July 2013 Briefing - Pharmacy

Here are what the editors at HealthDay consider to be the most important developments in Pharmacy for July 2013. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

After Hip Replacement, Aspirin Cost-Effective for VTE Prophylaxis

WEDNESDAY, July 31 (HealthDay News) -- Aspirin is a cost-effective choice for prophylaxis of venous thromboembolism (VTE) following total hip arthroplasty, but the choice of aspirin versus low-molecular-weight heparin (LMWH) for patients younger than 80 years undergoing total knee arthroplasty is unclear, according to research published in the July 17 issue of The Journal of Bone & Joint Surgery.

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Rituximab Equally Effective for Remission of Vasculitis

WEDNESDAY, July 31 (HealthDay News) -- Rituximab is as effective as conventional immunosuppressive therapy in maintaining remission in patients with severe antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, according to a study published in the Aug. 1 issue of the New England Journal of Medicine.

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Treatment Beneficial in Smoldering Multiple Myeloma

WEDNESDAY, July 31 (HealthDay News) -- For patients with smoldering multiple myeloma, treatment with lenalidomide plus dexamethasone correlates with delayed progression and improved survival, according to a study published in the Aug. 1 issue of the New England Journal of Medicine.

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Severe Hypoglycemia Ups Cardiovascular Risk in Diabetes

WEDNESDAY, July 31 (HealthDay News) -- Severe hypoglycemia is associated with a higher risk of cardiovascular disease in patients with type 2 diabetes, according to a meta-analysis of observational studies published online July 30 in BMJ.

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Health 'Mutual Accountability' Pilot Program Launching

WEDNESDAY, July 31 (HealthDay News) -- The State of Oklahoma Office of Management and Enterprise Services has chosen MedEncentive to conduct a three-year heath improvement program pilot among HealthChoice beneficiaries.

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Severe Hypoglycemia Common in Type 2 Diabetes

WEDNESDAY, July 31 (HealthDay News) -- Severe hypoglycemia is common among patients with type 2 diabetes, with the highest risk among those with near-normal or very poor glycemic control, according to a study published online July 30 in Diabetes Care.

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OK to Continue Aspirin Therapy Up to Pancreatic Surgery

WEDNESDAY, July 31 (HealthDay News) -- Patients on aspirin therapy do not have higher rates of perioperative bleeding, transfusion, or major procedure-related complications following elective pancreatic surgery, according to research published online July 26 in Surgery.

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Reversal of Medical Practices Common Over Past Decade

TUESDAY, July 30 (HealthDay News) -- Over 100 contemporary medical practices have subsequently been reversed over the last 10 years, according to a review published online July 22 in Mayo Clinical Proceedings.

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Back Pain Management Relying on Guideline Discordant Care

TUESDAY, July 30 (HealthDay News) -- Management of back pain is increasingly relying on guideline discordant care, including narcotic use, advanced imaging, and referrals to physicians, according to research published online July 29 in JAMA Internal Medicine.

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High H. pylori Cure Rate for Nonbismuth Quadruple Tx

MONDAY, July 29 (HealthDay News) -- Optimized nonbismuth quadruple regimens, either hybrid or concomitant, have a cure rate of more than 90 percent for Helicobacter pylori (H. pylori) infections, according to a study published in the July issue of Gastroenterology.

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FDA Updates Oral Nizoral Label to Reflect Safety Concerns

MONDAY, July 29 (HealthDay News) -- The U.S. Food and Drug Administration has approved label changes for Nizoral (ketoconazole) oral tablets and added a Medication Guide detailing various associated safety concerns.

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No Change in HPV Vaccine Coverage for Teen Girls in 2012

MONDAY, July 29 (HealthDay News) -- In 2012 there was little increase in human papillomavirus (HPV) vaccination among teenage girls, according to a report published in the July 26 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Centrally Acting ACE Inhibitors Slow Decline in Dementia

MONDAY, July 29 (HealthDay News) -- For patients with dementia, the rate of cognitive decline is slowed for those taking centrally acting angiotensin-converting-enzyme (ACE) inhibitors (CACE-Is), especially in the first six months of treatment, according to a study published in the July issue of BMJ Open.

