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Medical Marijuana Can Save Lives - Here's the Evidence

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This week, Attorney General Jeff Sessions paused a discussion of the opioid epidemic to, once again, go after marijuana. He suggested that addictive pain medication wasn’t the only problem and that many heroin addicts start out “with marijuana and other drugs.”

 

There is a relationship between cannabis and opioids, but Mr. Sessions has it backward. Marijuana isn’t a gateway drug to opioid addiction; it’s a safer alternative to pain medicines. Mr. Sessions’s vow to crack down on marijuana will only make the opioid epidemic worse.

 

We know that 40 percent of all opiate overdose deaths involve a prescription opiate. So having legal access to cannabis as another option for pain relief may actually reduce consumption of opiates.

 

I know it sounds counterintuitive, but consider the evidence. To start, a large study assessed the effect of medical-marijuana laws on opiate-related deaths between 1999 and 2010 in all 50 states and reported a 25 percent decrease in opiate overdose mortality in states where medical marijuana was legal, compared with those where it wasn’t. The study found that in 2010, medical-marijuana laws resulted in an estimated 1,729 fewer deaths than expected.

 

Other epidemiologic studies found similar results. A study published last year examined opiate-related deaths in Colorado between 2000 and 2015. Researchers compared mortality rates before and after the state legalized recreational cannabis in 2014. For controls, they chose two nearby states: Nevada, which legalized only medical cannabis, and Utah, where all cannabis use is illegal. The study found a 6.5 percent drop in opiate-related deaths after recreational cannabis became legal in Colorado.

 

Likewise, other researchers examined the link between medical cannabis and opiate use in a group of patients with chronic pain in New Mexico, one of the states hardest hit by the opioid crisis. They reported that subjects who had access to medical cannabis were 17 times more likely to stop using opiates for pain compared with those not using cannabis.

 

Because these are all observational studies, they cannot prove a causal link between cannabis use and lower opiate-related mortality. Still, the consistent epidemiologic evidence is hard to ignore.

 

Why might cannabis work so well as an alternative to opioids? It does offer some mild pain relief. But more significant, both opiates and cannabis — like all recreational drugs — cause the release of dopamine in the brain’s reward pathway. That signal conveys a powerful sense of pleasure and craving. Thus, cannabis might pre-empt some of the rewarding effects of opiates, decreasing the general desire to use them.

 

There is also intriguing preliminary evidence that cannabidiol, a major component of marijuana, can blunt craving in individuals with opioid dependence following a period of abstinence.

 

If cannabis were actually a dangerous gateway drug, as the attorney general suggested, it would be very easy to see in the data. We would find that medical-marijuana laws increased opiate drug use and overdose deaths, when in fact just the opposite has happened.

 

Author: Richard A. Friedman is a professor of clinical psychiatry and the director of the psychopharmacology clinic at the Weill Cornell Medical College

 

Further Reading:

“Jeff Sessions' Approach to Solving the Opioid Addiction Crisis” : http://sco.lt/5nhcAb“Is There a Role for Medical Cannabis in Combating the Opioid Epidemic?” : http://bit.ly/MintzPostX“Four Newtown Area Docs Are Approved to Prescribe Medical Marijuana” : http://sco.lt/5QxUEz
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Danny Bilow's comment, June 20, 12:39 PM
Michael, What an interesting read! I think the younger generation is starting to be more accepting as far as using marijuana for medicinal purposes. As we move forward I think Cannabis will become accepted more and more as an alternative to pharmaceuticals. This is especially important to get people off of opiates and use cannabis as a treatment for pain.
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Doctors: Marijuana Can Save Lives
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Medical Marijuana Can Save Lives - Here's the Evidence

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This week, Attorney General Jeff Sessions paused a discussion of the opioid epidemic to, once again, go after marijuana. He suggested that addictive pain medication wasn’t the only problem and that many heroin addicts start out “with marijuana and other drugs.”

 

There is a relationship between cannabis and opioids, but Mr. Sessions has it backward. Marijuana isn’t a gateway drug to opioid addiction; it’s a safer alternative to pain medicines. Mr. Sessions’s vow to crack down on marijuana will only make the opioid epidemic worse.

 

We know that 40 percent of all opiate overdose deaths involve a prescription opiate. So having legal access to cannabis as another option for pain relief may actually reduce consumption of opiates.

