8 things that excellent hospital doctors do

first_img Related: By Sanjay Saint and Molly Harrod May 4, 2017 Reprints Tags hospitalspatientsphysicians First Opinion8 things that excellent hospital doctors do When doctors focus on survival, we can overlook what patients need to feel ‘well’ Departure. He recaps the plan for the day, bids you a pleasant goodbye, and leaves your room as he found it — bedrails, lights, and TV volume adjusted to the way they were before the visit.Anticipatory planning. She prepares for your leaving the hospital by making sure you have transportation and appropriate medical follow-up, as well as the help you need at home to ensure that you continue to improve.Collaboration. He treats all members of the hospital team — nurses, social workers, pharmacists, residents, and medical students — with kindness and respect. In short, he plays well with others.The 12 remarkable doctors we observed had their individual differences, of course. Some spent more time joking with patients than others. A few encouraged the students or residents in the group to speak up more. There were variations in the way they did physical exams and how much time they spent with each patient. But they shared a desire to partner with their patients and to treat them with reverence and compassion — treatment all patients should receive. And they did the same with their colleagues.If you find yourself in the hospital, use this checklist to see how your doctors measure up. If they fall short in some regard, call them on it — politely, we hope. But if they pass, a resounding “thank you” would be appreciated.Sanjay Saint, MD, is the chief of medicine at the VA Ann Arbor Healthcare System and professor of internal medicine at the University of Michigan. Molly Harrod, PhD, is a medical anthropologist at the VA Ann Arbor Healthcare System. They are coauthors of “Teaching Inpatient Medicine: What Every Physician Needs to Know” (Oxford University Press, March 2017). This article reflects the personal views of the authors and not necessarily those of the University of Michigan or the Department of Veterans Affairs. To do this, we identified 12 doctors from around the US who are recognized as outstanding teacher-physicians. We scrutinized their bedside behavior, did semi-structured interviews with them, and talked with current and former members of their hospital rounding teams. A good relationship between a patient and his or her physician is the cornerstone of superb medical care. That relationship is important when you know the doctor well. It may be even more important when you don’t, say when you are in the hospital.Growing competition for new customers is inspiring American hospitals to focus on providing a more positive patient experience — and hospitals expect their doctors to do their part.We wanted to know what defines great physicians in the hospital setting (sometimes called attending physicians), both in terms of their interactions with patients and how they teach the next generation of doctors — residents and medical students — as they go about their hospital rounds.advertisement Based on our research, we have drawn up a checklist of items reflecting how these top doctors interact with their patients. It might come in handy if you or a loved one must spend some time in a hospital. One caveat: You may be cared for by a team of hospital physicians, some of whom are in training. We compiled the checklist with the most experienced physician in mind; he or she supervises the team. That said, all team members should ideally display these behaviors.Preparation. She has studied your medical records and is familiar with the latest lab tests and other diagnostic results.Arrival. He enters your room smiling, introduces himself to you, and shakes your hand. He establishes a personal connection with you through brief, informal conversation.Hand hygiene. She washes her hands before touching you.Physical exam. He closes the hospital door or closes the curtain to preserve your privacy. He warms the stethoscope before applying it directly to your skin — not to your hospital gown. He explains his actions, and works to make sure you feel you are being treated gently.Communication. She speaks with you while sitting on a stool or kneeling in order to communicate at your eye level. She asks how you are feeling, explains medical issues clearly and in layman’s language, and tries to make sure you and, if appropriate, your family member understands. She makes sure that you agree with the medical treatments that have been proposed and asks how you feel about these recommendations. She encourages you to ask questions. Related: What we learned, in a nutshell, is that the way these doctors work is uniformly at odds with the familiar perception of the hospital physician as rushed and impersonal.advertisement Sanjay Saint About the Authors Reprints Doctors who can’t communicate bad news are technicians, not true physicians @sanjaysaint Molly Harrod Carsten Koall/Getty Imageslast_img read more

