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Policy & practice.

Army and NIMH to Study Suicides

The National Institute of Mental Health has signed a memorandum of understanding with the U.S. Army to study suicide and suicidal behavior among active-duty soldiers, National Guard members, and Army Reservists. The 5-year, $50 million effort will be the largest study of suicide ever undertaken by the institute, according to a statement. The goal is to identify risk and protective factors for suicide, and to help the Army develop effective intervention programs. In 2007, 115 Army members committed suicide; of those, 36 committed suicide while deployed, 50 did so post deployment, and 29 had never been deployed.

Mental Illness and Hospitalizations

About 8.5 million hospital admissions in 2006 involved patients with a mental illness or a mental health comorbidity, according to the Agency for Healthcare Research and Quality. Of those, about 1.4 million patients were admitted with a mental health diagnosis while about 7.1 million were admitted for a physical condition and had a mental health comorbidity. The AHRQ report said the largest number of admissions (about 730,000) was for depression or other mood disorders. The next largest (about 381,000) was for schizophrenia and other psychotic conditions. About 131,000 patients were hospitalized for dementia or delirium, about 76,000 for anxiety or adjustment disorders, and about 34,000 for attention-deficit/hyperactivity disorder or personality disorders. The data come from the AHRQ report, Hospital Stays Related to Mental Health, 2006, based on the Nationwide Inpatient Sample.

Many Have Drug 'Gap' Coverage

A total of 13% of Medicare beneficiaries enrolled in Part D prescription drug plans and 63% of those in Medicare Advantage plans with prescription benefits had some form of coverage in the "doughnut hole," or coverage gap, according to a Centers for Medicare and Medicaid Services study on Part D drug claims. The study, which included data on Medicare drug claims for the 25 million Part D beneficiaries, also indicated that the vast majority of enrollees used the drug benefit: In the program's first year, 90% of enrollees filled at least one prescription. In addition, the use of generic drugs has been high in Part D, rising from 60% in 2006 to nearly 68% in the first quarter of this year.

Program Cuts Illicit Drug Use

A government-supported program used to screen patients seeking health care for signs of substance abuse can reduce illicit drug use among patients seeking medical care in a wide variety of health care settings, a study found. The Screening, Brief Intervention, and Referral to Treatment program uses a variety of techniques to screen patients for signs of substance abuse. If a patient screens positive, immediate steps are taken to help the patient effectively deal with the problem. The study, published in Drug and Alcohol Dependence, found that rates of illicit drug use dropped by nearly 68% by 6 months after screening. Illicit drug users receiving brief treatment or referral to specialty treatment also reported other quality of life improvements. The Substance Abuse and Mental Health Services Administration has been awarding grants to expand the program since 2003.

Nondrug Approaches to PTSD Tested

Researchers at the Southeast Louisiana Veterans Health Care System will test a series of interventions, from yoga to guided imagery, to treat posttraumatic stress disorder and major depression in veterans returning from Iraq and Afghanistan, and their families. The randomized controlled study was funded by a grant from the Department of Defense's new Center of Excellence for Psychological Health and Traumatic Brain Injury. The $411,000, 2-year grant will study the effectiveness of a technique that includes meditation, biofeedback, and small group support. The technique was developed by the Washington-based Center for Mind-Body Medicine.

U.S. Pharmaceutical Sales Outlook

The U.S. pharmaceutical market is expected to grow l%-2% in 2009, resulting in sales of about $292-$302 billion, according to analysis from the health care market research firm IMS Health. This latest projection is down from the 2%-3% increase projected by IMS earlier this year, and reflects the expected impact of patent expirations, fewer launches of new products, and the slowing U.S. economy. Worldwide pharmaceutical sales are expected to grow 4.5%-5.5% in 2009, similar to growth this year.

HIPAA Enforcement 'Limited'

The Centers for Medicare and Medicaid Services has not provided effective oversight and has taken only "limited actions" to ensure that covered entities adequately implement patient privacy regulations contained in the Health Insurance Portability and Accountability Act of 1996, according to a report from the Health and Human Services Department's Office of Inspector General. The OIG found that the CMS had not conducted any compliance reviews of covered entities, and instead relied on complaints to target investigations. However, the CMS has received very few complaints about violations, the report said. "As a result, the CMS had no effective mechanism to ensure that covered entities were complying with the HIPAA security rule" or that electronic health information was being adequately protected, the report concluded. CMS has taken steps to begin conducting compliance reviews in an effort to identify security problems and vulnerabilities under HIPAA, the OIG said.
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Title Annotation:Practice Trends
Author:Ault, Alicia
Publication:Clinical Psychiatry News
Date:Dec 1, 2008
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