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Policy & practice.

Patients Benefit from MDs' Notes

Patients given access to the physicians' notes in their medical chart understand their care better, according to a study in Annals of Internal Medicine. Meanwhile, only a small handful of patients--8% or fewer--reported that the notes caused confusion, worry, or offense. The study looked at more than 13,000 patients given electronic access to their own visit notes from 105 primary care physicians, finding that 87% of patients opened at least one office visit note. More than three-quarters of those said the open notes helped them feel more in control of their care, and a large majority of those taking medications reported increased adherence because of the notes. At the same time, the open notes didn't seem to increase physicians' workloads, although some physicians said they spent more time writing notes. "Patients accessed visit notes frequently, a large majority reported clinically relevant benefits and minimal concerns, and virtually all patients wanted the practice to continue," the authors concluded.

Antibacterial Drugs Boosted

The FDA has formed an internal task force that will support the development of new antibacterial drugs, which the agency says is a critical public health goal and one of its top priorities. The FDA Safety and Innovation Act, signed into law in July, requires the new Antibacterial Drug Development Task Force to help develop and revise guidance related to antibacterial drugs. The panel also will explore novel approaches to facilitate antibacterial drug development, identify issues related to unmet medical needs for antibacterial drugs, and use existing collaborative agreements with outside groups to promote drug development. "Our hope is that this effort will result in important new breakthroughs in the field of antibacterial drug development and help in the fight against antibiotic resistance," Dr. Rachel Sherman, associate director for medical policy in the FDA's Center for Drug Evaluation and Research and cochair of the task force, said in a statement.

Medicaid Expansion Plans Murky

It's not clear how many states will move forward to expand Medicaid eligibility in the aftermath of the Supreme Court's decision on the Affordable Care Act that allows states to opt out of previously mandated Medicaid program expansions, according to an analysis from Health Affairs and the Robert Wood Johnson Foundation. The ACA had mandated that states expand Medicaid to cover adults under age 65 who earn less than 133% of the federal poverty level, but the high court said in June that states can decide whether or not to expand their Medicaid programs. The court's decision could cost about 6 million low-income adults coverage under Medicaid as states decide not to expand their programs, although half of those people will be eligible to purchase insurance on the private exchanges, the report said. Some states may consider implementing a partial expansion of Medicaid, the analysis said, but as of press time, the Health and Human Services department had not determined whether the ACA would allow that.

Health Coverage Up in 2011

Health coverage rates rose to 82% in 2011 for adults under age 65, the first such increase since 2007, according to a report from the nonpartisan Employee Benefit Research Institute. Still, nearly 48 million people were uninsured in 2011, although that number was down from 49.1 million in 2010, the report said. The increase in overall coverage came despite the fact that the percentage of people covered by employment-based health insurance benefits continues to decline, EBRI said. Employment-based benefits remain the most common way to get health coverage, but only 58% of the overall nonelderly population got their insurance that way in 2011, down from a high of more than 69% in 2000. This trend is likely to continue until "the economy gains enough strength to have a substantial impact on the labor market," EBRI said. Meanwhile, coverage through public programs such as Medicaid expanded in 2011 to include nearly 18% of the population, and individual coverage is stable at about 6%-7% of the population, the report said.

Draft Alcohol Guidance Published

The U.S. Preventive Services Task Force has proposed guidelines recommending screening of adults, including young adults and pregnant women, for alcohol misuse. The guidelines call on clinicians to provide anyone who screens positive for risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse. About 30% of the U.S. population engages in alcohol misuse, and more than 85,000 people die each year because of the problem, the task force said in its draft guidelines. "There is adequate evidence that brief behavioral counseling interventions are effective in reducing heavy drinking episodes in adults engaging in risky or hazardous drinking; these interventions also reduce weekly alcohol consumption rates and increase compliance with recommended drinking limits," the task force said, noting that the guidelines do not include adolescents because the data do not show clear benefits.

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Title Annotation:PRACTICE TRENDS
Author:Anderson, Jane
Publication:Internal Medicine News
Geographic Code:1USA
Date:Oct 15, 2012
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