Study finds men on long-acting opioids have lower testosterone
OAKLAND, Calif. — Men taking long-acting medications for chronic pain are almost five times more likely to have low testosterone levels, according to a new study by Kaiser Permanente.
The study, which the healthcare system called the first to show a significant difference in risk between short-acting and long-acting opioids, appeared in The Clinical Journal of Pain.
The retrospective study enrolled 81 men between the ages of 26 years and 79 years, who were seen in the chronic-pain clinic at Kaiser Permanente’s Santa Rosa Medical Center in California between January 2009 and June 2010. All study participants had been on a stable dose of an opioid for at least three months. Comparing the use of short-acting opioids, which immediately release the medication when taken, and long-acting opioids, which release it slowly, the study found that 74% of the men on the long-acting opioids had low testosterone, compared with 34% of those on the short-acting opioids.
"For years, doctors have been encouraged to prescribe long-acting opioids rather than short-acting opioids because we believe they were safer, had less abuse potential and offered more consistent pain control, but no study has ever been able to support this practice," Santa Rosa Medical Center anesthesiologist Andrea Rubinstein said.
A larger retrospective study of more than 1,500 male pain patients is currently underway, Kaiser Permanente said.
Pharmacists can improve health outcomes
A new study conducted by researchers at the University of Minnesota and nearby healthcare institutions shows that patients with diabetes experience better outcomes when they undergo face-to-face medication therapy management sessions with pharmacists.
Drug Store News has reported enough about the benefits of MTM to fill a book, but a scientific study showing a demonstrable benefit of it only makes the case stronger. It speaks to the growing role of the pharmacist as a key member of the patient’s healthcare team, every bit as important as nurses and doctors, and also points to a role of growing importance to pharmacy retailers themselves as they seek to distinguish themselves in the marketplace.
MTM services have a pretty strong track record of helping to improve medication adherence, and with medication nonadherence costing the healthcare system an estimated $290 billion per year, according to the New England Healthcare Institute, it could go a long way toward reducing healthcare costs. A study released in November 2012 found that drug makers lose $188 billion per year from non-adherence, while a Congressional Budget Office study, also from November, found that a 1% increase in the prescriptions filled by Medicare beneficiaries would reduce the program’s spending on medical services by 0.2% by reducing costs in areas such as hospitalizations.
Meanwhile, a study conducted by Virginia Commonwealth University and released Wednesday, found that patients at Thrifty White Pharmacy who participated in the 90-store chain’s medication synchronization program and took their medications correctly were more likely to stay well, make fewer clinic visits and require fewer hospitalizations.
Through MTM and other, similar services, pharmacists can do a lot to make sure patients take their medications, take them properly and get the most out of the therapies prescribed to them. And as a growing body of research shows, their efforts are paying off.
FDA approves new drug for potentially deadly ammonia conditions
SILVER SPRING, Md. — The Food and Drug Administration has approved a new drug for treating some disorders that harm the body’s ability to remove ammonia from the blood, the agency said Friday.
The FDA announced the approval of Hyperion Therapeutics’ Ravicti (glycerol phenylbutyrate) for the chronic management of certain urea cycle disorders in patients ages 2 years and older. Normally, when protein is absorbed and broken down by the body, it produces nitrogen as a waste product, which the urea cycle removes through the urine. But in people with UCDs, the nitrogen accumulates in the body as ammonia, which can travel to the brain and cause brain damage, coma or death.
"Ravicti provides another treatment for chronic management of urea cycle disorders, a group of life-threatening conditions," FDA Division of Gastrointestinal and Inborn Errors Products director Donna Griebel said. "The approval of this new therapeutic option demonstrates FDA’s commitment to providing treatments for patients suffering from rare diseases."
The drug is a liquid taken three times a day with meals and is intended for patients whose UCD can’t be managed with a protein-restricted diet or amino acid supplements alone.