Bulletin Today
Polypharmacy affects 1 in 3 U.S. adults with asthma
Among adults with asthma, 34.3% were found concurrently using five or more medications, compared to 14.1% for adults without asthma, according to a study published in the September/October 2024 issue of JAPhA. Using data from the 2005 to 2020 National Health and Nutrition Examination Survey, researchers also found that polypharmacy was associated with an increased risk of having an asthma attack and an asthma-related emergency department visit for adults with asthma.
As one of the most common chronic diseases, asthma affects over 262 million people worldwide. Patients with asthma are known to have increased comorbidities, such as depression and arthritis, that require medication management. However, polypharmacy remains a major issue with medication adherence.
“Multiple medication use can be challenging for patients with asthma, given that treatment regimens often involve inhalers or nebulizers, increasing the complexity of medication adherence. Despite these concerns, there is limited information on the prevalence of polypharmacy among patients with asthma,” wrote the study authors.
Their goal was to evaluate how widespread polypharmacy is in this population of U.S. adults and its associations with asthma control.
Based on the data evaluated, the researchers also found that disparities were associated with polypharmacy as were several characteristics such as older age, identifying as non-Hispanic Black, health insurance coverage, the number of health care visits, and multiple comorbidities.
The study authors said this highlights the necessity for appropriate care and policies among vulnerable populations. ■
Whooping cough cases are on the rise, says CDC
CDC reported that cases of whooping cough in the United States have reached the highest level in 10 years, with the West Coast and Middle Atlantic regions standing out as current hot spots.
So far in 2024, CDC said there have been more than 16,000 documented infections—a dramatic climb from 3,700 cases nationwide last year.
“The United States is beginning to return to pre-pandemic patterns where more than 10,000 cases are typically reported each year,” CDC said.
Infants younger than 1 year old are at the greatest risk for whooping cough and serious complications, including pneumonia and apnea, said CDC.
Experts have previously attributed the surge in infections as fallout from the COVID-19 pandemic. Transmission declined during the public health emergency due to a variety of factors. Many children also missed routine recommended immunizations. ■
AHA releases new stroke prevention guidelines
New guidelines issued from the American Heart Association (AHA) and the American Stroke Association are intended to help clinicians prevent stroke in patients with no history of cerebrovascular accident. The new guidelines provide evidence-based recommendations for strategies to support brain health and prevent stroke throughout an individual’s life. Key prevention recommendations from the guidelines include regular health screenings, identifying risk factors, lifestyle interventions, and taking medications when indicated, said AHA.
“This guideline is important because new discoveries have been made since the last update 10 years ago. Understanding which people are at increased risk of a first stroke and providing support to preserve heart and brain health can help prevent a first stroke,” said Cheryl D. Bushnell, MD, who chaired the guideline writing group, in an AHA press statement. “Some populations have an elevated risk of stroke, whether it be due to genetics, lifestyle, biological factors and/or social determinants of health, and in some cases, people do not receive appropriate screening to identify their risk.”
The guidelines, which replace the 2014 version, provide recommendations based on current evidence for strategies to prevent stroke throughout a person’s lifespan. The guidelines’ “Top 10 Take-Home Messages” focus on brain health; screening for and addressing adverse social determinants of health; diet; physical activity; GLP-1 receptor agonists; BP management; antiplatelet therapy; prevention of pregnancy-related stroke; endometriosis, premature ovarian failure, and early-onset menopause; and the importance of understanding transgender health. ■
CDC warns of potential public health risk from online pharmacies and counterfeit meds
Ordering from online pharmacies comes with a risk of receiving unapproved or counterfeit medications that could result in harm to the user, CDC announced.
The overwhelming majority of websites advertising prescription-only drugs, which the National Association of Boards of Pharmacy reports is almost 95%, are not legitimate pharmacies. Based on recent law enforcement activity, these operations draw in customers by offering deep discounts and waiving the requirement for a prescription. However, regulatory and law enforcement agencies say they are actually selling sham products that often contain fentanyl, which puts individuals at risk for overdose.
Consumers who have patronized an internet-based pharmacy should check for the business under FDA’s tool for finding state-licensed online pharmacies.
Patients are also advised not to take and to safely dispose of any suspected counterfeit medications and call 911 in the event of a poisoning emergency. ■
Why aren’t MOUD more available in U.S. jails?
A survey of more than 1,000 jails in the United States found that only about 44% offered medications for opioid use disorder (MOUD) to at least some individuals, and only 12.8% made these available to anyone with OUD. With two-thirds of people who are incarcerated in U.S. jails experiencing an SUD, “jails present a key opportunity for providing lifesaving treatments,” such as MOUD, said the study authors in research published September 24, 2024, in JAMA Network Open.
The research, which was supported by the National Institute on Drug Abuse, found that 70.1% of jails offered some kind of SUD treatment or recovery support. The most common reason cited for not offering MOUD was a lack of adequate licensed staff. The likelihood of a jail offering MOUD was greater for those located in counties with lower social vulnerability and shorter mean distances to the closest facility providing the treatment.
“These findings suggest that efforts and policies to increase MOUD availability in jails and the surrounding community may be associated with helping more individuals receive treatment,” the researchers concluded. ■
ACIP: Extra COVID-19 vaccine for older adults and PCV for 50 and older
CDC’s ACIP has voted to recommend a second dose of the 2024–2025 COVID-19 vaccine for those aged 65 years and older who have moderate or severe immunocompromising conditions. These individuals should receive the second dose of the COVID-19 vaccine 6 months after the first dose.
Through shared decision making, ACIP is also recommending additional COVID-19 vaccine doses for people who are moderately or severely immunocompromised.
CDC’s director has endorsed the new recommendations, which also include lowering the age for adult pneumococcal vaccination from 65 to 50. CDC noted that this change gives more adults the opportunity “to protect themselves from pneumococcal disease at the age when risk of infection substantially increases.” ■
Number of pharmacists increasing, says U.S. Census
According to the latest U.S. Census Bureau’s American Community Survey, the number of pharmacists in the United States continues to grow.
Data show that the number of pharmacists grew from 286,400 in 2018 to 337,400 in 2023, a 17.8% increase. The proportion of pharmacists in the total workforce also increased, starting at 0.22% in 2018 to 0.24% in 2019 and 0.26% in 2023.
Survey results also reveal that between 60% to 62% of the pharmacist workforce were women during this period. However, the data show that male pharmacists continue to earn more. ■