Do Prescription Drug Ads Tell Consumers Enough About Benefits and Side Effects? Results From the Health Information National Trends Survey, Fourth Administration.

Direct-to-consumer prescription drug advertising (DTCA) is a major source of consumer information about prescription drugs. The present study updates 2002 U.S. Food and Drug Administration phone survey questions that found that 44% and 61% of consumers thought that DTCA did not include enough information about benefits and risks, respectively. The present study was administered by mail using a nationally representative sample, and provides a more in-depth understanding of how these beliefs relate to demographic and health characteristics. Data collected from 3,959 respondents to the National Cancer Institute's 2011 Health Information National Trends Survey find results similar to the 2002 survey: 46% and 52% of respondents thought that DCTA did not include enough information about benefits and risks, respectively. Respondents fell into four groups: 23% agreed that DTCA tells enough about drug benefits and risks, 41% disagreed, 18% expressed no opinion, and 18% had discordant beliefs. DTCA attitudes were negatively associated with education, income, and whether respondents purchase prescription drugs; attitudes were positively associated with whether respondents understand prescription drug information. This study confirms that a plurality of Americans believe that DTCA does not include enough information about benefits and risks, suggesting that the educational effect of DTCA could be improved.

From adversary to partner: have quality improvement organizations made the transition?

OBJECTIVE: To describe the perceived impact of the Centers for Medicare and Medicaid Services Quality Improvement Organizations (QIOs) on quality of care for patients hospitalized with acute myocardial infarction, in the context of new efforts to work more collaboratively with hospitals in the pursuit of quality improvement. DATA SOURCE: Primary data collected from a national random sample of 105 hospital quality management directors interviewed between January and July 2002. STUDY DESIGN: We interviewed quality management directors concerning their interactions with the QIO interventions, the helpfulness of QIO interventions and the degree to which they helped or hindered their hospital quality efforts, and their recommendations for improving QIO effectiveness. PRINCIPLE FINDINGS: More than 90% of hospitals reported that their QIO had initiated specific interventions, the most common being the provision of educational materials, benchmark data, and hospital performance data. Many respondents (60%) rated most QIO interventions as helpful or very helpful, although only one-quarter of respondents believed quality of care would have been worse without the QIO interventions. To increase QIO efficacy, respondents recommended that QIOs appeal more directly to senior administration, target physicians (not just hospital employees), and enhance the perceived validity and timeliness of data used in quality indicators. CONCLUSIONS: Our study demonstrates that the QIOs have overcome, to some degree, the previously adversarial and punitive roles of Peer Review Organizations with hospitals. The generally positive view among most hospital quality improvement directors concerning the QIO interventions suggests that QIOs are potentially poised to take a leading role in promoting quality of care. However, the full potential of QIOs will likely not be realized until QIOs are able to engender greater engagement from senior hospital administration and physicians.

Validation of self-reported pneumococcal vaccination in behavioral risk factor surveillance surveys: experience from the sickness prevention achieved through regional collaboration (SPARC) program.

Behavioral risk factor surveillance system (BRFSS) is the primary surveillance tool for the ongoing measurement of state-specific delivery of pneumococcal polysaccharide vaccine. This study is the first validity assessment of self-reported pneumococcal vaccination status in a population-wide BRFSS survey. A subset of respondents to the sickness prevention achieved through regional collaboration (SPARC) BRFSS survey, which was conducted from June to September 1997 in a four-county area were assessed. Self-reporting of pneumococcal vaccination status was validated either by matching to Medicare claims or by reviewing of medical records. Self-reporting of pneumococcal vaccination had a sensitivity of 75% and a specificity of 83%. We conclude that self-reporting of pneumococcal immunization is a moderately sensitive and specific measure and that population-based surveys in the community can be validated when undertaken in collaboration with a local health care agency.

Improving the timeliness of written patient notification of mammography results by mammography centers.