No longer the hot new thing? Teen vaping falls, study says

first_img NEW YORK — Teen vaping, which has been skyrocketing, fell dramatically last year in the United States.A government survey released Thursday suggests the number of high school and middle school students using electronic cigarettes fell to 2.2 million last year, from 3 million the year before.Health officials have worried about the booming popularity of vaping products among kids and the potential impact on adult smoking rates in the future.advertisement Please enter a valid email address. They’re generally considered a less dangerous alternative to regular cigarettes. But health officials have warned nicotine in e-cigarettes is harmful to developing brains.The CDC study is based on a questionnaire filled out annually by about 20,000 students in grades 6 through 12. It focused on “current users” — kids who said they had used a tobacco product within the 30 days before they answered the survey.It found an overall decline in use of vaping devices, traditional cigarettes, and other tobacco products. Based on the survey responses, the CDC estimates that the number of middle and high school students using tobacco products fell to 3.9 million last year, from 4.7 million the year before.Adolescent cigarette smoking has been falling for many years, but the decline in e-cigarette and hookah use was more remarkable.In 2011, 1.5 percent of high school students said they’d recently vaped. That jumped to 16 percent in 2015, and it’s become more common than cigarette smoking. But it dropped to about 11 percent last year, the CDC said.For middle school students, about 5 percent said they’d recently vaped in 2015. That fell to about 4 percent last year, the study found.— Mike Stobbe HealthNo longer the hot new thing? Teen vaping falls, study says Privacy Policy “It certainly is a public health win,” said Brian King, an expert on smoking and health at the Centers for Disease Control and Prevention. About the Author Reprints Associated Press Leave this field empty if you’re human: It’s the first decline the CDC has reported in teen vaping since the agency began tracking it in 2011. The findings echo a recent University of Michigan survey, which also detected a decline in 2016.advertisementcenter_img It’s unclear why teen vaping fell last year, and it’s too soon to know if the numbers will continue to drop.One possibility may be a growing push to ban sale of e-cigarettes to minors, including a federal regulation that took effect in August. Another may be the influence of ad campaigns by the government and other organizations to discourage kids from smoking, the CDC said.E-cigarettes may also be losing their novelty among teens, said Matthew Farrelly, a tobacco control researcher at RTI International.Studies suggest many kids who vape use the products less often than kids who smoke cigarettes — a sign that vaping seems to be more social and experimental, some experts said.“These products were new and novel and now we’re starting to see that change,” said Robin Koval, president of Truth Initiative, a public health education organization that runs anti-tobacco ads.E-cigarettes are battery-powered devices that provide users with aerosol puffs that can contain nicotine. Research has found kids like to vape flavorings like strawberry and bubble gum, though often in nicotine-free versions. Teen vaping fell dramatically last year in the U.S., according to the CDC. Nam Y. Huh/AP Newsletters Sign up for Morning Rounds Your daily dose of news in health and medicine. Tags public health By Associated Press June 15, 2017 Reprints FDA issues sweeping regulations for e-cigarettes for first time Related:last_img read more

Could this be the first prescription video game? New data show it helps kids with ADHD

first_img By Rebecca Robbins Dec. 4, 2017 Reprints Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. What’s included? Business Akili Interactive Labs on Monday reported that its late-stage study of a video game designed to treat kids with ADHD met its primary goal, a big step in the Boston company’s quest to get approval for what it hopes will be the first prescription video game.In a study of 348 children between the ages of 8 and 12 diagnosed with ADHD, those who played Akili’s action-packed game on a tablet over four weeks saw statistically significant improvements on metrics of attention and inhibitory control, compared to children who were given a different action-driven video game designed as a placebo. The company plans next year to file for approval with the Food and Drug Administration. Log In | Learn More Unlock this article — plus daily market-moving biopharma analysis — by subscribing to STAT+. First 30 days free. GET STARTED GET STARTED A screenshot from Akili’s video game, designed to treat ADHD. Akili Interactive Labs STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Could this be the first prescription video game? New data show it helps kids with ADHD What is it? Tags medical technologymental healthpediatricspolicyresearchlast_img read more