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Automated EHRs Improve Immunization Reporting

FRIDAY, July 26 (HealthDay News) -- Automated public health reporting of immunization data via electronic health records (EHRs) significantly improves timeliness of reporting, according to a study published in Applied Clinical Informatics.

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FDA: New Test Detects TB and Antibiotic Resistance

FRIDAY, July 26 (HealthDay News) -- A new test to detect bacteria that cause tuberculosis (TB) and simultaneously determine if the bacteria are resistant to the antibiotic rifampin has been approved by the U.S. Food and Drug Administration.

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Flow Restrictors Protect Children From Liquid Medicine

FRIDAY, July 26 (HealthDay News) -- Adding flow restrictors to bottles limits the ability of young children to access liquid medicine, according to a study published online July 25 in the The Journal of Pediatrics.

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IOM Confirms Geographic Variation in Health Spending

THURSDAY, July 25 (HealthDay News) -- Considerable geographic variation exists in health care spending and utilization, but a geographically-based value index is unlikely to promote value improvement, according to a report published July 24 by the Institute of Medicine.

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FDA Warns Companies Selling Fraudulent Diabetes Products

WEDNESDAY, July 24 (HealthDay News) -- In an effort to crack down on potentially harmful products marketed toward people with diabetes, the U.S. Food and Drug Administration has sent warning letters to 15 foreign and domestic companies involved in the illegal sale of such items both online and in retail stores.

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New Mutation Identified in Pulmonary Arterial HTN

WEDNESDAY, July 24 (HealthDay News) -- A new mutation has been identified in pulmonary arterial hypertension, and riociguat appears to be beneficial in treating the condition, according to three studies published in the July 25 issue of the New England Journal of Medicine.

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Semagacestat Doesn't Improve Cognitive Status in Alzheimer's

WEDNESDAY, July 24 (HealthDay News) -- For patients with Alzheimer's disease, treatment with the small-molecule γ-secretase inhibitor semagacestat does not improve cognitive status and is associated with worsening of cognitive function, according to a study published in the July 25 issue of the New England Journal of Medicine.

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Continuing Statins Linked to Decreased Risk of Parkinson's

WEDNESDAY, July 24 (HealthDay News) -- Continuation of lipophilic statin therapy is associated with a decreased risk of Parkinson's disease (PD) when compared with statin discontinuation, according to a study published online July 24 in Neurology.

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HPV Vaccine Effective Against Oral Infections

WEDNESDAY, July 24 (HealthDay News) -- The bivalent human papillomavirus (HPV) 16/18 vaccine is effective against oral infection, according to a study published online July 17 in PLOS ONE.

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U.S. Physicians Not Supportive of Changes in Payment Models

TUESDAY, July 23 (HealthDay News) -- U.S. physicians accept some responsibility for reducing health care costs in their practice, but most do not want to change payment models, according to research published in the July 24/31 issue of the Journal of the American Medical Association.

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Deaths Estimated From Estrogen Avoidance After Hysterectomy

TUESDAY, July 23 (HealthDay News) -- Thousands of postmenopausal hysterectomized women are estimated to die each year because of low utilization of estrogen therapy (ET), according to a study published online July 18 in the American Journal of Public Health.

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Maternal Health Behaviors Affect Teen Boys' HPV4 Uptake

TUESDAY, July 23 (HealthDay News) -- Maternal utilization of preventive care and a history of genital warts may influence utilization of the quadrivalent human papillomavirus vaccine (HPV4) among adolescent boys, according to a study published online July 18 in the American Journal of Public Health.

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Clinical Trial Results for Cancer Drugs Often Not Published

TUESDAY, July 23 (HealthDay News) -- Although the U.S. Food and Drug Administration Amendments Act requires publication of the results of completed trials of cancer drugs conducted in the United States, results for almost half of the studies have not been made publicly available three years later, according to research published online July 22 in the Journal of Clinical Oncology.