 

I know it sounds counterintuitive, but consider the evidence. To start, a large study assessed the effect of medical-marijuana laws on opiate-related deaths between 1999 and 2010 in all 50 states and reported a 25 percent decrease in opiate overdose mortality in states where medical marijuana was legal, compared with those where it wasn’t. The study found that in 2010, medical-marijuana laws resulted in an estimated 1,729 fewer deaths than expected.

 

Other epidemiologic studies found similar results. A study published last year examined opiate-related deaths in Colorado between 2000 and 2015. Researchers compared mortality rates before and after the state legalized recreational cannabis in 2014. For controls, they chose two nearby states: Nevada, which legalized only medical cannabis, and Utah, where all cannabis use is illegal. The study found a 6.5 percent drop in opiate-related deaths after recreational cannabis became legal in Colorado.

 

Likewise, other researchers examined the link between medical cannabis and opiate use in a group of patients with chronic pain in New Mexico, one of the states hardest hit by the opioid crisis. They reported that subjects who had access to medical cannabis were 17 times more likely to stop using opiates for pain compared with those not using cannabis.

 

Because these are all observational studies, they cannot prove a causal link between cannabis use and lower opiate-related mortality. Still, the consistent epidemiologic evidence is hard to ignore.

 

Why might cannabis work so well as an alternative to opioids? It does offer some mild pain relief. But more significant, both opiates and cannabis — like all recreational drugs — cause the release of dopamine in the brain’s reward pathway. That signal conveys a powerful sense of pleasure and craving. Thus, cannabis might pre-empt some of the rewarding effects of opiates, decreasing the general desire to use them.

 

There is also intriguing preliminary evidence that cannabidiol, a major component of marijuana, can blunt craving in individuals with opioid dependence following a period of abstinence.

 

If cannabis were actually a dangerous gateway drug, as the attorney general suggested, it would be very easy to see in the data. We would find that medical-marijuana laws increased opiate drug use and overdose deaths, when in fact just the opposite has happened.

 

Author: Richard A. Friedman is a professor of clinical psychiatry and the director of the psychopharmacology clinic at the Weill Cornell Medical College

 

Further Reading:

“Jeff Sessions' Approach to Solving the Opioid Addiction Crisis” : http://sco.lt/5nhcAb“Is There a Role for Medical Cannabis in Combating the Opioid Epidemic?” : http://bit.ly/MintzPostX“Four Newtown Area Docs Are Approved to Prescribe Medical Marijuana” : http://sco.lt/5QxUEz
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Danny Bilow's comment, June 20, 12:39 PM
Michael, What an interesting read! I think the younger generation is starting to be more accepting as far as using marijuana for medicinal purposes. As we move forward I think Cannabis will become accepted more and more as an alternative to pharmaceuticals. This is especially important to get people off of opiates and use cannabis as a treatment for pain.
Radovan Andrejko's comment, September 6, 1:36 PM
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Doctors: Marijuana Can Save Lives
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LAST OCTOBER, AOBiome Therapeutics, a life sciences company based in Cambridge, Massachusetts, announced the results of a 12-week clinical trial of an experimental acne drug. In the randomized double-blind and placebo-controlled trial, a topical spray containing a beneficial bacteria was shown to be safe and effective in reducing the severity and number of acne lesions, the company said.

“Because we bring trials to patients in their homes, we remove barriers, whether geography or time and inconvenience, that are preventing them from participating.”

The drug must successfully go through another round of testing — what’s called a Phase III trial — before AOBiome can apply to the Food and Drug Administration for marketing approval.

It all sounds like the standard drug development process, but it’s not.

Volunteers for the completed trial were recruited through social media and internet advertisements, and more than 8,000 people were screened online to see if they were eligible. The resulting 372 participants received the drug or a placebo in the mail and used company-issued iPhones to take selfies of their acne, a phone app to send the photos to physician-investigators for evaluation, and video conferencing to communicate with study staff.

That’s markedly different from a typical drug trial, in which patients are often required to visit a research site a dozen or more times for evaluation, said Dawn Anderson, a managing director in Deloitte Consulting LLP’s life sciences practice, who advises biopharma and research companies on drug development. They might have to take time off from work, drive hours to the site, and then wait for their appointment. Participation can be “quite a burden of time and effort,” Anderson said. And it can remain off-limits to patients who live too far away.