Timely reporting of mammogram results helps to reduce anxiety for women with negative results and speeds up diagnosis or treatment in the case of abnormal results. The goal of this project was to improve the rate at which Virginia mammography centers provide a written report to women in lay terms within 30 days of a mammogram. The project included six intervention and five control mammography centers. The baseline period was prior to when new regulations in the Mammography Quality Standards Act (MQSA) took effect in April 1999. The re-measurement period was after April 1999. Data were obtained from abstraction of mammography reports and patient notification letters from a sample of patients with negative and abnormal mammography results at each mammography center. Each intervention mammography center received a notebook that included numerous tools on systems for patient notification and tracking, baseline notification rates and other abstracted information, biopsy recommendations, sample results letters, and a copy of the MQSA. For negative mammograms, the intervention group in aggregate increased from 24% at baseline to 79% at re-measurement in their rate of notification within 30 days. The control group increased from 25% to 46%. For abnormal mammograms, increases were from 35% to 85% and from 25% to 58%, respectively. The intervention group's increases were considerably higher, suggesting an effect due to the interventions that involved technical assistance, education, and system change. All increases were statistically significant (p < 0.01). At baseline, three intervention centers and two controls had policies for written notification. All 11 had policies at re-measurement. However, only two of the five control centers could provide clear supporting documentation for dates of notification at re-measurement. Mammography centers can benefit from guidance in the form of intervention materials specifically designed to address the MQSA sections that apply to patient notification, tracking, and positive predictive value of biopsy recommendations.

Evaluación de la calidad de vida en sobrevivientes de cáncer infantil / Evaluation of quality of life in infantile cancer survivors

Se estudió la calidad de vida de 44 sobrevivientes de cáncer infantil tratados en un hospital pediátrico. Se realizó un exámen psicológico, psiquiátrico y familiar a todos ellos. La calidad de vida fue evaluada por la presencia de síntomas físicos, psíquicos, funcionamiento familiar, nivel socioeconómico, desarrollo cognitivo y afectivo-social. El análisis estadístico incluyó la razón de disparidad(odds ratio OR), desviación típica(DT) e intervalos de confianza del 95 por ciento(IC=95 por ciento). El nivel de significación se estableció en 5 por ciento. Como prueba de significación estadística se utilizó la prueba de equis al cuadrado con corrección de Yates y exacta de Fisher. Aunque el 75 por ciento de los pacientes tenía una calidad de vida buena, la mayoría tenía problemas psicológicos no resueltos en el plano individual y familiar. Se recomienda realizar intervenciones psicosociales en todo paciente oncológico infantil, desde el momento del diagnóstico, hasta el término de la adolescencia, incluyendo a la familia, equipo tratante, escuela y comunidad

Evaluación de la calidad de vida en sobrevivientes de cáncer infantil / Evaluation of quality of life in infantile cancer survivors

Se estudió la calidad de vida de 44 sobrevivientes de cáncer infantil tratados en un hospital pediátrico. Se realizó un exámen psicológico, psiquiátrico y familiar a todos ellos. La calidad de vida fue evaluada por la presencia de síntomas físicos, psíquicos, funcionamiento familiar, nivel socioeconómico, desarrollo cognitivo y afectivo-social. El análisis estadístico incluyó la razón de disparidad(odds ratio OR), desviación típica(DT) e intervalos de confianza del 95 por ciento(IC=95 por ciento). El nivel de significación se estableció en 5 por ciento. Como prueba de significación estadística se utilizó la prueba de equis al cuadrado con corrección de Yates y exacta de Fisher. Aunque el 75 por ciento de los pacientes tenía una calidad de vida buena, la mayoría tenía problemas psicológicos no resueltos en el plano individual y familiar. Se recomienda realizar intervenciones psicosociales en todo paciente oncológico infantil, desde el momento del diagnóstico, hasta el término de la adolescencia, incluyendo a la familia, equipo tratante, escuela y comunidad

Causas de diarrea crónica infantil / Causes of chronic diarrhea in children

Se estudiaron los hechos clínicos de 100 pacientes consecutivos referidos a un consultorio de gastroenterología por diarrea crónica, dos causas fueron las responsables de los 3/4 de los casos: giardiasis (42 pacientes) y enfermedad celíaca (32 pacientes); esto último documentado histológicamente de acuerdo con los criterios actualmente aceptados