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Pros and Cons of Electronic Cigarette Regulation Discussed

TUESDAY, July 23 (HealthDay News) -- The pros and cons of electronic cigarette (EC) regulation are discussed in to two editorials published online July 23 in The Lancet Respiratory Medicine.

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Ischemic Stroke Described in Patients With Fungal Meningitis

MONDAY, July 22 (HealthDay News) -- Patients presenting with acute ischemic stroke may have fungal infections attributable to contaminated methylprednisolone associated with epidural injections, according to a case series published online July 22 in JAMA Neurology.

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Premiums Expected to Be About 20 Percent Lower in 2014

MONDAY, July 22 (HealthDay News) -- Premiums in the Health Insurance Marketplace are likely to be about 20 percent lower than anticipated in 2014, according to a report published by the U.S. Department of Health and Human Services (HHS).

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Tablets Help Physicians Keep Up With Medical Research

MONDAY, July 22 (HealthDay News) -- Most physicians find keeping up with the latest research to be challenging, but the use of tablets and smartphones may help, according to a report published by Wolters Kluwer Health.

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ADHD Drug May Reduce Risk of Falling in Elderly

MONDAY, July 22 (HealthDay News) -- A single dose of methylphenidate, a drug used to treat attention-deficit/hyperactivity disorder and narcolepsy, improves gait control in healthy older adults and may reduce their risk of falling, according to a study published in The Journals of Gerontology.

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Chemoprophylaxis Found to Be Safe After Spine Trauma Surgery

FRIDAY, July 19 (HealthDay News) -- Thromboembolic chemoprophylaxis seems to be safe and efficacious in at-risk trauma patients having spinal stabilization surgery, according to a retrospective review published in the July 15 issue of Spine.

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Missed Diagnoses, Med Errors Most Common Malpractice Claims

FRIDAY, July 19 (HealthDay News) -- The most common medical misadventures resulting in malpractice claims in primary care are missed or delayed diagnoses and medication errors, according to a review published online July 18 in BMJ Open.

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Top Challenges for Docs Include Financial Management

FRIDAY, July 19 (HealthDay News) -- The top issues and challenges facing physicians include managing changing reimbursement models with payors and financial management, according to a report published by Wolters Kluwer Health.

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Newer Anticoagulants Linked to Gastrointestinal Bleeding

FRIDAY, July 19 (HealthDay News) -- Patients taking the new generation of oral anticoagulants appear to have a higher risk of gastrointestinal bleeding compared with standard care, particularly when treated for venous thrombosis or acute coronary syndrome, according to a review published in the July issue of Gastroenterology.

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~2 Percent of Opioid Rx Bought by 0.7 Percent of Patients

THURSDAY, July 18 (HealthDay News) -- A small proportion of opioid prescription purchasers (0.7 percent) obtain an average of 32 prescriptions from 10 different prescribers, accounting for 1.9 percent of all opioid prescriptions, according to a study published online July 17 in PLOS ONE.

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Antipsychotics Induce Insulin Resistance Without Weight Gain

THURSDAY, July 18 (HealthDay News) -- Atypical antipsychotic drugs induce insulin resistance even in the absence of weight gain and mechanisms regulating eating behavior, according to a study published online July 8 in Diabetes.

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Financial Incentives Can Drive Health IT Adoption

WEDNESDAY, July 17 (HealthDay News) -- Financial incentives can drive providers' adoption of health information technology, including e-prescribing, according to a study published in the July issue of Health Affairs.

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Low-Dose Aspirin May Reduce Women's Colorectal Cancer Risk

WEDNESDAY, July 17 (HealthDay News) -- In healthy women, long-term use of alternate-day, low-dose aspirin may reduce the risk for colorectal cancer, according to a study published in the July 16 issue of the Annals of Internal Medicine.

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Free Postpartum Contraception Optimizes Pregnancy Intervals

WEDNESDAY, July 17 (HealthDay News) -- Providing postpartum contraception to low-income women through publicly-funded programs helps avoid short pregnancy intervals, according to research published online July 8 in Obstetrics & Gynecology.