In the case of AOBiome’s acne drug trial, there were no in-person screening interviews, and no doctor visits. The trial was entirely what people in the trade call “virtual.”

“Because we bring trials to patients in their homes, we remove barriers, whether geography or time and inconvenience, that are preventing them from participating,” said Dr. Belinda Tan, co-founder and chief medical officer of Los Angeles-based Science 37, which uses proprietary software, along with wireless devices, to conduct virtual clinical trials with drug companies — including the one with AOBiome.

It’s a trend that many experts suggest is sorely needed. Fewer than 5 percent of Americans participate in clinical trials, and they often don’t stay. The average dropout rate is 30 percent. Nearly a fifth of trials are prematurely shut down due to participation shortfalls, according to a 2015 analysis, and many end up taking twice or even three times as long to complete as planned, experts say.

Whether virtual clinical trials are the way forward is a matter of some debate, and industry analysts say a host of challenges remain before virtual trials — which currently represent a tiny fraction of the more than 100,000 registered clinical research studies in the United States — become the norm. These include overcoming a conservative corporate culture, ensuring that the technology is easy for patients to use, managing and analyzing the enormous amount of data that round-the-clock sensors generate, and proving the data’s reliability and validity to regulators.

Still, according to analysts like Ken Getz, a research associate professor at Tufts University School of Medicine and founder of the Center for Information & Study on Clinical Research Participation (CISCRP) in Boston, a non-profit that educates the public about clinical research participation, easing the way for volunteers to enroll in clinical trials is critical to future drug development. Recent CISCRP research has suggested that the top five reasons for leaving a trial “are all associated with the inconvenience of having to go to a physical location to participate in the trial,” Getz said.

“What’s at jeopardy is the ability to bring new treatments into the marketplace efficiently, yet in an affordable way,” Getz added, “— and quickly.”

THE RESPONSE FROM many large biopharmaceutical companies, and even some midsize and smaller biotech firms, has been to test the feasibility of virtual clinical trials and the myriad digital technologies — smartwatches, mobile apps, and wearable biosensors — that make virtual trials possible.

“We don’t want to read neutral; we want to be better than the current state.”

So far, virtual participation has been tried in a mix of observational studies of the technologies alone, and mostly early-stage drug trials — often alongside traditional brick-and-mortar strategies. The pharmaceutical giant Pfizer was the pioneer. In 2011, its drug to treat overactive bladder was already on the market, based on the results of traditional trials. But the company wanted to compare those results to a virtual trial to determine whether site-less trials were feasible for future drug research.

In a study called REMOTE, either the active drug or a placebo was shipped to participants’ homes, where they entered data about their bladder function in an e-diary on a company-supplied mobile phone. Many participants dropped out, however, and only 18 individuals were randomly assigned to treatment — far fewer than Pfizer’s 283-person goal. The initial online registration process turned out to be too complicated and the e-diaries were not user-friendly, investigators said in a 2014 journal article.

Nevertheless, REMOTE was considered groundbreaking and inspired other scientists to explore the possibilities of virtual clinical trials. Merck, one of the world’s largest pharmaceutical companies, has completed two small pilot trials since the REMOTE trial results were published. In the first two-week trial, 14 healthy volunteers were given Januvia, a diabetes medication, and instructed to periodically draw blood at home through finger sticks, dry it in a stabilizing matrix, and ship it to investigators. The company then surveyed participants about their reaction to doing these things at home. “It was roughly neutral compared to coming into the clinic and getting your blood drawn,” said Matthew Moyer, director of clinical supply technology at Merck. “We don’t want to read neutral; we want to be better than the current state.” Responding to that, the 14 healthy volunteers in the second pilot were given a small device that sits on the forearm and draws a tiny amount of blood using micro needles. Moyer said the volunteers found it much less painful and easier to use than finger sticks — and they also preferred it to going to a clinic.

The French pharmaceutical company Sanofi has also tested the feasibility of digital technology in clinical trials. It extended a traditional Phase I trial of an experimental drug, in which healthy volunteers periodically visited a research site to have their weight, mobility, blood pressure, and blood glucose levels measured, into volunteers’ homes. Collaborating with Waltham, Massachusetts-based PAREXEL International, a biopharmaceutical service company, Sanofi instructed the volunteers to use various sensors and wireless devices to take their own measurements.

