HEALTH

CVS Caremark study finds need for improvements in healthcare access, costs

BY Antoinette Alexander

WOONSOCKET, R.I. CVS Caremark announced on Thursday the results of its 2009 “Health IQ” study, which underscores the need to improve health outcome, increase access and curb costs.

The study, which examined consumer attitudes and behaviors around health care and prescription usage, was commissioned in April among 2,000 consumers who report taking at least one maintenance medication. Cooper Research, a healthcare research company in Cincinnati, conducted the Internet-based study.

According to the findings, 13% of respondents were not covered by a prescription drug health insurance plan. Those under the age of 65 and those with a household income of less than $50,000 are less likely to be covered. In addition, 15% of caregivers are not covered. Roughly 1-in-10 consumers do not obtain yearly checkups, but the number jumps to 26% for those without prescription drug coverage.

The study also found that many consumers consider prescription costs to be confusing and 66% have not spoken to anyone in the past 12 months about how to save money on their prescriptions, while one-fourth of respondents said they simply don?t know who to ask. Among the one-third who have sought advice, an equal proportion spoke to their pharmacist or their doctor.

To help improve medication adherence, CVS Caremark offers its Proactive Pharmacy Care program, which is focused on helping consumers understand the benefits of taking their medicine consistently, and how they can reduce the cost.

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Study: Birth control pill use may decreases risk of urinary incontinence

BY Michael Johnsen

WASHINGTON A new study from Sweden published Wednesday found that users of oral contraception have significantly reduced rates of urinary incontinence compared with women who used other forms of contraception.

Researchers at the Karoliska Institute and at Gothenburg University used the Swedish Twin Registry to examine the relationship between the use of oral contraceptives and urinary incontinence. After using statistical methods to control for factors such as age, Body Mass Index and ever having been pregnant, the data showed that the women who had used oral contraceptives had lower rates of lower urinary tract symptoms than non-users.

“With so many women using oral contraceptives, it is vital that we continue to fully understand their non-contraceptive effects, both positive and negative,” stated Dale McClure, president of the American Society for Reproductive Medicine. “This kind of research will help us better advise our patients as they make decisions about contraception, or possibly seek to avoid urinary tract problems.”

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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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