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Prostate Cancer Treatment Linked to Kidney Injury

TUESDAY, July 16 (HealthDay News) -- Among men with non-metastatic prostate cancer, treatment with androgen deprivation therapy is associated with an increased risk of developing acute kidney injury, according to a study published in the July 17 issue of the Journal of the American Medical Association.

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CMS Medicare Physician Fee Schedule Could Benefit Docs

TUESDAY, July 16 (HealthDay News) -- The Centers for Medicare and Medicaid Services has released the 2014 proposed Medicare physician fee schedule, which could help create a more equitable payment system by adjusting misvalued codes and proposing new complex management codes, according to a report published by American Academy of Family Physicians.

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Acid Reflux Medications May Constrict Blood Vessels

TUESDAY, July 16 (HealthDay News) -- The mechanism by which proton pump inhibitors (PPIs) increase the risk of major adverse cardiovascular events may now be better understood, according to a study published online July 3 in Circulation.

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In U.K., Experts Call for HPV Vaccination for Young Gay Men

TUESDAY, July 16 (HealthDay News) -- In the United Kingdom, young men who have sex with men (MSM) should be vaccinated against human papillomavirus (HPV) infection to reduce their risk of developing anal cancer, according to an editorial published in the August issue of Sexually Transmitted Infections.

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EHRs May Slow Growth in Ambulatory Health Care Costs

MONDAY, July 15 (HealthDay News) -- Adoption of electronic health records (EHRs) modestly slows growth in ambulatory health care costs, according to research published in the July 16 issue of the Annals of Internal Medicine.

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Tool Helps Emergency Providers ID Drug-Seeking Behavior

MONDAY, July 15 (HealthDay News) -- Emergency providers are fairly accurate at identifying drug-seeking behavior, demonstrating fair agreement with prescription drug monitoring program criteria, according to a study published online July 11 in the Annals of Emergency Medicine.

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CMS Proposes New Rule for Outpatient Payment Policies

MONDAY, July 15 (HealthDay News) -- A new rule proposes updating Medicare payment policies and rates for the hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) services, according to a report issued by the Centers for Medicare and Medicaid Services.

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Omega-3 Fatty Acids Linked to Risk of Prostate Cancer

FRIDAY, July 12 (HealthDay News) -- High blood concentrations of long-chain omega-3 polyunsaturated fatty acids (PUFA) are linked to an increased risk of prostate cancer, according to research published online July 10 in the Journal of the National Cancer Institute.

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Novel Misoprostol Insert Reduces Labor Time, Need for Oxytocin

FRIDAY, July 12 (HealthDay News) -- Use of a 200-microgram misoprostol vaginal insert significantly reduces the time to vaginal delivery and the need for oxytocin, in women with an unfavorable cervix, compared to those using a dinoprostone vaginal insert, according to a study published online July 8 in Obstetrics & Gynecology.

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FDA Approves Gilotrif for Late-Stage Lung Cancer

FRIDAY, July 12 (HealthDay News) -- The drug Gilotrif (afatinib) has been approved by the U.S. Food and Drug Administration to treat spreading cases of non-small-cell lung cancer (NSCLC) caused by certain gene mutations, the agency said Friday.

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AMA Offers Guidance for Improving EHR Effectiveness

FRIDAY, July 12 (HealthDay News) -- The American Medical Association (AMA) House of Delegates has voted for policies to help physicians navigate patient interaction while using electronic devices and to improve the interoperability of electronic health records (EHRs).

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Physicians Frustrated by Third-Party Interference

FRIDAY, July 12 (HealthDay News) -- Third-party interference is the most commonly cited key frustration for physicians, according to the results of a survey published in Physicians Practice.

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Grants of $150 Million for Community Health Centers

THURSDAY, July 11 (HealthDay News) -- Grants totaling $150 million are to be shared by 1,100 community health centers to help enroll patients in insurance programs, according to the U.S. Department of Health and Human Services (HHS).

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Health Searches May Be Leaked to Third Parties

THURSDAY, July 11 (HealthDay News) -- Free health-related websites often have third-party tracking elements and leak search terms to third-party tracking entities, unlike U.S. government or physician-oriented websites, according to a research letter published online July 8 in JAMA Internal Medicine.