The researchers are currently writing up the results for a paper, but Lionel Bascles, Sanofi’s global head of clinical sciences and operations, shared some results. “The compliance is slightly lower as soon as the volunteers reach home — still high but lower,” Bascles conceded. “Second, the compliance is lower when it’s more invasive…So at home, the volunteers did not feel like complying too much with blood glucose, but blood pressure, weight, or mobility was easy for them to measure.”

Todd Krueger, AOBiome’s president and CEO, said the virtual nature of his company’s trial yielded significant benefits. Online recruitment was relatively fast, dropout rates were lower than expected, and compliance was better than expected. “Once you develop a relationship with somebody online, it’s not particularly difficult to send them emails to remind them to take the product,” said Krueger.

Krueger also said the trial was cheaper to administer than a traditional trial because he didn’t have to train and manage investigators at multiple research sites. In addition, paying research sites for patient visits is expensive, costing anywhere from $3,000 to $7,000 per visit, said Deloitte’s Anderson. “Now multiply that by 12 to 24 visits for every single patient in the trial, multiply that by hundreds or thousands of patients, and you’re talking about a tremendous component of your budget, anywhere from 60 percent or more,” she said.

Companies also want to get more and better data through virtual trials. In 2016, for example, the British pharmaceutical company GlaxoSmithKline sponsored a feasibility study of an iPhone app for use by rheumatoid arthritis patients. Patients answered questions about joint stiffness and pain, and the app recorded data that the smartphone’s accelerometer sensors captured as patients did wrist motion exercises.

“The study found that raw accelerometer data could be converted into a score that was much more precise than motion-scoring exercises conducted in a physician’s office,” a Deloitte report noted.

Companies also see virtual trials as a way to add new yardsticks — what scientists call endpoints — for evaluating the efficacy of experimental drugs. “There are life sciences companies who are not taking away their focus on traditional endpoints, on things like survival in cancer, but they are adding endpoints that are objective, quantitative measures of quality of life,” said Glen de Vries, president and co-founder of Medidata Solutions, a U.S. company whose cloud-based software platform is used by scientists, physicians, statisticians, and others involved in clinical trials, including the GlaxoSmithKline trial. Participants can use smartwatches, sensor-laden patches, and other digital devices at home, de Vries said, to measure things like sleep quality and movement.

Moyer said Merck plans to continue to conduct pilot studies, and Bascles said Sanofi also has more studies in the works. The Swiss pharmaceutical company Novartis has three trials underway with Science 37, including one testing an experimental drug for the treatment of cluster headaches and another testing an experimental drug for NASH syndrome, a non-alcoholic fatty liver disease. In each trial, Science 37 is recruiting patients online who will then participate remotely, while other patients will be recruited and followed in the traditional brick-and-mortar method.

“Cluster headache is another great example of why this [remote] technology can be so powerful,” said Jake LaPorte, global head of digital development at Novartis. 

“Oftentimes, these folks are incapacitated,” he continued, “depending on how bad the headache is. So it’s very hard for them to get to a site so they can be observed by a physician.”

Of course, there will always be trials that could never become entirely virtual, including those that require X-rays, MRIs, or biopsies, for example. And some diseases and disorders lend themselves more readily to the virtual approach than others because patients are already using digital tools at home, said Tan of Science 37. “We selected our initial therapeutic areas where telemedicine is more common as a practice and where you can reach out to people and capture outcome measures virtually — diabetes, dermatology, and psychiatry,” she said.

Eventually, however, digital tools could be used to reduce patient visits to research sites even for cancer drugs, Tan said, as long as a medication’s side effects are not severe.

FOR ALL THE experimentation, a number of obstacles remain before completely or even partly virtual trials become the norm. The biopharmaceutical industry is far behind other industries, such as banking and retail, that have embraced digital technologies. Moyer of Merck co-leads the patient technology initiative at TransCelerate Biopharma, a consortium of 19 of the world’s largest biopharmaceutical companies that works to streamline and improve clinical trials. The initiative recently surveyed member companies and others to find out why the industry has been slow to incorporate digital technologies into clinical trials.

“What the data shows us is that patients value, more than anything else, the relationship that they establish with the study coordinator and with the investigator.”

