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APhA hails success of 10-city diabetes tour

BY Jim Frederick

SAN DIEGO —Clinically trained pharmacists working directly with patients, and in collaboration with other members of those patients’ healthcare teams, can have a significant impact on the rising diabetes epidemic and its enormous financial costs, an ongoing experiment in pharmacist intervention reveals.

That experiment actually is a major disease-management project undertaken by community pharmacists and sponsored by the American Pharmacists Association Foundation and pharmaceutical giant GlaxoSmithKline. Now in its fourth year, the APhA Foundation’s Diabetes Ten City Challenge is an an employer-funded collaborative health management program in which participants are empowered, by community pharmacist “coaches,” to self-manage their diabetes.

The foundation unveiled the initial results of the program at APhA’s 2008 Annual Meeting here March 16. Those results show clear improvement for “patients with diabetes who actively work to improve glycemic control,” including “fewer complications from co-morbidities such as heart disease, stroke and renal disease,” according to the group.

“The interim report on the Diabetes Ten City Challenge shows that the collaborative practice model utilizing community-based pharmacist coaching, application of evidence-based diabetes care guidelines and self-management strategies can play a key role in helping patients to successfully manage chronic disease,” said Toni Fera, director of patient self-management programs for the APhA Foundation. A total of 29 employers are participating in the DTCC through contracts for patient care services in 10 geographic locations: Charleston, S.C.; Chicago; Colorado Springs, Colo.; Cumberland, Md.; Honolulu; Milwaukee; northwest Georgia; Los Angeles and Tampa, Fla.

The interim results reported by Fera and colleagues involved 914 patients with diabetes, each of whom received three or more months of pharmacist care. Improvements in key clinical measures were seen, including glycosylated hemoglobin (A1C) levels. Other improvements included a lowering of LDL cholesterol levels and systolic blood pressure, and a rise in the number of patients who had foot exams and flu shots. Patients enrolled in the program also took better charge of their own health, with self-management goals for nutrition, exercise and weight reduction.

“Participant satisfaction with pharmacist-provided diabetes care improved markedly from baseline to one year,” APhA reported. “Patients rating their overall care as 9 or 10 (excellent) increased from 39 percent to 87 percent, and the final survey results indicated that 97.5 percent of patients were satisfied or very satisfied with the care they received from their pharmacist coach.”

Fera and other APhA leaders said the promising interim results of the 10-city diabetes initiative are in line with the successes demonstrated by a longer-running and better-known patient-care initiative in collaborative care—the Asheville Project in North Carolina, now ongoing for a decade. “DTCC exemplifies how a successful pilot project was used as a launching pad to form a quasi–pharmacy, practice–based research network,” APhA noted in its findings. “The Asheville Project has demonstrated that pharmacist intervention in a broad population resulted in employer savings of between $1,622 and $3,356 per patient annually.

“The long-term clinical and financial benefits demonstrated in the Asheville Project provide convincing evidence to employers and other purchasers of health services that return on investment is likely from programs that include medication therapy management services and other disease management approaches. In similar fashion, Fera and colleagues expect the positive trends observed in their interim DTCC analysis to drive down total direct medical costs over the long term.”

William Ellis, executive director and chief executive officer of the APhA Foundation, pointed out how DTCC and the Asheville Project highlight the role of pharmacists in assisting with drug therapy decisions, providing patient education and monitoring adherence and efficacy.

Employers will be able to evaluate the economic impact of the program for total health care during the next DTCC reporting phase. Fera said in San Diego that those findings will be disseminated by APhA in late 2008 or early 2009.

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JPMA refutes media reports about dangers of baby bottle materials

BY Jenna Duncan

MT. LAUREL, N.J. The media has been asked by the Juvenile Products Manufacturers Association to halt stories with claims of purported negative health effects from using baby products containing bisphenol A (BPA). JPMA claims that statements of ill health linked to items containing BPA are often misleading and frighten consumers.

According to JPMA, research has shown that when used properly, products made with BPA do not pose a health threat.

Robert Waller, Jr., the president of JPMA, said, “JPMA is extremely disappointed in the media for speculating that Health Canada’s assessment of BPA would recommend labeling the chemical a dangerous substance, when in fact the report has not even been issued yet.”

Claims in the media have stated that risk may come from the plastic shields on pacifiers, parts of baby bottles or sippy cups being broken down or chewed, and then ingested with food or saliva. Scientific findings indicate that BPA may cause estrogenic effects in laboratory animals, and so concerns about the safety of baby products, especially bottles, has been under scrutiny.

JPMA, whose mission is to educate consumers and industry professionals about juvenile products and safety, is referring consumers to its Web site, www.babybottles.org, for more information on BPA and related health findings.

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American Greetings reports fiscal 2008 profit

BY Doug Desjardins

CLEVELAND American Greetings generated $83.3 million in earnings for fiscal 2008, including $15.6 million in the fourth quarter ended Feb. 29, and more than $1.77 billion in total sales for year. Total sales were down about 1 percent from $1.79 billion the previous year, but earnings were up 96 percent from $42.4 million.

“I’m pleased we were able to achieve earnings within our forecasted range and exceed our cash flow guidance,” said American Greetings chief executive officer Zev Weiss. “Our strong cash flow allowed us to make two acquisitions in the digital photo space and repurchase shares.”

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