News Briefs

06/08/2022

History of COVID Affects Work Performance

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tired at work

People who have recovered from COVID-19 often experience lingering memory, attention, and concentration problems that affect their work, according to a study published in Scientific Reports.

Researchers from the University of Waterloo collected data from 94 full-time working adults who either had or had not contracted COVID-19 at least one month prior to the study. Both groups were matched on key demographic characteristics.

The group who had experienced COVID-19 reported more cognitive failures at work, which are defined as problems with attention, memory, and action. Those cognitive failures were associated with decreased self-ratings of job performance and increased intentions to voluntarily leave one's current job.

"These results may have important implications for managers and organizations more broadly," said lead author James Beck, an associate professor in Waterloo's Psychology department. "Individuals returning to work after contracting COVID-19 may experience difficulties returning to their pre-COVID-19 level of performance and accommodations may be necessary. These accommodations might include reducing workloads, extending deadlines, or providing flexible work arrangements."

 

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06/08/2022

COVID Vaccination Safe and Effective During Pregnancy

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Vaccinations

Getting a second or third dose of the COVID-19 vaccine in the final stages of pregnancy protects infants from this virus, according to a study published in JAMA Internal Medicine.

Of 21,643 newborns included in the register-based cohort study, 9,739 (45%) were born to women who received a second or third dose of a COVID-19 mRNA vaccine during the last two trimesters of pregnancy. Those infants had a lower incidence of confirmed SARS-CoV-2 infection than infants whose mothers were unvaccinated. Vaccination was more effective against the Delta variant than the Omicron variant.

[[Read More: Health-Care Workers Change Their Minds on Vaccinations]]

Similar protective benefits against infant infection have been observed for pertussis and influenza vaccination during pregnancy in randomized clinical trials and observational studies, the study authors noted. Receiving a COVID-19 vaccine during pregnancy does not increase the frequency of complications around the time of childbirth.

[[Read More: Patients with Allergic Reaction to First COVID Shot Are Often Fine After the Second]]

"Young infants are at higher risk of severe COVID-19 compared with older children, and there is no approved COVID-19 vaccine for this age group. Getting fully vaccinated against COVID-19 during pregnancy helps protect young infants from potential SARS-CoV-2 infection when they are born," said Dr. Deshaye Fell, Scientist at the CHEO Research Institute and Associate Professor in the University of Ottawa's Faculty of Medicine.

06/07/2022

Limited Evidence Supports the Role of Cannabis for Pain Relief

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medical marijuana

The pain-relieving effects of cannabis and related products are based on their ability to mimic the body's own endocannabinoid system, which can affect the sensation of pain. A federally funded systematic evidence review of 3,000 studies (25 of which had scientifically valid evidence) found that just three products showed evidence providing pain relief: Dronabinol (Marinol) and nabilone (Cesamet), both FDA-approved synthetic products; and nabiximols (Sativex; not available in the United States), a sublingual spray.

In the review, researchers sorted products into high, comparable, and low ratios of THC to CBD and compared their reported benefits and side effects. Dronabinol and nabilone, both of which contain 100% tetrahydrocannabinol (THC), showed the strongest benefit among the products studied. Nabiximols contains equal parts THC and cannabidiol (CBD).

The review found an otherwise surprising dearth of evidence. "In general, the limited amount of evidence surprised all of us," said lead author Marian S. McDonagh, PharmD, emeritus professor of medical informatics and clinical epidemiology in the OHSU School of Medicine.

"We saw only a small group of observational cohort studies on cannabis products that would be easily available in states that allow it, and these were not designed to answer the important questions on treating chronic pain."

While 22 states have legalized marijuana (both medical and recreational), few of the products available in dispensaries have been well studied. "For some cannabis products, such as whole-plant products, the data are sparse with imprecise estimates of effect and studies had methodological limitations," the authors wrote in the Annals of Internal Medicine.

"Cannabis products vary quite a bit in terms of their chemical composition, and this could have important effects in terms of benefits and harm to patients," said co-author Roger Chou, MD, director of OHSU's Pacific Northwest Evidence-based Practice Center. "The evidence for one cannabis-based product may not be the same for another."

 The project was funded by Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services.

 

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06/06/2022

Medication Adherence Improves Outcomes

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self administering a shot

Patients with cystic fibrosis who adhered to prescribed cystic fibrosis transmembrane conductance regulator modulator (CFTRm) therapies were significantly less likely to be hospitalized than nonadherent patients in a recent study, researchers reported at the May ISPOR conference in Washington, D.C.