“The one thing that came up again and again was the risk from a pharmaceutical company perspective of feeling like you’re a first-mover in an area,” said Moyer. “So perhaps you’re trying something out that is cutting edge but there is a high degree of risk and a relatively high degree of investment in testing that technology out. If it doesn’t work or if it’s not accepted from a regulatory perspective, the burden is on you as a single company to bear that cost.”

TransCelerate is trying to overcome this reluctance by, among other things, building a database for members to share their experiences with using digital technology in trials.

Another challenge is making sure that the sensors and digital tools used in a trial are generating accurate data — that a heart monitor is correctly measuring the number of heart beats, for example — and that the data is not corrupted or its security breached. And of course, researchers must also convince the FDA, which approves the design of clinical trials before they can begin, that digital data is a valid way to measure the safety and efficacy of a drug. “The FDA is very comfortable in engaging right now in study-by-study discussions, and we’ve been happy with their response,” said LaPorte of Novartis. But the industry really needs some general guidelines from the agency about how to run virtual trials, he adds.

Theresa Eisenman, a spokesperson for the FDA, confirmed in an email message that the agency is interested in virtual trials. “The FDA is open to innovative trial designs that create efficiencies, serve the needs of patients while protecting their interests and safety, and create data that will be fit for use for regulatory decisions,” said Eisenman.

Eisenman declined to comment on any industry guidance the FDA may be considering beyond what is already publicly available, but given all of the variables and patients’ differing comfort levels with technology, several experts believe that hybrid trials that include both a virtual component and in-person visits will have the greatest chance for success.

“What the data shows us is that patients value, more than anything else, the relationship that they establish with the study coordinator and with the investigator,” said Getz of Tufts University School of Medicine. “It’s very, very hard to create that kind of rapport remotely.”


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Social Media Tips for Pharma and Healthcare Marketers –

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The average consumer spends nearly two hours on social media daily and, especially for healthcare and pharma, social networks have become the connective tissue between brands and health system stakeholders. These platforms are where patients, caregivers, and even HCPs engage with health-related information and seek the counsel of their peers.

Each and every day millions “like,” comment, and share disease state education, treatment solutions, support programs, and more. They also expect healthcare brands to provide the same level of immediacy and engagement already experienced with consumer package goods, entertainment, and other less-regulated verticals.

The obvious challenge for pharma marketers is that user generated content exposes companies to concerns ranging from reputation management to privacy concerns to adverse event reporting. Making matters even more complicated, the platforms themselves change often, from seemingly weekly channel enhancements to security changes to tweaked algorithms. That makes keeping abreast of new FDA guidance and technological features a true balancing act, demanding non-stop attentiveness, and proven compliance expertise.

The combination of unprecedented audience reach with complex tech, regulatory, and reputations concerns makes implementing social best practices more vital than ever before. So I’ve compiled 50 tips for pharma paid and organic campaigns to help you not only avoid problems, but get the most out of social media for your brands. Let’s start with the market leader, Facebook…

Part 1: 17 Super Ideas for Facebook

1. Ensure your Facebook Page appears in search results by avoiding age or country restrictions, and including a profile picture, cover photo, and call-to-action button. Make sure to add basic info and, lastly, ensure your Page is published.

2. Facebook allows advertising to three core audiences: your Facebook followers, all of Facebook (according to your target criteria), and to a Custom Audience, i.e. existing customers, like website visitors or email lists. Build success from the ground up by selecting the audience best in line with your goals.

3. If an organic page post has received high engagement in the form of likes, shares and comments, that tells you about its popularity; boost such a proven post with paid promotion to reach an even greater audience.

4. Track your Facebook Page performance alongside similar Pages or competitors by adding Pages to watch under the Insights tab:


5. Uncertain of which ad version to launch? Leverage the split test function in Facebook Ads Manager to gather insights based on a specific variable – target audience, delivery, placements, or creative. You can opt for the test to finish early based on the winning ad, enabling your brand to move forward with confidence.

6. Facebook favors ads light on copy. But don’t forget to use the custom link description, which allows you to share an additional sentence for detail.

7. New to advertising on Facebook? Facebook Blueprint offers free online training on all aspects of marketing through the platform. You can also take online exams to earn Blueprint Certification, the only certification officially recognized by Facebook.

8. Your Facebook followers can see how long it takes your brand to respond to a message – so be prompt to maintain good ratings. A solid benchmark can be found with Johnson & Johnson: despite having close to 800,000 page followers, they typically reply within a day.


