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Patients' life circumstances an important factor in care

Treatment plans need to incorporate patients' social and economic circumstances, including access to medical care or health insurance, rather than just follow standard guidelines for care, a new study says. Inattention to such factors could lead to errors in providing patient care, according to Saul J. Weiner, MD, lead author of the study in the July 20 Annals of Internal Medicine. For the study, standardized patients made 399 unannounced visits to 111 internists between April 2007 and April 2009 at practices in Chicago and Milwaukee. Actors portrayed patients and followed scripts that contained hints of clinically significant biomedical issues, such as an asthma patient wheezing at night. The scripts also featured contextual issues, including unemployment. The interactions were recorded on audiotape. Dr. Weiner defined contextual issues as elements of a patient's environment or behavior that are essential to providing care. Researchers analyzed the recordings and doctors' ...

High cholesterol common in younger adults, but screening rates remain low

Two in three young adults have at least one risk factor for coronary heart disease. But fewer than half of the people in this age group get their cholesterol levels tested, according to a study in the July/August Annals of Family Medicine. Lead author Elena Kuklina, MD, PhD, recommends that physicians bolster cholesterol screening efforts in adults 20 to 45 to help prevent coronary heart disease and discuss with patients the importance of maintaining a healthy weight, exercising and not smoking -- regardless of whether they are at risk for heart disease. Risk factors include having a parent with heart disease, smoking, high blood cholesterol, physical inactivity and being obese or overweight, according to the American Heart Assn. "I find that to be incredibly troublesome. ... Obviously our sensitivity to risk for coronary heart disease needs to move up earlier in the timeline," said Clyde Yancy, MD, immediate past president of the AHA and medical director of the Baylor Heart and ...

Drug-disposal bill gets Senate's nod

The Senate has unanimously passed legislation that would give physicians and consumers additional options for disposing of unused prescription drugs. By providing safe and lawful ways for patients and physicians to get rid of unused medicines, illicit drug use could be curtailed and potential deaths could be avoided, said lawmakers who supported the bill, which passed Aug. 4. "Unused and unwanted medication creates a health hazard, but federal law currently prohibits people from giving their old medication to established drug take-back programs," said Sen. John Cornyn (R, Texas), who introduced the legislation with Sen. Amy Klobuchar (D, Minn.). "As a result, unused medication is often diverted by drug abusers or improperly flushed into our water system. This cost-free and common-sense bill will allow state and private entities to institute responsible drug take-back programs." As much as 17% of prescribed medication goes unused and could contribute to environmental problems i ...