HEALTH

Study finds optimistic women have lower risk of developing heart disease

BY Michael Johnsen

DALLAS Optimistic women have a lower risk of developing heart disease or dying from any cause compared with pessimistic women, according to research reported in Circulation: Journal of the American Heart Association, the AHA stated Monday.

Researchers also reported that women with a high degree of cynical hostility — harboring hostile thoughts toward others or having a general mistrust of people — were at higher risk of dying; however, their risk of developing heart disease was not altered.

“As a physician, I’d like to see people try to reduce their negativity in general,” stated Hilary Tindle, Mlead author of the study and assistant professor of medicine at the University of Pittsburgh. “The majority of evidence suggests that sustained, high degrees of negativity are hazardous to health.”

In the largest study to date to prospectively study the health effects of optimism and cynical hostility in post-menopausal women, researchers found that white and black American women’s attitudes are associated with health outcomes.

Optimistic women, compared to pessimistic women, had a 9% lower risk of developing heart disease and a 14% lower risk of dying from any cause after more than eight years of follow-up. Furthermore, women with a high degree of cynical hostility, compared to those with a low degree, were 16% more likely to die during eight years of follow-up.

“Prior to our work, the strongest evidence linking optimism and all-cause mortality was from a Dutch cohort, showing a more pronounced association in men,” Tindle said.

Tindle’s team studied 97,253 postmenopausal women (89,259 white, 7,994 black) ages 50 to 79 from the Women’s Health Initiative. The women were free of cancer and cardiovascular disease at the start of the study.

Using the Life Orientation Test Revised Questionnaire to measure optimism and cynical hostility, researchers categorized scores into quartiles: high scores of 26 or more were considered optimists; scores of 24 to 25 were considered mid-high; scores of 22 to 23 were considered mid-low; and scores below 22 were considered pessimists.

Optimism was defined as answering “yes” to questions like, “In unclear times, I usually expect the best.” Pessimism was defined as answering “yes” to questions like, “If something can go wrong for me, it will.”

Race also appears to modify the relationship between optimism and death, with a stronger association seen in African-American women as compared to white women. Among African-American women, optimists (vs. pessimists) had a 33% lower risk of death across eight years of follow-up. Among white women, optimists (vs. pessimists) had a 13% lower risk of death. Researchers also found that optimists (as compared to pessimists) were more likely to be younger (especially in blacks); live in the Western United States; report higher education and income; be employed and have health insurance; and attend religious services at least once a week.

Optimists were less likely to have diabetes, high blood pressure, high cholesterol or depressive symptoms, smoke, be sedentary or have a high body mass index. However, the relationship between optimism and heart disease and death persisted even after considering all of these factors.

“This study is a very reasonable stepping stone to future research in this area — both on potential mechanisms of how attitudes may affect health, and for randomized controlled trials to examine if attitudes can be changed to improve health,” Tindle said.

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Wireless home-based healthcare applications, services set to grow, analysis finds

BY DSN STAFF

NEW YORK That $4.4 billion opportunity is really only the tip of the iceberg. The real opportunity, especially for pharmacists and their nurse practitioner/physician assistant partners, is in the ancillary services that will accompany the functionality behind wireless diagnostic devices — think a medication therapy management/chronic disease coaching one-two punch.

It’s not a question of if wireless diagnostic devices will realize that full $4.4 billion potential, but when. That’s primarily because cost will be a big driver behind adoption of these devices. The fact is that no matter what shape healthcare reform takes, the system will eventually go bankrupt without an emphasis on disease-management/prevention (a.k.a. MTM/chronic disease coaching).

Another driver behind widespread adoption will be how nicely wireless diagnostic device functionality will dovetail with the currently-developing electronic health records. As is evident with the current meteoric rise in popularity of iPhone and other smart phone applications, not to mention the increasing popularity of such social media sites as Facebook and Twitter, it’s more and more becoming a wired, wired world out there.

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The Harry and Louise ad I would like to see

BY Rob Eder

Louise: [Sneezing and coughing incessantly.] HAAAA-CHOOOOOOO! Oh, Harry! Can you believe the doctor won’t be able to see me until a week from next Monday?

Harry: A week from next Monday? That’s almost two weeks from now. That seems like an awfully long time to wait—what if it’s something serious?

Louise: At this rate, whatever it is, I’ll either be all better or stone dead by the time I get an appointment!