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U.S. Adults Value Health Care Provider Skill Evaluation

THURSDAY, July 11 (HealthDay News) -- Most adults feel that health care providers who treat them should adhere to a recertification program, including passing examinations, attending educational programs, and undergoing certification, regardless of time in practice, according to a report published by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) and the Citizen Advocacy Center.

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Docs Don't Often Talk to Patients About Dietary Supplements

THURSDAY, July 11 (HealthDay News) -- Although primary care physicians are discussing dietary supplements with patients during outpatient visits, these exchanges happen infrequently, according to research published in the June issue of Patient Education and Counseling.

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One in Five U.S. Adults Will Have Trouble Paying Medical Bills

THURSDAY, July 11 (HealthDay News) -- About one in five U.S. adults will have problems paying health care bills in 2013, including about 10 million adults with year-round insurance coverage, according to a report published by the American Medical Association (AMA).

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Red Cross Issues Emergency Call for Blood Donors

THURSDAY, July 11 (HealthDay News) -- The American Red Cross has issued an emergency request for blood and platelet donors of all blood types, according to report posted July 9.

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Improvement Needed in Drug Post-Marketing Studies

WEDNESDAY, July 10 (HealthDay News) -- Since the requirement in 2007 that drug makers conduct post-marketing studies, the number of studies not yet started has declined while the number of studies fulfilling obligations has nearly doubled, according to a report published in the July 10 issue of the Journal of the American Medical Association. However, more than 40 percent of studies had not yet been started in 2011, and the number of studies with delays doubled as of 2011.

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Health Insurance Marketplaces Not Required to Verify Claims

WEDNESDAY, July 10 (HealthDay News) -- Health insurance marketplaces will not be required to verify consumers' income and health insurance status and can rely on self-reported information, the Obama administration announced Friday.

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Tablets More Useful Than Smartphones for Docs Using EHRs

WEDNESDAY, July 10 (HealthDay News) -- Although tablets are less often used by physicians than smartphones, they are more frequently used for accessing electronic health records (EHRs), and time spent on tablets is much higher, according to two reports published by AmericanEHR Partners.

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Soy Supplement Doesn't Cut Prostate Cancer Recurrence

TUESDAY, July 9 (HealthDay News) -- For men at high risk of biochemical recurrence after radical prostatectomy, daily consumption of a soy protein supplement is not associated with a reduction in the risk of recurrence, according to a study published in the July 10 issue of the Journal of the American Medical Association.

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Vitamin D, Coronary Heart Disease Link Varies by Race

TUESDAY, July 9 (HealthDay News) -- Low concentrations of serum 25-hydroxyvitamin D (25[OH]D) are associated with an increased risk of coronary heart disease (CHD) among whites and Chinese, but not among blacks or Hispanics, according to a study published in the July 10 issue of the Journal of the American Medical Association.

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Digital Divide Plagues Underserved Areas

TUESDAY, July 9 (HealthDay News) -- Electronic health record (EHR) adoption is uneven, with traditionally underserved areas having lower adoption rates across the United States, according to a study published online June 26 in Health Services Research.

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Statins Usually Well Tolerated, With Few Adverse Effects

TUESDAY, July 9 (HealthDay News) -- Adverse events from statin therapy are not common, according to a review published online July 9 in Circulation: Cardiovascular Quality and Outcomes.

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ASCO Urges Breast Cancer Chemoprevention Discussion

TUESDAY, July 9 (HealthDay News) -- Health care providers are encouraged to discuss chemoprevention as a clinical option with women at increased breast cancer (BC) risk, according to a newly updated American Society of Clinical Oncology (ASCO) clinical practice guideline published online July 8 in the Journal of Clinical Oncology.

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Adoption of Electronic Health Records Is Progressing

TUESDAY, July 9 (HealthDay News) -- In 2012, 44 percent of hospitals reported having at least a basic electronic health record (EHR), according to an annual report published by the Robert Wood Johnson Foundation.