9. Not seeing the results expected from your Facebook ad? Optimize the ad in real-time by editing your audience, budget & schedule, placements, creative, or delivery choices within Ads Manager.

10. Finding the right hire can be challenging and expensive. Consider posting openings on your Facebook business page – a free and easy feature introduced in February of 2017. Potential applicants can search for relevant openings by location and industry, among other criteria, and easily apply through the platform.

11. Take advantage of Facebook Audience Network (FAN) to extend your ad campaigns to your target audience off of Facebook. Campaigns delivered through FAN typically see larger reach at a lower cost per result.

12. Unbranded Facebook pages that put people – not treatments – at the center can be a game-changer for pharma. They also help you avoid the complications of branded content, often difficult or impossible to control within a social network. When done right, such unbranded content can nonetheless lead to important behavioral change, driving patients to prescribers, improving their adherence to treatment and motivating them to join awareness programs.

A great example is “Quitter’s Circle,” the unbranded page managed by Pfizer and the American Lung Association, which provides informative and motivational content to more than 150,000 followers.


13. Attending a conference? Unveiling a new treatment center? Welcoming a new physician? Let your Facebook followers in on the action with FacebookLive. These videos now stay on your page, so followers can engage with your content even if they missed it live.

14. Stand out in a sea of sameness, like the American Cancer Society did, by using a video in place of a cover or profile image. Facebook supports videos of up to 7 seconds for profile videos and reels of 20 to 90 seconds for cover videos. For best results, Facebook recommends uploading a pixel size no less than 820 x 462.


15. User-generated content, be it a positive Facebook review or Instagram post, is one of the best ways to increase trust in your organization. Consider featuring testimonials as a paid ad to reach your target audience in a more relatable, peer-to-peer way.

16. If increasing site traffic is the key objective of your Facebook ad campaign, conduct a preliminary split test to measure the cost per click of unique link clicks compared to landing page views. In my experience, link clicks are almost always more cost efficient.

17. Based on the size of your audience and key objectives, advertising on Facebook can be extremely cost effective. In fact, the minimum daily budget for impressions is as low as $1/day. The below ad sets, for example, achieved 2,182 impressions and reached 273 unique people within our target audience for a spend of only $37.75:


Looking for more of my top social media tips? Check out 5 Tips on Unbranded Facebook Pages for Pharma Marketers and 4 Key Advantages of Instagram Stories for Pharma Marketers.


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Sharing Health Information on Social Media

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Social media is widely used for exchanging news, photos and opinions. But today, it’s also being used by patients to share health information with their physicians.

Some 65 percent of millennials and 43 percent of all adults think it’s okay to contact doctors about health concerns by posting on their social media pages or through direct messaging, according to a 2018 American Osteopathic Association survey. And 54 percent of millennials and 42 percent of all adults would like to friend or follow their providers on social media. But is that wise?

Aside from privacy issues, social media “can lack the subtle emotions that help give context to information being shared, which can cause the meaning of messages to be misinterpreted,” says Jay Bhatt, DO, the American Hospital Association’s senior vice president and chief medical officer.

But while patients should not send their physician a photo of their rash over Facebook or post private health information, there is some value to connecting with providers online.

A medical practice’s social media presence may provide a window into what the physician or practice values, which allows patients to determine whether those values are consistent with their own, says Vineet Arora, MD, an academic hospitalist at UChicago Medicine.


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Flu Vaccine May Provide NO PROTECTION AT ALL from H3N2 Virus, the Dominant Strain This Year

Canadian influenza researchers reported Thursday in the online journal Eurosurveillance that the first reckoning of how well the flu vaccine is protecting against H3N2 viruses this year in North America has a dismal answer: not very.

 

Their midseason estimate, based on data from the four provinces where roughly 80 percent of Canadians live, suggested that the H3N2 component of the vaccine is 17 percent effective at preventing infection. Last year it was estimated at 37 percent in Canada and 34 percent in the U.S.

 

In working-age adults, the estimated protection is lower still: 10 percent. That is in line with the protection level Australia saw in its harsh winter 2017 flu season.

 

And in the case of the assessment of the H3N2 component, the confidence intervals cross zero, which means the researchers cannot rule out the possibility there was no benefit from that part of the vaccine.

 

The report does not estimate how well this year’s vaccine protects against H1N1 viruses. Skowronski said there has simply been too little H1N1 disease in Canada so far this winter to make that calculation. 