Harry: What about this stuff I was reading about these clinics that operate at the local pharmacy? From what I understand, a bunch of chains have set up these clinics in their stores—CVS, Walgreens, Target, Kroger. Those chains all have stores around here.

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you!

Louise: Thanks. Ya, I know; I heard about those clinics. Dr. Hedenbutt says the clinics are bad for America. Dr. Hedenbutt says it’s like going to McDonalds for health care.

Harry: How is it like going to McDonalds? They don’t serve hamburgers.

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you.

Louise: Thanks, Harry.

Harry: Don’t mention it. Why did Hedenbutt say the clinics are like McDonalds?

Louise: He said because they are cheapening the medical profession.

Harry: Cheapening the medical profession? Did he say how?

Louise: Well, now that you bring it up, he didn’t really get into it.

Harry: Why?

Louise: Well, Harry! He’s a busy man—I mean, after all, he DOES have other patients, and he had been talking to me for almost three minutes at that point!

Harry: THREE minutes! It only took Hedenbutt THREE minutes to give you an entire physical examination?

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you.

Louise: Thanks, Harry.

Harry: [Handing her a tissue.] You’re welcome. So, let’s get back to this three-minute physical Hedenbutt gave you.

Louise: Well, Dr. Hedenbutt didn’t actually perform the exam…

Harry: He didn’t?!

Louise: No.

Harry: Who did?

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you.

Louise: Thanks, Harry.

Harry: You’re welcome. Who did?

Louise: That lovely young woman who works with him. I can’t remember her name. She’s been with Hedenbutt for the last few years. She’s just great! She takes lots of time to talk to me about my blood pressure and whether I am keeping away from cigarettes and getting enough exercise. She actually gave me a tip on a low-impact aerobics class they teach at the Y. I think she’s the one who writes most of my prescriptions. She is really smart and so good-looking, too; she’d be just perfect for Harry, Jr. I bet she’s a good cook, and she and Little Harry would make us such beautiful grandchildren…

Harry: Leave Harry, Jr., out of this. So, this one, this “Super Girl”… She’s a doctor?

Louise: No, she’s something else, some kind of a nurse. A nurse-something… An NB? Or maybe it’s NC?

Harry: You mean an NP? A nurse practitioner?

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you.

Louise: Thanks, Harry.

Harry: You’re welcome.

Louise: Yes, that’s it—a nurse practitioner.

Harry: Did Hedenbutt mention that those are the people that work in these retail clinics? That it’s mostly NPs?

Louise: No, he didn’t say anything about that. He just said they were cheapening medicine.

Harry: Well, from what I read, a trip to one of these clinics is definitely cheaper than a visit to Hedenbutt. The last time I was there and they drew my blood, I thought it was in payment. He might as well let me pay him in blood since he stopped accepting our insurance. Meanwhile, I read that the clinics take most major insurance plans, and some plans—including ours—actually offer a lower co-pay for a clinic visit.

Louise: Well, Dr. Hedenbutt said that if he and a couple of his doctor friends have their way, the government would shut down those clinics.

Harry: That explains a lot.

Louise: What does that explain?

Harry: It explains why there are no clinics around here. So, anyway, did Hedenbutt’s office say why it’s going to take so long to get you an appointment?

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you.

Louise: Thanks, Harry. They are just so backed up ever since that nice young NB, uh, ND…

Harry: NP!

Louise: Yeah, the NP—she moved about two weeks ago to a nice town outside of Chicago. She left about two weeks ago.

Harry: Working for another doctor?

Louise: Not sure—don’t think so. Sounds like a fancy operation—Take Care Health Systems, I think it was.

Harry: Louise, that’s one of those retail clinics I’m talking about.

Louise: Really?

Harry: Yes, Louise. You know, I just wish someone would set the record straight on these retail clinics because health care is really messed up in this country, and I think these clinics could be doing more to help us fix it. If only people like Hedenbutt would just stop spreading lies about the clinics, we might be able to get you checked out right now instead of sitting here talking about it.

Louise: HAAA-HAAAA … HAAAA-CHOOOOO!

Harry: Gesundheit.

Louise: Thanks, Harry.

Harry: You’re welcome, Louise.

Correction: In the July 20, 2009, issue of Drug Store News, a photo on page 6 incorrectly listed Kirk Hodgdon, principal, growth catalyst for Bolin Marketing, as an associate of Carma Labs.

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