HPREP, a program for underrepresented minority teens, helped me become a doctor

first_img It’s hard to describe the magical feeling of watching someone who looks like you achieve the unimaginable. It’s how I felt the night in 2008 when, as the on-call cardiology fellow, I watched television in one of the hospital’s family lounges as Barack Obama clinched the presidency. It’s also how I felt in 1992 when, as a Latina high school student, I walked through the doors of Cornell University Medical College (now Weill Cornell Medicine) to participate in its three-year-old Health Professions Recruitment Exposure Program. I saw medical students who looked like me and, for the first time, seriously imagined myself as a physician.Every Friday afternoon, I left my high school in Brooklyn for the Upper East Side of Manhattan, eagerly awaiting that week’s HPREP activities. I heard trailblazing stories of people like Dr. Louis Sullivan, the first black resident at New York Hospital‑Cornell Medical Center, who became the 17th secretary of the Department of Health and Human Services under President George H. W. Bush. I beamed with pride learning that I was standing on the shoulders of giants in medicine.I recall that it was the first time I learned anything about cardiovascular physiology, which perhaps planted the seed for my future career choice. To be honest, though, I don’t remember much about the science I learned then. The most valuable lesson was in seeing not just one but dozens of medical students and faculty who looked like me.advertisement Just 4 percent of instructors (the lowest rank held by faculty physicians) are Latino. Among full professors and deans, less than 3 percent are Latino. It’s easy to imagine how a young person of color might be dissuaded from entering academic medicine — and along with that the talent lost from a field dependent on innovation.That’s where HPREP has made a difference.A physician community that resembles the face of the “American community” benefits everyone. Students trained in racially and ethnically diverse medical school environments feel more culturally competent and prepared to care for the patients they serve. As we treat increasingly complex patients and work within larger multidisciplinary teams, medicine has evolved from an individual to a team sport. A winning team is one that leverages all of its members’ unique abilities and talents and recognizes that “great minds think differently.”My own path in medicine has been bolstered by HPREP and other programs like it at later stages of my training and career. My peers and faculty members have helped mitigate feelings I mistakenly thought were unique to me: frustration about microagressions, stereotype threat, isolation, and self-doubt. I was not the only one mistaken for anyone but the doctor, or who cringed every time I witnessed someone call my Latina patient “Mami.”The early affirmations I got from HPREP inspired me for years after I had completed the program, and still motivate me. A few years ago, I was filled with joy and hope while speaking with HPREP students and their families at their annual graduation ceremony in the spring. I reminded them that they not only belonged in medicine, but could truly thrive in it. That’s what HPREP did for me.Jessica M. Peña, M.D., is a cardiologist and assistant professor of medicine and radiology at Weill Cornell Medicine. I’m a young black woman. Why do so many people assume I’m not a doctor? These doctors are trying to get more people of color to join their ranks. What some have overcome is startling Tags educationHealth Disparitiesphysicians Jessica M. Peña By Jessica M. Peña Oct. 31, 2018 Reprints First OpinionHPREP, a program for underrepresented minority teens, helped me become a doctor The program, which celebrates its 30th anniversary in 2019, was started by medical students at Weill Cornell Medicine with the aim of drawing more underrepresented minority students into the medical field. Now a national program under the auspices of the Student National Medical Association, more than 7,000 high school students have participated in the HPREP program.Programs like HPREP are often referred to as pipeline programs. I think that’s a faulty metaphor. To me, the pipeline conjures the image of a predetermined linear trajectory. Yet the work of the medical students, faculty volunteers, and staff members who orchestrate these programs is far from linear or simple. HPREP and programs like it are more like complex navigation systems that never stop working. They involve countless hours of nurturing, mentoring, and building communities, all driven by a strong passion for equity and a commitment to give back.Such programs are still sorely needed. Although the U.S. has become more diverse since I started my HPREP program in 1992, the medical profession hasn’t changed that much. Latinos/Hispanics now make up 18 percent of the U.S. population, but only 5 percent of medical school graduates. African-Americans make up 13 percent of the U.S. population, but just 5 percent of medical school graduates. In my field of cardiology, the percentage may be even lower.For students from underrepresented minorities who do become physicians, those who decide to pursue careers in academic medicine face other challenges. They are less likely to be promoted, have lower incomes than their white counterparts, and are less likely to receive research grants from the National Institutes of Health.center_img [email protected] Related: HPREP’s message was simple yet enormously powerful: You belong here and don’t let anyone sell you short.advertisement While in the program, medical students also helped me take my first practical steps in the long journey toward my career as a physician — working on college essays, understanding the financial aid process, and the like. Related: About the Author Reprints Adobelast_img read more