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Supplement Use Common Among Facial Cosmetic Surgery Patients

TUESDAY, July 9 (HealthDay News) -- Herbal supplement use is common among patients undergoing facial cosmetic surgery, especially in females and older patients, according to a study published in the July issue of Plastic and Reconstructive Surgery.

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Dose Reduction Ups Recovery After First-Episode Psychosis

MONDAY, July 8 (HealthDay News) -- Patients in remission from first-episode psychosis have better long-term recovery after reduction or discontinuation of antipsychotics rather than maintenance treatment, according to a study published online July 3 in JAMA Psychiatry.

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Drug Overdose Deaths, ER Visits Up for Women Since 1999

WEDNESDAY, July 3 (HealthDay News) -- Drug-related deaths and emergency department visits have increased among women since 1999, according to research published in the July 2 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Work Loss Not Tied to Drug Choice in Rheumatoid Arthritis

WEDNESDAY, July 3 (HealthDay News) -- Therapy including a biological agent is not superior to conventional therapy in reducing work loss in patients with early-stage rheumatoid arthritis (RA) who fail to respond to methotrexate, according to research published online July 1 in JAMA Internal Medicine.

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Home Telemonitoring Intervention Ups BP Control

WEDNESDAY, July 3 (HealthDay News) -- For patients with uncontrolled blood pressure (BP), use of a telemonitoring intervention involving home BP telemonitors and pharmacist case management is associated with greater improvements in BP control than those seen with usual care, according to a study published in the July 3 issue of the Journal of the American Medical Association.

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Obama Administration: ACA's Employer Mandate Delayed

WEDNESDAY, July 3 (HealthDay News) -- The Obama Administration is postponing a major Affordable Care Act (ACA) provision, the employer mandate, according to an announcement made Tuesday via the U.S. Department of the Treasury website.

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Progestin Tx Reasonably Effective for Early Endometrial Cancer

TUESDAY, July 2 (HealthDay News) -- Conservative management with oral progestin can be a reasonable treatment option for many patients with stage 1A endometrial cancer, according to research published in the July issue of Obstetrics & Gynecology.

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Post-Breast Cancer, Metformin Has No Effect on Mortality

TUESDAY, July 2 (HealthDay News) -- For older women with diabetes and breast cancer, there is no association between metformin use and all-cause or breast cancer-specific mortality, according to a study published online April 30 in Diabetes Care.

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Salsalate Improves Glycemic Control in Type 2 Diabetes

TUESDAY, July 2 (HealthDay News) -- Salsalate, a prodrug form of salicylate, improves glycemic control and reduces inflammation in patients with type 2 diabetes, but also has some undesirable cardiac and renal effects, according to a study published in the July 2 issue of the Annals of Internal Medicine.

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Hypertension, Lipid Control Improved, 1988 to 2010

TUESDAY, July 2 (HealthDay News) -- Concomitant hypertension and hypercholesterolemia control have improved from 1988-1994 to 2005-2010, according to research published in the July 2 issue of Circulation.

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New Rule for Contraception Coverage, Religious Bodies

TUESDAY, July 2 (HealthDay News) -- The final rule has been issued on contraception coverage and religious organizations, respecting the religious considerations raised by non-profit organizations while increasing access to contraceptive coverage for women, according to a report published by the U.S. Department of Health and Human Services.

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FDA Approves First Non-Hormonal Tx for Hot Flashes

MONDAY, July 1 (HealthDay News) -- Brisdelle (paroxetine) has been approved by the U.S. Food and Drug Administration as the first non-hormonal treatment to treat hot flashes associated with menopause.

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Prehospital Triage Policy for Suspected Stroke Ups tPA Use

MONDAY, July 1 (HealthDay News) -- Implementation of a prehospital triage policy for patients with suspected stroke is associated with increased use of intravenous (IV) tissue plasminogen activator (tPA), according to a study published online July 1 in JAMA Neurology.

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Etanercept Reduces Work, Activity Impairment in RA

MONDAY, July 1 (HealthDay News) -- For patients with moderate-to-severe rheumatoid arthritis (RA), continued etanercept treatment is associated with reduced work and activity impairment, according to a study published online April 1 in Arthritis Care & Research.

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