Child vaccinations up despite fears
At the beginning of the year, a major global controversy was settled when it turned out that a study published in The Lancet in 1998 linking the measles-mumps-rubella vaccine to autism in children turned out to be a whopper of a fraud.
But despite the exposure of the study’s author — and outbreaks of preventable diseases among children in the United States and Europe, thanks to parents who opted to have their kids vaccinated — it appears that sowing fear of childhood vaccines still appears to have some currency.
Republican presidential candidate Michele Bachmann decided to try and spend a bit of that currency in a debate last month when she criticized Texas Gov. Rick Perry for mandating the human papillomavirus vaccine for girls in his state, later claiming that a woman had approached her and said the vaccine caused her daughter to develop mental retardation. In contrast with the millions who bought Wakefield’s fraudulent research, Bachmann drew ridicule from voices on the left and the right. Merck, which makes Gardasil (human papillomavirus quadrivalent [types 6, 11, 16 and 18] vaccine, recombinant), responded by saying that the vaccine’s safety and efficacy were supported by clinical trials. Meanwhile, American Academy of Pediatrics president O. Marion Burton said Bachmann’s statement was “false” and had “absolutely no scientific validity.”
Meanwhile, vaccinations of children against a wide range of diseases have risen dramatically in recent years. According to the Centers for Disease Control and Prevention’s “2010 National Immunization Survey,” of the 17,000 households that participated, immunizations of children born between 2007 and 2009 against measles, mumps, rubella, rotavirus, hepatitis A, pneumococcal disease and Haemophilus influenzae type B were at 90% or more. In addition, vaccinations against polio, chickenpox and hepatitis B remained at or above 90%.
Also, immunization rates did not differ between racial and ethnic groups for most vaccines, and thanks to recent increases in coverage among minority children, levels for most vaccines in other racial and ethnic groups were similar to or higher than those among white children, though large disparities between racial and ethnic groups have remained with other health services.
Some holes in vaccination rates have nevertheless persisted. According to research by the CDC, 115 people ages 18 years and younger died from influenza-related causes between September 2010 and August 2011. According to the research, information about influenza vaccination was available for 74 of those children ages 6 months and older; 17 (23%) received influenza vaccine in the appropriate number of doses at least 14 days before illness onset. The CDC recommends that everybody ages 6 months and older be vaccinated against the flu, a recommendation that has been in place since 2008.
Industry aims to prevent primary nonadherence
While medication nonadherence is a perennial problem that costs the healthcare system $290 billion per year, one of the least explored facets of it is primary nonadherence, when patients receive new prescriptions on paper or electronically and never drop them off or pick them up. But some researchers hope to change that.
The study, conducted by Kaiser Permanente Colorado and the University of Colorado, and published in the Journal of General Internal Medicine, found 11% of diabetes patients failed to pick up or fill their new prescriptions. But this study took place in an integrated healthcare system with extensive use of electronic health records; studies in nonintegrated health systems have found general rates of primary nonadherence to be as high as 22%, though the higher rate could be because of lack of data sharing between different organizations and pharmacy claims databases.
What makes an issue like primary nonadherence particularly significant in diabetes is the scope of the disease. According to the Centers for Disease Control and Prevention, 26 million Americans have Type 1 and Type 2 diabetes, and Type 2 diabetes — once called adult-onset diabetes — has grown rapidly among children.
Earlier this year, the National Association of Chain Drug Stores Foundation announced plans to fund two studies on primary nonadherence in response to the lack of available scholarship on it — a recent analysis by the NACDS Foundation and the Rand Corp. found that out of 4,600 peer-reviewed studies on nonadherence, only three addressed primary nonadherence. The studies, to be conducted by research teams from Harvard University and the University of Mississippi, will focus on various interventions for addressing primary nonadherence at the community pharmacy level in order to determine which are the most effective. Preliminary results are expected to appear in July, with the rest expected within two years.
“The reason we want to focus on primary medication nonadherence in the community is because of the large preponderance of patients who don’t have a health plan that’s integrated,” NACDS Foundation president Edith Rosato told Drug Store News. “We feel that community pharmacists can have a tremendous impact on helping patients become more adherent.”
Still, retail pharmacies already are finding ways to address the problem. Last month, Rite Aid joined forces with UnitedHealth Group’s Diabetes Prevention and Control Alliance to launch a program for diabetes patients at select stores in New York and Washington. Under the program, trained pharmacists will consult quarterly with enrolled patients to evaluate their medication adherence and review their test results for blood pressure, blood glucose and cholesterol. “By participating in the Diabetes Prevention and Control Alliance, Rite Aid is able to offer participating patients the benefit of one-on-one counseling from a Rite Aid pharmacist specifically trained in diabetes care and medication therapy management,” Rite Aid EVP pharmacy Robert Thompson said. “This type of care has been proven to better manage diabetes and improve overall health, lowering healthcare costs in the long run.”
Novo Nordisk educates diabetics with e-books
BAGSVAERD, Denmark — Danish drug maker Novo Nordisk has launched a five- volume series of e-books designed to help patients work with their healthcare providers to better manage their diabetes.
The series is part of the Cornerstones4Care patient-support program launched earlier this year, and the books will be available at such e-book sites as iBooks, Reader Store, the Nook Book Store and Free-eBooks.net toward the end of this year.
“With an increasing demand for e-books, we saw an opportunity to share our existing diabetes education book series in a new and innovative format that meets the changing technology needs of today’s patient,” Novo Nordisk corporate VP diabetes marketing Camille Lee said.