What a Grand Rabbi’s request might teach us about combating vaccine hesitancy

first_img But there was a twist. The characteristics of ultra-Orthodox Jewish communities that might potentially make them vulnerable to the spread of vaccine hesitancy — being tight-knit, distrustful of outside authority — are the same ones that members have used to encourage other families to vaccinate.An ultra-Orthodox oncology nurse in Brooklyn heard, from her cousin in New Jersey, that some neighbors weren’t vaccinating their kids. So she started texting with parents, refuting misinformation, explaining the science and safety of immunization, and, eventually, lugging reams of research to meetings in homes around the tri-state area.Rabbis have stated that vaccines are kosher and urged their congregations to protect themselves and their children by getting immunized.The email that Brown received was a similar effort from within the community — but the interventions that ensued weren’t just meant for families. They were also designed to help doctors.The request started with none other than Grand Rabbi David Twersky, a spiritual leader — the rebbe — of the Skver Hasidic sect. Descended from a long line of revered religious teachers, Twersky guides his ultra-Orthodox community from New Square, a patch of former farmland 20 minutes west of the Hudson River.“There are thousands and thousands of people over the years who are going to the rebbe for blessings — or if they have a problem, to ask advice,” explained Victor Ostreicher, a businessman who’d grown up close to the rabbi.The questions that these visitors ask can be about almost anything. But in October, when the measles outbreak began, more and more of them had to do with vaccines. “Some people were scared,” Ostreicher went on: So-and-so had told them they shouldn’t vaccinate, somebody else told them they should, and some doctor had said something that raised questions in their minds. They wanted to know what the rebbe advised. Please enter a valid email address. The Refuah Health Center in Rockland County, N.Y. Erica Yoon for STAT Leave this field empty if you’re human: “Not that the rebbe had the question if vaccinations should be given,” Ostreicher said. “He was 100% sure.” But Rabbi Twersky thought it might be useful to have a document from some medical authority that he could show visitors, to help convince them that immunizations would not only protect their children, but also that the injections were safe.Over the years, when congregants came to him with serious health problems, he often recommended that they go to the Mayo Clinic, in Rochester, Minn. And Ostreicher — a founder of Rockland County’s Refuah Health Center, where many members of the community get health care — has often accompanied them as a patient advocate. In the last seven years, he estimates, he’s made the trip around 10 times.“Mr. Ostreicher is our founder and our board treasurer, he’s also in many businesses, and has an ability to interact with and navigate very difficult things,” explained Chanie Sternberg, president and CEO of Refuah. “Going to Mayo is two sides of one coin: It’s helping the patient understand the system, and helping the doctor understand the patient.” Eric Boodman By Eric Boodman May 10, 2019 Reprints About the Author Reprints Newsletters Sign up for STAT Health Tech Your weekly guide to how tech is transforming health care and life sciences. When the illness began to spread in the last seven months, it brought tension with it, as contagion often does. About two-thirds of the cases were occurring within outbreaks in New York: one in Brooklyn, the other in Rockland County, both places with substantial ultra-Orthodox Jewish communities. Apparently, measles took off when some travelers returned stateside from Israel, and its spread was aided by an anti-vaccine tract circulating among some religious families. But some in these communities felt that, because of a small minority within their ranks, attention was unfairly focused on the group as a whole.As Aron Wieder, a Rockland County legislator, put it, “The misrepresentation of the Orthodox community as not being vaccinated — it’s spreading like the measles disease.”advertisement HealthWhat a Grand Rabbi’s request might teach us about combating vaccine hesitancy [email protected] center_img Related: Can officials require vaccinations against measles? A century-old case may give them a foothold In a religious N.Y. community, an unprecedented response to measles puts trust in government to the test While volunteering in this way, Ostreicher had encountered a number of practitioners specializing in a bunch of organs, but he’d become especially friendly with Brown. That wasn’t entirely a coincidence. Brown makes a point of getting to know the friends and family who come to his patients’ appointments. He enjoys it, and it can be a useful diagnostic tool; the hangers-on are often best-equipped to tell him about what he calls “those transient symptoms that … may not come across in a 90-minute neurological observation.”So, when Grand Rabbi Twersky asked for a letter stressing the importance of vaccines, Ostreicher reached out to Brown, who in turn got in touch with his Mayo Clinic colleague, pediatrician and vaccine researcher Dr. Robert Jacobson, who sat down to write. He wrote about the hospitalizations that happen in a quarter of measles cases, about the brain swellings that can occur, about the chances of death. He wrote about how the measles-mumps-rubella shot prevents the disease.