School soda sales suffer

A study by the American Beverage Associate found that the sales of full calorie soft drinks in schools are decreasing, falling from 57 percent of sales in 2002 to 45 percent of sales in 2005. Some experts cite the drop as a victory in the battle against childhood obesity. Bottled water, diet soda sales and fruit juice sales increased.

However, independent economist Dr. Robert Wescott found that sales of sports drinks, which are also loaded with sugar, increased 70 percent during the same time period. This finding has lead many industry critics like NYU nutrition professor Marion Nestle to question whether the drop in soda sales can be called a complete victory. She told the Associated Press that the switch from sodas to sports drinks might be “a substitution of one bad product for another.”

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When a drink is more than a drink

Alcohol flows more freely at home, so say researchers with the Alcohol Research Group at the Public Health Institute. A study on the amount of alcohol in drinks prepared at home and those prepared in licensed restaurants or bars reveals that home-poured beverages often contain a much higher percentage of alcohol. For physicians this means that a patient reporting the amount of alcohol consumed over a period of time may be under-representing actual figures. Results of the study were published in the November edition of Alcoholism: Clinical & Experimental Research.

“Without valid and reliable measures of how much alcohol is being consumed by a population, the ability to assess risk is compromised,” said Lorraine Midanik, in an article published on EurekAlert. Midanik is a professor in the school of social welfare at the University of California at Berkeley and an affiliate senior scientist with the Alcohol Research Group. “Population estimates of alcohol use derived from self-reports are used to determine risk for various adverse health and social outcomes. Population estimates of alcohol use also help us to understand trends in the U.S. population. That is, ‘are people drinking more, less or about the same alcohol over time?,’ ‘how are these trends related to morbidity and mortality?,’ and ‘what does this mean for policies that may affect alcohol consumption?’”

The inability to obtain accurate information poses a challenging task to physicians as calculating consumption trends and treating alcoholism becomes guesswork.

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HIV patients report discrimination by their doctors

Research published in the September 2005 edition of Journal of General Internal Medicine reveals that more than a quarter of HIV-infected patients may perceive that they are discriminated against by physicians and other health care providers. In the study, 26 percent of a nationally representative sample of 2,455 HIV-infected adults reported that they felt discriminated against by physicians and other health care providers, according to a release by the journal’s publisher, Blackwell Synergy. More than half of the reports of discrimination was attributed to physicians and ranged from perceiving that providers had been uncomfortable with them, treated them as an inferior, preferred to avoid them or refused health care completely.

For an abstract of the study or to purchase a full-text version, go to www.blackwell-synergy.com/toc/jgi/20/9.

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New AAFP tool keeps tabs on state legislatures

With the expected introduction of almost 93,000 bills in state legislatures during 2006, keeping up could be difficult. Your Academy hopes its new tracking system, State Net, (http://custom.statenet.com/aafp) will help you stay informed and engaged. The system depends on a partnership among the policy divisions of state chapters and the national organization. State policy experts will submit bills and issues of interest to AAFP to be loaded into the system. Then the system will provide updates on those bills as they move through the legislative process. Chapters should also be able to recognize trends across states by searching the system by issue. Aside from specific updates on a bill’s progress, the system will provide links to AAFP policy on the issue and information on state chapter support or opposition of the bill.

For more information, go to the AAFP News Now article on the subject at www.aafp.org/x40856.xml.

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Does disease management save money?

A study from Cornell University and Thomson Medstat on the return on investment of disease management programs reveals mixed results for programs targeting depression, diabetes and asthma, but yields positive results for programs targeting congestive heart failure or multiple illnesses. Many businesses have adapted disease management programs into health plans to reap the cost-savings, but more research is needed, says lead author Ron Z. Goetzel, Ph.D., director of the Institute for Health and Productivity Studies at Cornell University and vice president of consulting and applied research at Thomson Medstat, a business solutions company.

