PHARMACY

Study: Diabetics at higher risk of tuberculosis infection

BY Allison Cerra

NEW YORK — Researchers from the University of Texas Health Science Center at Houston found that patients with diabetes are at higher risk of contracting tuberculosis, a deadly bacterial disease, than nondiabetics.

The study investigators discovered among 233 patients that were diagnosed with TB between March 2006 and March 2008 — which included 61 patients in southern Texas and 172 in northeastern Mexico — 25% of TB cases were attributed to the presence of diabetes, while 6% of TB cases were caused by HIV.

"With the increase in diabetes patients in TB-endemic areas, our findings highlight the reemerging impact of diabetes mellitus, known as Type 2, on TB control in regions of the world where both diseases are prevalent," said Blanca Restrepo, lead investigator and associate professor of epidemiology at the University of Texas School of Public Health Brownsville Regional Campus, a part of UTHealth. "There is a need to focus on identifying the opportunities to prevent TB in diabetes patients."

"Physicians should be screening at-risk diabetic patients for TB, and patients should be aware of their diabetes status," Restrepo added. "Opportunities are being missed for patients and physicians to work together to manage both diseases."

The results of the study, which was funded by the National Institutes of Health, were published in the May issue of the Bulletin of the World Health Organization.

"This research confirms results from several other studies showing an increased risk of TB in people with diabetes and means that it is important that clinicians actively seek to diagnose diabetes in people with TB and vice versa," said Knut Lonnroth, medical officer in the Stop TB department at the World Health Organization. "WHO and several partner organizations are in the process of finalizing a Collaborative Framework for Care and Control of Tuberculosis and Diabetes, which will guide countries on how to prepare health services for coordinated management and prevention, especially countries with high burden of both diseases."

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HealthPrize, RealAge look at social media, gaming technology to improve adherence

BY Alaric DeArment

SAN DIEGO — HealthPrize Technologies and RealAge will launch a study next month that will test HealthPrize’s medication adherence technologies on patients taking asthma medications, the two companies said Wednesday.

HealthPrize is the creator of an Internet and mobile app that uses behavioral economics and gaming dynamics to improve medication adherence, while RealAge is a health website that uses the RealAge Test to assess a person’s mortality risk based on health-related factors.

The study will provide asthma patients who have taken the RealAge Test with access to HealthPrize’s adherence platform, where they can earn points for taking their medications, engage in health education and receive chances to win prizes.

“The medication adherence space presents a substantial opportunity for us and the 27 million people who have taken the RealAge Test,” RealAge president Gregg Zegras said. “We are uniquely positioned to motivate consumers to follow a prescribed health plan because people come to us when they are at the point of readiness to change their lifestyle behaviors.”

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Many caregivers forgo their own medication adherence, research finds

BY Antoinette Alexander

WOONSOCKET, R.I. — Many people who provide care and support to loved ones said they are more likely to be nonadherent to their own personal medication regimen than to neglect providing medications to those they are caring for, according to a new study by researchers at Harvard University, Brigham and Women’s Hospital and CVS Caremark. Given this, there’s a significant opportunity for pharmacists and doctors to identify and work with caregivers to improve medication adherence and chronic disease management.

In a study published online this week in the Journal of the American Pharmacists Association, the researchers said, "Approximately one-half of caregivers reported they are more likely to forgo their own medications than the medication needs of their caregivees, especially if cost was a problem, and that caring for their family members was more important than caring for themselves."

The researchers added, "Our findings indicate caregiving status may be an important characteristic for providers to identify and that caregivers may represent a fertile target for adherence interventions to improve chronic disease management and prevent chronic disease."

More than 65 million Americans describe themselves as caregivers, and as the U.S. population ages, that number is expected to grow. The latest study is a product of CVS Caremark’s three-year collaboration with Harvard University and Brigham and Women’s Hospital to research pharmacy claims data to better understand patient behavior, and how the healthcare system can improve it, particularly around medication adherence.

The JAPhA study was published as CVS Caremark is sponsoring a forum on adherence at the National Press Club in Washington, D.C., to discuss the research findings of its collaboration and to outline future research and program initiatives the company is pursuing to address the problem that is estimated to cost the U.S. healthcare system almost $300 billion annually.

For the JAPhA study, the research team conducted an online survey of 2,000 retail pharmacy customers of which 38%, or 762 respondents, described themselves as caregivers. Of that group:

  • 45% said they somewhat or strongly agreed that they are more likely to forget to take their own medications, even though they provide family members with their medicines;

  • 46% said caring for their family is more important than caring for themselves, and 52% said they are more likely to sacrifice their own health to make sure they properly care for family members;

  • 53% reported that managing both their personal health and caring for another is stressful and that they eat to cope with that stress; and

  • When comparing caregivers with noncaregivers, caregivers said they are 10% more likely to forget taking their medicines, 11% are likely to stop taking their medications if they feel better and 13% said they are likely to forget filling their refills.

"These results highlight an important opportunity for our industry to work with a target population to increase adherence," stated Troyen Brennan, EVP and chief medical officer of CVS Caremark, and a co-author of the study. "Doctors need to identify caregivers so they can provide appropriate support. In addition, pharmacists are uniquely positioned to intervene and encourage caregivers to take their medicine, because the caregiver is often the person who is picking up medications for both family members and themselves."

"We found there is a compelling relationship between caregiving and medication adherence," stated William Shrank of Brigham and Women’s Hospital and Harvard Medical School, and lead author of the study. "Caregivers appear to be so focused on helping family members that they often forget to take care of themselves — behavior that can have severe consequences for their health and well-being. Healthcare professionals should identify and target this group to help them better manage their personal health while caring for family members."

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