“Here at Mayo Clinic we not only make sure all of our children get this vaccine on a timely basis,” he wrote, “but we make sure all of our medical staff get the vaccine as well.”Then he pressed send.The Grand Rabbi wasn’t the only authority in Rockland County who wanted some backup.The doctors and nurses at Refuah had already been doing everything they could to stop the outbreak. “We’ve been working in lockstep with the Department of Health to offer vaccinations to anyone willing to receive them. We did robocalls, banners, town hall meetings. Word of mouth is a big one,” said Dr. Corinna Manini, the center’s chief medical officer. “We have automated ways for people to call in 24/7 and determine their measles vaccination status.”But they still had questions about how best to deal with patients hesitant to get vaccines.They’re hardly the only ones. “Physicians sometimes feel overwhelmed about these vaccine-hesitant parents,” said Eve Dubé, a medical anthropologist who studies vaccine hesitancy at the Québec National Institute of Public Health, in Canada. “They feel their own expertise is being criticized. For physicians to be told, ‘I don’t trust what you’re saying’ — that can be very emotional.”So, as the Grand Rabbi began circulating Jacobson’s letter, and as the measles outbreak continued, the leaders at Refuah decided to fly the doctor in from Minnesota. “It was important for our providers to hear from someone who had done the research — what works and what doesn’t work,” said Sternberg, the president and CEO.The training was planned for March 25 — one day before the Rockland County executive declared a month-long state of emergency, in which all unvaccinated children were banned from indoor public spaces such as houses of worship, malls, and schools. So many Refuah practitioners wanted to listen to Jacobson they couldn’t all fit in the conference room, and he had to give his talk twice.He began the way he would in his own practice: with the presumption that parents will vaccinate their children. “Say, ‘Your child’s due for the MMR vaccine, I’ll have the nurse come in and do it,’ … with the assumption, you came to see me, this is what we do as part of the visit,” he explained in an interview this month. It’s the same thing he does for other routine procedures. “I don’t get into a long discussion about the benefits and risks of a stethoscope exam. I just say, ‘Now I’m going to take a listen to your heart.’”It was a technique that had worked in a 2013 study, when researchers filmed 111 discussions in which physicians brought up vaccines and found that those who asked parents about vaccines were more likely to face hesitancy than those who assumed the shots would take place.But there will be some parents who continue to express worry. As tempting as it might be to simply hand them some pamphlets to read, Jacobson explained, this is the moment for the physician to start asking questions. “You step back, and you say, ‘So I understand you don’t want to do the MMR vaccine. Can you tell me why?” he said. “This is really important because clinicians who might just jump into it and start giving advice on the vaccine without knowing what the parent’s concern is may completely miss the boat and have really failed to connect with the parent.”After all, he said, the parent and the pediatrician are after the same thing: To protect the child. Only once that sense of trust and shared purpose is established — one built on hearing out the parent’s questions and concerns — only then might the practitioner have a chance at changing someone’s mind with evidence and advice. “The clinician’s effectiveness will be in that room and in that relationship of caring one on one,” he said.It’s hard to say, once Jacobson flew back to Minnesota and the Refuah practitioners dispersed back to their exam rooms, whether his words had a direct effect on the local measles numbers themselves. After all, the training coincided with other public health measures. Last week, the Rockland County executive announced that “19,661 safe and effective MMR vaccinations have been given since the outbreak began; clearly illustrating that the combined outreach and education efforts have had a significant effect.”Yet there’s long been a fraught relationship between the county administration and the area’s ultra-Orthodox communities.  Though the reasons might be different from place to place, similar sentiments are felt in various communities across the U.S. and abroad. As Dubé put it, “We’re in an era of lower trust — in elites, in medical authorities, in experts. … It’s larger than just vaccines.”In her work as an anthropologist, interviewing mothers of new babies, Dubé has heard it again and again, how beliefs are rooted in relationships, with concerns about vaccines spreading from friend to friend, family member to family member, beloved leader to congregant.We listen to the people we know. Often, they have more power than statistics in a flyer or advisories on a website. So this long chain in defense of immunization — from rebbe to community leader, community leader to trusted doctor, trusted doctor to expert colleague, expert colleague to practitioners in the rebbe’s own backyard — might be less circuitous than it sounds. As a neurologist whose patients return to see him year after year, Dr. Robert Brown Jr., of Mayo Clinic, hears about plenty besides strokes and aneurysms. His older patients pull up smartphone photos of grandkids and great-grandkids; his farmer patients talk of rough winters, rainy spells, fluctuations in the price of corn. While investigating memory loss and personality change, he hears about dogs, football games, vacations, and funerals.But in November, someone he’d met in the clinic sent him a question he wasn’t expecting. The man was in Rockland County, N.Y., a leader in the ultra-Orthodox Jewish community. He was concerned about a measles outbreak there, and was wondering how to address parents’ hesitations about vaccines.The question is an important one, puzzled over by pediatricians and psychologists alike, and it’s taken on a new urgency in 2019, when the number of confirmed measles cases in the United States — 764, as of last week — is the highest it’s been in 25 years. How that question arrived in Brown’s inbox, it turns out, might just help inform the answer.advertisement @ericboodman Related: General Assignment Reporter Eric focuses on narrative features, exploring the startling ways that science and medicine affect people’s lives. Tags infectious diseasepublic healthVaccineslast_img read more