“Overall, there has been little scientifically rigorous research conducted to determine the financial impact of disease management,” Goetzel said in a release by Thomson Medstat. “That’s a concern, because companies and government agencies have increasingly adopted DM to control the cost of care for individuals with chronic medical conditions — a minority of the population responsible for a majority of health care spending.”

The DM industry’s revenues jumped from $85 million in 1997 to more than $600 million in 2002. Typically, DM programs are designed to ensure patients follow specific, proven clinical care guidelines. Many offer counseling and education while promoting diet, exercise, stress reduction and smoking cessation.

The study was published in the summer 2005 edition of Health Care Financing. To read the study, go to www.cms.hhs.gov/HealthCareFinancingReview.

Aetna plans to pay primary care physicians for depression management

On Nov. 2, one of the nation’s largest insurers announced a pilot project designed to provide incentives to primary care physicians for screening and treating depression. The first phase of the program will involve 120 select physician offices in Texas, Oklahoma, Pennsylvania, New Jersey, Maryland, Virginia and the District of Columbia, but the intention is to roll it out nationally after several months of testing, says Jill Griffiths, a spokesperson for Aetna in Hartford, Conn.

“The Texas Academy of Family Physicians is excited to see that Aetna, one of the largest managed care organizations in the country is pursuing a preventive strategy for the identification and treatment of depression, a disease that is increasing at an alarming rate,” says TAFP President Samuel T. Coleridge, D.O. “Depression not only affects the patient but also his or her family and friends. When employed, depression adversely affects co-workers and results in lost productivity and unhappiness for everyone. It is imperative that primary care physicians, such as family physicians, be intimately involved in any comprehensive program to treat depressed patients, and that there are no barriers to treatment in the form of referrals or medications.”

“We know depression can be effectively treated and that 80 percent of patients who receive appropriate treatment feel better physically and emotionally. Early intervention will improve medical outcomes and that is why we want to involve primary care physicians, where symptoms can first be recognized,” said Mary Fox, head of Aetna Behavioral Health, in the company’s press release.

“However, we also know primary care physicians face tight time constraints in treating all their patients and that screening and properly assessing patients for depression takes time. That is why we are providing financial reimbursement for their services, easy-to-use tools, and a clinically proven model to coordinate care management. By bringing this direct focus on the early treatment of depression, we can make sure our members get improved mental health care,” Fox said.

Reimbursement for screening and treatment of depression should be 30 to 40 percent higher for participating physicians, according to a November 2 story in The New York Times. Physicians wanting to take part in the project should go to www.aetna.com/aetnadepressionmanagement/.

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ICE your phone

Entering a contact name and number in your cell phone under the acronym, “ICE” — short for “in case of emergency” — is what one Cambridge-based paramedic recommends as an effective way to ensure proper care during an emergency. Bob Brotchie, a 13-year veteran of the East Anglian Ambulance NHS Trust, is credited with the idea that has worked its way around the globe. “Almost everyone carries a mobile phone now, and with ICE we’d know immediately who to contact and what number to ring,” Brotchie said in a release by the British ambulance service. For more information, go to www.iceyourphone.org.

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Sex Ed 101

Pfizer Inc. will work to spread sexual health awareness through the launch of www.pfizersexualhealth.com, an online resource providing comprehensive content and unique tools, according to a Pfizer press release. The Web site, independently created by seven U.S. medical schools for health educators and medical students, includes a variety of teaching materials to enhance knowledge of diagnosing and treating sexual health conditions.

“Sexual health is a critical component of overall health, but unfortunately is not a traditional focus of medical school curricula. It’s so important that sexual health and the important issues related to this topic, which include dysfunction, sexually transmitted diseases, and abuse, are addressed and that medical professionals are prepared to practice them,” said Ben Kramer, M.D., U.S. Medical U.S. Pharmaceuticals Urology/Respiratory Division, Pfizer Inc., according to the release.

Content created by the medical schools includes comprehensive information on male and female sexual anatomy; sexual history; gay, lesbian, bisexual and transgender health; sexually transmitted infections; adolescent medicine and sexual assault or abuse.