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As U.S. health system lags other nations, need grows for larger role for pharmacists

BY Jim Frederick

Opponents of health reform are usually quick to make comparisons between our nation’s healthcare system and that of the rest of the world. Americans, they argue, enjoy the most advanced and most effective health care in the world. And forcing the U.S. system to change – either through new, evidence-based government payment incentives, federally mandated quality and cost controls, or through new methods for delivering primary care or making health decisions on behalf of patients – would only jeopardize the patient-doctor relationship and undermine the best healthcare network in the world.

Those opponents of change are wrong, in part because they’re willing to accept the status quo for U.S. health care, which is unsustainable for the simple reason that the nation can’t afford the current fee-for-service health system and its skyrocketing costs. But they’re also wrong because they’re proceeding from a flawed assumption: that our health system is tops among all nations.

A new report from the non-profit National Academies, the National Institutes of Health and the Department of Health and Human Services smacks that argument “upside the head,” as we say in the South. Based on a major comparison study of many health markers in 17 developed countries including the U.S., Canada, Australia, Japan and western European nations, the report “gives low marks to the United States in the health of its citizens, finding that Americans have higher rates of injury and disease and die sooner than their counterparts in other developed countries,” writes DSN associate editor Alaric DeArment.

The U.S., he reports, ranks “at or near the bottom in terms of infant mortality and low birth weight, injuries and homicides, teenage pregnancies and sexually transmitted infections, prevalence of HIV and AIDS, drug-related deaths, obesity and diabetes, heart disease, chronic lung disease and disability.” Equally striking, we’ve had “the highest infant mortality rate of any high-income country for decades while also ranking poorly in premature birth and the proportion of children who live to age 5 years.”

“What concerns our panel is why, for decades, we have been slipping behind,” says the report’s lead author, Virginia Commonwealth University professor of family medicine Steven Woolf.

If ever there was a time when the nation’s health care system was ripe for big change – including a larger role for pharmacists as disease managers, front-line patient care team members and wellness advocates – that time is now.

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BMI an appropriate gauge of health risks, study finds

BY Alaric DeArment

NEW YORK — A new study indicates body mass index is a reliable indicator of obesity-related health risks.

The study, published Saturday in the journal Obesity Research and Clinical Practice, compared the merits of BMI to other measures of body size as a predictor of obesity-related cardiovascular health risks. The study’s authors noted that some have questioned the validity of BMI.

"There has been a lot of controversy recently over whether BMI, which is based simply on weight and height, is a good clinical indicator of obesity-related health risks, especially when compared to more complex measures and newer technologies," Columbia University epidemiology professor Andrew Rundle said. "I wanted to see how well BMI performs compared to other proposed measures, and our research shows that BMI performs well as a predictor of health risks. If your BMI is heigh, chances are good it’s because you have an excess of fat tissue and that you have other health risks."

Rundle and a team of researchers analyzed cross-sectional measurements of height, weight, waist circumference, percent body fat, blood pressure measurements, cholesterol levels and fasting glucose levels among more than 12,000 adults from a database maintained by EHE International, a 100-year-old provider of preventive medicine and annual physical exams. Rundle is a member of EHE’s advisory board.


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OTC purchase decisions based on experience

BY Michael Johnsen

At least half of consumers cited prior use (58%) as the most commonly reported method to select an OTC remedy, according to an online survey of more than 900 AccentHealth viewers conducted in September. Decisions also are commonly made by reading packages at the shelf (54%) or from a pharmacist’s recommendation (50%).

To see more Patient Views, click here.

Patient Views is a new, exclusive consumer insights feature that appears in every edition of DSN magazine, as well as the daily e-newsletter DSN A.M. If you could ask 4,000 patients anything at all, what would it be? Send your questions to [email protected].

Source: AccentHealth. To view the demographic breakdown of participants, click here.

 

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