There’s a fight brewing in Congress over pharma’s patents

first_imgD.C. Diagnosis STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. What’s included? About the Author Reprints Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Washington Correspondent Nicholas Florko reports on the the intersection of politics and health policy. He is the author the newsletter “D.C. Diagnosis.” Log In | Learn More D.C. Diagnosis is STAT’s weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox.Pharma’s ready to rumble … over patentsThere’s a fight brewing over legislation meant to rein in the over-patenting of drugs. Drug makers are trying to gut a bill from Sens. John Cornyn (R-Texas) and Richard Blumenthal (D-Conn.) that would open up drug makers to Federal Trade Commission lawsuits when they’re suspected of product hopping (where drug makers introduce a new, slightly tweaked version of a drug to thwart competition) and patent thicketing (where drug makers file dozens or even hundreds of patents on a single drug to keep competitors off the market well beyond the exclusivity period awarded by the FDA). Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED There’s a fight brewing in Congress over pharma’s patents center_img What is it? Alex Hogan/STAT By Nicholas Florko June 18, 2019 Reprints GET STARTED @NicholasFlorko Nicholas Florko [email protected] Tags Congressdrug pricinggovernment agenciespolicylast_img read more

Too many drug makers and universities fail to report trial results in Europe

first_img Under EU rules overseen by the European Medicines Agency, trial sponsors must report results one year after the end of a trial. DANIEL LEAL-OLIVAS/AFP/Getty Images @Pharmalot By Ed Silverman July 3, 2019 Reprints Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Too many drug makers and universities fail to report trial results in Europe Unlock this article — plus daily coverage and analysis of the pharma industry — by subscribing to STAT+. First 30 days free. GET STARTED What is it? Pharmalot GET STARTED Ed Silvermancenter_img Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Log In | Learn More STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. What’s included? About the Author Reprints [email protected] A large percentage of drug makers, universities, and hospitals continue to fail to publicly post clinical trials results, according to new data released by European officials, who took the opportunity to issue a reminder that the information is required in the interest of improving public health.As of April, results were available for nearly one-third of completed clinical trials that were registered in the European Union clinical trials database, also known as EudraCT. Specifically, of almost 27,100 trials that were completed, results should have been posted for more than 18,400 of them, but results were available for only approximately 5,800 trials. Tags pharmaceuticalsresearchSTAT+last_img read more

