Doctors and Pharmacists: An underused resource to manage drug costs for older adults

The majority of Americans over age 50 take two or more prescription medicines to prevent or treat health problems, and many of them say the cost weighs on their budget, the new University of Michigan National Poll on Healthy Aging finds. But many older adults aren't getting ---- or asking for ---- as much help as they could from their doctors and pharmacists to find lower-cost options, the new data reveal.

These first results from the National Poll on Healthy Again poll suggests an opportunity for health professionals and patients to talk more about drug costs, both in everyday interactions and in formal medication reviews that insurance may cover.

The poll will issue new data on a regular basis starting in early September and is directed by the University of Michigan Institute for Healthcare Policy & Innovation and sponsored by Michigan Medicine and AARP.

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Improving cardiac care through innovative diagnostic systems

Coronary angiograms are x-ray pictures that reveal how blood flows through the heart's arteries and can highlight obstructions. They provide essential information for diagnosing, treating, and managing coronary heart disease, the single largest cause of death in the U.S.

Yet when cardiologists assess these images, they have only their own eyes to visually evaluate the severity of potential blockages ---- estimations which drive critical decisions about whether a patient will need additional testing, surgery, or other major interventions. Research suggests that without standard tools to make these measurements, cardiologists interpret angiograms incorrectly in up to one out of five cases ---- meaning that some patients do not receive potentially life-saving treatments, while others undergo unnecessary invasive (and costly) procedures.

Now, a team led by Brahmajee Nallamothu, M.D., M.P.H., U-M professor of interventional cardiology, and Kayvan Najarian, Ph.D., U-M associate professor of computational medicine and bioinformatics, is developing a fully automated, computer-based tool to rapidly analyze angiogram videos and generate standardized assessments in real-time.

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4 takeaways from The Lancet report on Alzheimer's Disease burden

Alzheimer's and related dementias are the "greatest global challenge for health and social care in the 21st century," according to a new report from The Lancet Commission on Dementia Care.

A 24-member international commission panel convened last year to examine the diseases' burden, author the report, and share key messages. Recently, representatives from the group, including Helen C. Kales, M.D., a U-M professor of psychiatry and founding director of the U-M Program for Positive Aging (PPA), unveiled their findings at the Alzheimer's Association International Conference in London.

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Reducing overtreatment in cancer patients: When is active surveillance appropriate?

For certain slow-growing or low-risk cancers, surgery and other treatments might not be the best course of action. In a new Perspective piece in the New England Journal of Medicine, researchers from the University of Michigan Comprehensive Cancer Center examine whether active surveillance could be a strategy to reduce overtreatment in certain patients.

Each of the Perspective's authors research overtreatment within his or her respective specialty. Megan Haymart, M.D., associate professor of internal medicine, treats patients with thyroid cancer. David C. Miller, M.D., M.P.H., professor of urology, sees patients with prostate cancer. Sarah T. Hawley, Ph.D., M.P.H., professor of internal medicine, researches patient and provider preferences around breast cancer treatment.

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Islands of mindfulness: Pausing for a moment while washing hands can help physicians restore balance

Medicine at Michigan Magazine

By  Vineet Chopra, M.D., M.SC., and  Sanjay Saint, M.D., M.P.H.

A day in the life of a physician can be hectic. It doesn't matter if you are in training, established in clinical practice, or whether you're in an inpatient, outpatient or emergency room setting ---- providing high-quality, clinical care can lead to feelings of being hurried, rushed and even frenzied. Mindfulness might be a solution to this challenge.

Even during frantic days, islands of mindfulness may be established within oceans of chaos. One such oasis is when we wash our hands before laying them on a patient...a hypothesized "mind-hand" connection is an ongoing pilot study at the VA Ann Arbor Healthcare System.

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How to pick the right PICC for a patient? There's an app for that

More than a million times a year, doctors and nurses insert tiny tubes into the veins of American hospital patients to deliver lifesaving medicines, give fluids and nutrition and monitor key vital signs. Yet, doctors and nurses have only recently had an evidence-based guide for choosing which kind of device to use, in which patient, for the best and safest result. A team at the University of Michigan and VA Ann Arbor Healthcare System created a free smartphone app for both Apple iOS and Android devices, helping clinicians at the point of care choose among intravenous or vascular access devices of all kinds.

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