who had a normal mammogram within the last year could choose to have their next mammogram up to 24 months after your last one, according to the American Cancer Society.

The CDC has recommendations for health care facilities to reduce the risk of COVID-19 transmission during screening, such as:

Providers can discuss the risks and benefits of being screened now or at a later date, including the consideration of the patient’s personal and family history, other risk factors, and timing of the last screening test

News

Featured Content

All Content