 

Whatever the reason, the findings confirm the fact that people who’ve been vaccinated are among those contracting flu this season.

“This is low protection. And the overall message is: People who have been vaccinated should not consider themselves invincible against this H3N2 virus that’s circulating,” said Dr. Danuta Skowronski, lead author of the report and an influenza epidemiologist at the British Columbia Center for Disease Control.


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Social media may provide opportunities for cancer research, but caution urged

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Adoption of social media has increased dramatically over time, with the number of worldwide users projected to increase from 1 billion in 2010 to 3 billion by 2021.

Mining this new form of derived data could be a novel frontier for personalized and precision cancer medicine, according to Mina S. Sedrak, MD, MS.

 Sedrak — assistant professor in the department of medical oncology and therapeutics research at City of Hope — presented research on the mechanisms by which social media and mobile technology may enhance individual and population health behaviors and outcomes in cancer care during this year’s ASCO Annual Meeting.

“We know from prior literature that social influences play key roles in shaping health behavior,” Sedrak, a HemOnc Today Next Gen Innovator, said during an interview. “Multiple studies have shown that certain health traits — such as smoking and weight gain — correlate with social ties within a network.

“Peer-to-peer interaction has been demonstrated to influence individual behavior in many health-related settings,” Sedrak added. “However, there are a number of important challenges that we have to take into consideration. Social media is an incomplete, new and evolving area of research, and there remain many unanswered questions about how best to study these new modes of communication.”

HemOnc Today spoke with Sedrak about how social media may be used to study social influences on health behaviors, advance cancer research and enhance outcomes for patients with cancer, as well as the challenges that must be overcome before this novel approach toward personalized medicine becomes a reality.

 

Question: Can you describe the potential for using social media to study social influences on health behaviors?

Answer: Social media may be a new method for studying social influences on health behavior. Traditional forms of studying health influences and health behavior include the use of observational data. We often use large forms of data, such as a large cohort data set, and conduct secondary analysis to understand how peer-to-peer influences impact an individual or population’s behavior. Another way we can study this is by performing health behavior intervention experiments, through which we evaluate specific strategies that influence individual behaviors. Social media gives us new and powerful methods to look at larger cohorts of the population beyond what traditional data sets or smaller health behavior experiments may provide. Information from our daily interactions and exposures are now measured and recorded as digital footprints. This tapestry of information that includes data from social media, wearables, mobile apps and other digital health tools may enable us to learn about the role of social influences on health behaviors in ways previously unimaginable.

 

Q: How can social media be used to advance cancer research and enhance outcomes for individuals with cancer?

A: The use of social media platforms for cancer research is in an early, proof-of-concept stage. There are several potential opportunities for us to examine the value of this new mode of communication in oncology. One is the potential to use social media platforms to listen to the public discourse on cancer to better inform our understanding of population needs. Key questions include: Can social media be used to examine the opinions, attitudes, sentiments and reported norms of social behavior among individuals and communities? What are patients saying when they talk about their cancer experience online? What are physicians saying? And how are these dialogues different or similar? Can we identify communication patterns and gaps, such as access, speaking, processing and using information? And can we examine how all of this relates to cancer health disparities?

Another potential benefit is to link social media data with numerous data that we collect about patients, including genetic information, demographic and clinical data, wearables and mobile health. Does integrating all of these big data together help us better understand the cancer continuum? Can it help us learn more about our patients outside of a 20-minute visit that we have with them in the clinic? Can it help us better understand their disease and cancer experience, and how does this affect their community and the people around them?

Finally, social media may potentially be used as an intervention or strategy to influence health behavior and outcomes. Can we tap into the power of social networking online to improve patient and physician behavior? It remains unclear whether this is something we can or even want to do, but there is no denying that social media is a powerful tool, and we have many questions to answer about its value and utility in oncology.


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7 Ways to Connect with Millennial Patients

7 Ways to Connect with Millennial Patients | alantichealthcarepharmacy.com | Scoop.it

Appealing to Millennials, many of whom are making their own decisions about eyecare for the first time, requires targeted marketing. But another factor can be equally powerful in appealing to this age segment: having cutting-edge technology online and in your office.