A separate study found similar results in patients with ulcerative colitis and Crohn’s disease. Medication-adherent patients had fewer hospitalizations, shorter stays in the hospital if hospitalized, and lower inpatient costs than nonadherent patients.

Both studies were retrospective analyses of a deidentified commercial claims database. Adherence was measured by using a proportion of days covered metric among patients who had medical claims with ICD-10 codes for their respective study during 2019. Researchers examined outcomes, including hospitalizations, inpatient bed days and inpatient costs.

Nishita Hira, AllianceRx Walgreens Prime clinical program manager and an author of the CF study, said that the research findings reinforce the role specialty pharmacies play in supporting CF patients. “Specialty pharmacies can help support adherence through monthly touchpoints with patients. These include refill reminders and screening for and counseling on adherence barriers — such as administration difficulties or side effects — that may pose a threat to continued adherence. Through improving adherence, specialty pharmacies can have a beneficial outcome on patient quality of life.”

The same holds true for patients with UC/Crohn’s disease, according to Renee Baiano, clinical program manager at AllianceRx Walgreens Prime and an author of the UC/Crohn’s disease study. “The continual interaction between the patient, specialty pharmacy and provider is fundamental in the continuity of care for IBD patients. Specialty pharmacists can improve the quality of life for these patients by providing expert advice and support of treatment regimens, as well as by encouraging medication adherence.”

“For patients, the message is staying adherent can keep you out of the hospital,” said Edward Witt, Walgreens manager of health analytics, research and reporting, and an author of the study. “For payers and providers, medication adherence is a key factor for reducing inpatient costs and improving quality of care.”

06/02/2022

Colorado Passes the First Law Giving Patients the Right to Repair Their Own Powered Wheelchairs

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wheelchair

Powered-wheelchair users face a lengthy uphill battle to get even the simplest repairs done, but Colorado is trying to ease the process.

Under current law, powered wheelchair users can only obtain maintenance, diagnostics, or repairs directly from the manufacturer. The power-wheelchair market is dominated by two suppliers, both of which are owned by private equity firms, explains Kaiser Health News. Both seek to increase profits by limiting spending on technicians and repairs.

“They usually keep a limited inventory of parts on hand and wait until health plans approve repair claims before ordering parts,” according to KHN.

Wheelchair users often can’t make their own repairs because the wheelchairs often require a key or passcode to make repairs, and any repairs a user does male can endanger insurance payments or warranties. Even independent shops can’t make the repairs as the wheelchair manufacturers restrict access to parts, tools, and service manuals.

Wheelchair users report months-long waits for even simple repairs and have been fighting to be able to repair their wheelchairs themselves or through independent repair shops.

The Colorado bill requires the manufacturer to provide embedded software, firmware, parts, tools, and documentation (such as diagnostic, maintenance, or repair manuals) to independent repair providers and wheelchair owners so they can diagnose, maintain, and repair the wheelchairs. Failure to comply, under the bill, will be deemed a deceptive trade practice.

Legislators in Pennsylvania and Massachusetts are considering similar bills, and at least three right-to-repair bills have been introduced in Congress this year.

05/31/2022

CVS Health Launches Virtual Primary Care

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CVS

CVS Health has launched a new virtual care solution that will give members access to primary care, chronic condition management, on-demand care, and mental health services virtually, with the option of being seen in-person when needed at an in-network provider, including MinuteClinic. Patients can now receive care virtually, through at-home health services, or in a retail or community-based setting. The virtual primary care provider also can help members identify in-network specialists and other health service providers as needed.

CVS Health Virtual Primary Care will feature a member-selected care team that may include nurse practitioners, registered nurses and licensed vocational nurses who will consult with a dedicated CVS pharmacist when needed. The program will use an interoperable electronic health record that will help members transition between virtual and in-person care. Clinical data can be shared with other providers. With the introduction of CVS Health Virtual Primary Care, Aetna is offering plan sponsors more benefit options to meet their member’s evolving needs.

Additionally, Caremark members will now have a solution that will allow them to access more CVS Health services and capabilities. By combining health services, a coordinated care team and clinical data on a single digital platform, CVS Health Virtual Primary Care will help all members receive health guidance and care coordination that directs them to the lowest cost, clinically appropriate care.

“We’re meeting people where they are on their healthcare journey and providing care that is more convenient and easier to access. When we make it simple, we can help people lead healthier lives,” said Creagh Milford, vice president of Enterprise Virtual Care at CVS Health. The program is currently being sold to Aetna fully-insured, self-insured plan sponsors and CVS Caremark clients. It will become effective for eligible Aetna members starting Jan. 1, 2023, and for eligible CVS Caremark members during the second quarter of 2023.