Cannabis use among older adults is on the rise, study says

first_img Please enter a valid email address. Privacy Policy Kay Nelson, left, and Bryan Grode, retried seniors, chat in the lobby of a cannabis dispensary in Santa Ana, Calif. Jae C. Hong/AP The legalization of cannabis in many states for medical and recreational purposes has led to a surge in interest in using it to treat a variety of long-term health conditions and symptoms. Among the new users: older adults.The proportion of adults 65 years and older who reported using marijuana use increased from 2.4% in 2015 to 4.2% in 2018, according to a study published Monday in the journal JAMA Internal Medicine.Researchers at the New York University School of Medicine analyzed data collected from the 2015-2018 National Survey on Drug Use and Health, a nationally representative survey of non-institutionalized individuals in the U.S., and identified a number of key groups among older adults who have experienced a marked increase in cannabis use. Those groups include women, racial and ethnic minorities, adults with higher family incomes, those who reported receiving mental health treatment, and individuals with diabetes.advertisement Newsletters Sign up for Morning Rounds Your daily dose of news in health and medicine. Leave this field empty if you’re human: “Cannabis use was very stigmatized in the past but now we have all these new laws passing about medical use of cannabis, so people are curious to see if it is something that can be used to treat their chronic disease,” said Han.advertisement Related: By Shafaq Zia Feb. 24, 2020 Reprintscenter_img Han said it’s also important for health care providers to be aware of growing cannabis use among older adults. While it’s possible that cannabis use could provide health benefits, older adults are especially vulnerable to the potential side effects or other harms.“As health care providers, we don’t do a very good job of screening older patients for substance use. This is something we need to be asking, and be prepared to answer any questions about,” said Han. As more states legalize marijuana, pregnant women and their doctors grapple with how to talk about it Rosalie Liccardo Pacula, a health policy and law expert at the University of Southern California who was not involved in the study, said she hoped future research efforts would focus on the mechanisms that drive increase in cannabis use among older adults.“I would argue that the mechanism is more important than the finding that cannabis use has gone up,” she said. “Have individuals been medically using it for a long time and are now 65 years and older or are these new people, 65 years and older, who are now willing to try cannabis?”There is limited scientific evidence on the potential benefits and harms of cannabis use. While the legalization of cannabis at the state level has eased some restrictions on research, there is still limited supply — and cannabis use remains illegal at the federal level.Experts say the growing use of cannabis by older adults in the U.S. demands for more rigorous empirical evidence that can help weigh its benefits and potential harms. Dramatic increases in cannabis use overall piqued the curiosity of researchers and compelled them to look closely at trends among older adults, even though they are not typically associated with high levels of drug use, according to Benjamin Han, co-author of the research. HealthCannabis use among older adults is on the rise, study says Tags marijuanalast_img read more

Covid-19 vaccine research must involve Black and Latinx participants. Here are 4 ways to make that happen