According to the most recent U.S. Census, there are 80 million Millennials in the U.S. compared to only 65 million Gen Xers and 74 million Baby Boomers. By the year 2020, Millennials will make up over 50 percent of our patient base. Therefore, optometrists should consider incorporating technology throughout the office, from the reception area to the exam room to the optical, to suit Millennials’ expectations.

Offer Easy Online Appointment Booking
From what I’ve observed on the teaching staff at Nova Southeastern University, in addition to working part-time at We Are Eyes in Boca Raton, Fla., Millennials are more likely to put off seeing doctors. They often wait to see if the problem will subside on its own. In addition to that, they feel that they don’t have the time to go to the doctor. When they are sick, Millennials are more likely to turn to Google, WebMD or urgent care centers for healthcare information before visiting a doctor. If they finally decide to go to a doctor’s office, Millennials are frequently intimidated by making an appointment over the phone. They prefer buying products and tickets online, making restaurant reservations online, so, therefore, would prefer to make doctors’ appointments online.

Enable Communication Via Cell Phone & Texting
When collecting contact information, get a cell phone number first, then an e-mail. Skip the home phone number and the daytime or work phone number. If you want a Millennial to schedule an appointment, allow them to do so from their mobile device. There are plenty of services that connect to your practice management software to send text or e-mail reminders of an upcoming appointment.

And the practice management software that is already being used in many offices may have mobile and online scheduling incorporated directly. A third-party service may not be needed anymore. For example, Eyefinity has online scheduling called Eyefinity Patient Engagement. This allows patients to schedule from mobile devices, and also to confirm or change appointments, access or update their medical history from the patient portal, and ask questions within the secure software. Whatever platform you use to communicate with patients, be sure it is HIPAA-compliant.

Update Web Site & Social Media Pages
Your web site should be optimized for mobile viewing, and you should have Facebook and Yelp pages that are updated on a daily basis. If a patient has a good experience in your office, take the time to ask them to post a positive review immediately. If the doctor does not want to have this conversation personally with the patient, designate an employee to do so. It’s best to ask before they leave the office. Give patients an extra incentive to like your Facebook page, or post a review, by offering them an optical cleaning cloth or an extra starter kit of contact lens solution or water bottle, or another token of appreciation.

 

Dr. Nguyen using an iPad to image a patient in the exam room. Dr. Nguyen says using mobile technology in the exam room can make it easier to educate the patient, which appeals to many Millennials.

Share Digital Images of Eyes in Exam Room
In the examination room, ODs should consider digital imaging techniques that can be viewed immediately by the patient. Millennials are more likely to understand the results of their examination if they can see it on an iPad or computer monitor. For example, a patient is more likely to be compliant to their prescribed contact lens wearing and replacement schedule if they can see the giant papillary conjunctivitis under their eyelids or the deposits stuck to their over-worn contact lenses.

I recommend large touch-screen monitors, or tablets, to view test results and ocular photos. When a patient has a question about their diagnosis, the doctor should have a face-to-face discussion with them. But once the question is answered, optometrists should consider taking a moment to send the patient an e-mail with more information. Don’t hand a Millennial a paper brochure. Send them an e-mail with a link to your web site or another credible web site.

Use Modern Measuring Technology in Optical
The optical area should also have modern technology available. I know many experienced opticians who are spot-on with their PD sticks. But measuring a pupillary distance manually with a PD stick is considered too basic and inaccurate by Millennials. iPad programs are available to measure PDs and simulate the optics and clarity of digital lenses. This adds perceived value to the optical purchase, which can help practices differentiate themselves from online glasses retailers.

Evaluate State of Technology Annually
The challenge with incorporating technology into a practice is that technology is ever-changing. Millennials are used to change, they expect it. So, never get too comfortable with the technology you have. An updated version will be available soon. To keep up with the most tech-savvy generation, practices may have to change the patient experience constantly.

Market New Technology
Once you have created your high-tech, mobile-friendly practice, market the technology to Millennials as an experience. Make a video creating a digital tour of your practice showing the technology you use. Post the video to your web site and Facebook page. Millennials live in a world of instant gratification, so marketing and communicating should be done in a timely manner. When you get new diagnostic technology, or new technology in your optical, it should be posted immediately.

 


Thuy-Lan Nguyen, OD, practices in South Florida, teaches at Nova Southeastern University College of Optometry, and works part-time as an associate at We Are Eyes in Boca Raton, Fla. To contact her: TLNGUYEN@nova.edu


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