first_img [email protected] By Kathryn Stephenson and Bisola Ojikutu June 26, 2020 Reprints Women and Black patients are poorly represented in clinical trials, analysis finds @HarvardCFAR First OpinionCovid-19 vaccine research must involve Black and Latinx participants. Here are 4 ways to make that happen Yet past experience shows that Covid-19 vaccine trials will likely have challenges meeting enrollment targets like these. In 2019, for example, the Food and Drug Administration approved 11 new cancer drugs based on clinical trials that enrolled just 4% of Black participants, despite the fact that Black individuals account for 13% of the U.S. population and have the highest death rate for most cancers.advertisement Everyone in medical research shares the responsibility to promote equitable representation in Covid-19 vaccine trials. Here are some ways we can do this:Step 1. Acknowledge the problem. We must recognize the importance of enrolling Black and Latinx participants in these studies, even in the context of unprecedented rapid enrollment. Studies must report the demographics of trial enrollment while they are ongoing.Step 2. Provide appropriate funding to trial sites to support diversity initiatives. It takes money to translate informed consent forms, reimburse participants for transportation, staff clinics on weekends and nights, and advertise in a broad array of neighborhoods and media outlets. It also takes money and institutional will to build a diverse research workforce that reflects affected communities and is representative of the country as a whole.Step 3. Address research mistrust by engaging communities now, at the beginning, not when it’s time to share the final results. This means investigators need to meet with local stakeholders in Black and Latinx communities, host webinars and virtual town halls, do interviews on community radio, and put themselves out there on social media.Step 4. Pay people back for trusting in the medical research community. We need to make any successful Covid-19 vaccine that comes out of this herculean research effort accessible to everyone in this country — regardless of race, ethnicity, or the ability to pay for it. The fair and transparent distribution of an effective Covid-19 vaccine is paramount.Vaccines can be transformative. They have the potential to provide medical shelter against deadly diseases like Covid-19, allowing communities to safely emerge from this pandemic and rebuild.The recent protests against racism in the United States are calls to medicine and science too: Black and Latinx communities must be a part of the critical endeavor to develop a vaccine for Covid-19.Kathryn Stephenson is the director of the clinical trials unit in the Center for Virology and Vaccine Research and an infectious disease physician at Beth Israel Deaconess Medical Center in Boston. Bisola Ojikutu is the director of the Community Engaged Research Program in the Harvard Center for AIDS Research and an infectious disease physician at Brigham and Women’s Hospital and Massachusetts General Hospital. @k_stephensonMD [email protected] People wait to be tested for Covid-19 at a mobile testing station in a public school parking area in Compton, Calif. ROBYN BECK/AFP via Getty Images Beyond words: medical institutions must act to support Black lives center_img Related: About the Authors Reprints Related: Kathryn Stephenson Clinical trials also establish the safety and effectiveness of new interventions, and there is no guarantee that the effects of an intervention will be the same across populations. Contemporary medical studies point to disparities in response rates to pharmacological therapies by race and ethnicity. No one knows for sure if such variances are products of the socioeconomic realities faced by trial participants, a variety of environmental factors, or genetics, but they are real. The development of a Covid-19 vaccine is progressing at an incredible pace, breaking down barriers to the invention, manufacture, and testing of potential vaccine candidates. The Department of Health and Human Services says it aims to have “substantial quantities of a safe and effective vaccine available for Americans by January 2021.”To achieve this goal, each of the five leading Covid-19 vaccine candidates will need to be tested in approximately 30,000 people — a total of 150,000 research participants in the next six months. This will be a massive and unprecedented undertaking.Equally unprecedented is the opportunity that Covid-19 vaccine development presents to break down barriers to the engagement of Black and Latinx individuals in clinical trials research. Ideally, vaccine trials should include participants from communities that have the highest risk of infection. In the case of Covid-19, those at-risk communities are disproportionately Black and Latinx. To match local demographics of Covid-19, Black or Latinx individuals would need to comprise up to 40% of vaccine trial participants nationwide.advertisement Most clinical trials are designed to enroll racially and ethnically diverse groups of participants and honestly aim to do that. But it’s a hard goal to achieve. The hours that clinics are open are too limited for people of color whose employers prohibit taking off work; study budgets don’t always pay for interpreters and translations that would facilitate participation by non-English speakers; study protocols often exclude individuals with chronic illnesses like diabetes and hypertension, which disproportionately impact people of color.The pressure to enroll participants and quickly accumulate data can be intense, especially in a pandemic, often eclipsing the goal of equitable representation.Another barrier to equitable clinical trial participation is the pervasive structural racism that is intricately woven into the fabric of our society. The U.S. has a shameful history of unethical experimentation on Black men and women, from experimental surgeries performed without anesthesia on enslaved Black women to the misappropriation of cervical tissue from Henrietta Lacks and the infamous Tuskegee syphilis study. This history has led to understandable and pervasive mistrust of clinical research. It is no wonder that Black and Latinx patients often say to us, “I don’t want to be a guinea pig in your experiments.”Layered on top of this are strong anti-immigrant and sometimes xenophobic views that keep Latinx individuals and others who weren’t born in the U.S. away from contact with health care institutions, including research groups.A recent survey conducted by the Pew Research Center demonstrates how this sordid history and ongoing structural inequity could affect clinical trial participation: Even if a Covid-19 vaccine were available today and proven effective, only 54% of Black adults would be willing to take it, compared to 74% of white adults. The statistics would likely be equally dismal for participation in Covid-19 vaccine trials. Bisola Ojikutu Tags CoronavirusresearchVaccineslast_img read more

Bristol’s novel treatment for psoriasis meets study goals, beats rival Amgen drug

first_img [email protected] About the Author Reprints STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Adam Feuerstein Bristol Myers Squibb said Tuesday that an oral drug designed to treat psoriasis differently from currently approved medicines demonstrated superiority to placebo and a competing drug from Amgen — achieving the goals of a large Phase 3 clinical trial.The safety profile of the Bristol drug called deucravacitinib, was “consistent” with previously conducted studies, the company added. What’s included? Log In | Learn More Pharma @adamfeuerstein Senior Writer, Biotech Adam is STAT’s national biotech columnist, reporting on the intersection of biotech and Wall Street. He’s also a co-host of “The Readout LOUD” podcast. center_img Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Unlock this article — plus daily coverage and analysis of the pharma industry — by subscribing to STAT+. First 30 days free. GET STARTED What is it? Courtesy Bristol Myers Squibb By Adam Feuerstein Nov. 3, 2020 Reprints GET STARTED Bristol’s novel treatment for psoriasis meets study goals, beats rival Amgen drug Tags drug developmentpharmaceuticalsSTAT+last_img read more