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News you can use, June 2013

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CMS news, mammography rates, updated 'flush list,' SIDS risk research

Senate confirms Tavenner as head of CMS

The U.S. Senate confirmed Marilyn Tavenner, BSN, MHA, as CMS Administrator on May 15 with a 91–7 vote. A nurse who rose to become the group president of outpatient services for Hospital Corporation of America and then the state of Virginia’s former Secretary of Health and Human Resources, Tavenner was the acting head of CMS and is the first Senate-confirmed head of CMS since 2006. 

Tavenner became acting administrator of CMS after Donald Berwick, MD, MPP, FRCP, who served through a politically controversial recess appointment that bypassed the Senate, stepped down in December 2011.

Nominated by President Barack Obama to lead the federal agency that administers Medicare and provides funds and guidance to states for their Medicaid and Children’s Health Insurance programs, Tavenner will continue to guide CMS as it implements the health care reform law. 

“We are very pleased the Senate confirmed Marilyn Tavenner as the Administrator of the Centers for Medicare and Medicaid Services,” said Stacie Maass, BSPharm, JD, APhA Senior Vice President of Pharmacy Practice and Government Affairs. “APhA looks forward to continuing our work with Administrator Tavenner and her agency to make certain that patients receive the full benefit of pharmacists’ care and services.”

FDA updates ‘flush list’ for disposing of medications safely

When certain drugs pass their beyond-use dates or patients no longer need or use them, the drugs should be flushed down the sink or toilet, according to FDA, which recently updated its list of medicines recommended for disposal by flushing.

The “flush list” drugs are alphabetized by trade name and active ingredient and there is a printable PDF copy of each drug’s Medication Guide (http://apha.us/142GqSJ).

“As a pharmacist, you can help to prevent childhood medication poisonings by teaching your patients and their caregivers about proper medication storage and disposal. To eliminate the risk of accidental ingestions, FDA recommends flushing, in a sink or toilet, certain medications that may be especially harmful,” Dale Slavin, PhD, Acting Director of FDA’s Safe Use Initiative, told Pharmacy Today.

Medicine take-back programs are another method to eliminate beyond-use, unneeded, and unused medications, according to an FDA webpage for consumers (http://apha.us/ZqPXa8). City or county governments’ household trash and recycling services and community pharmacists are good sources of information for locating medicine take-back programs. Links to national prescription drug take-back events are available from DEA.

For medicines not listed on the flush list, careful disposal of medicines in the household trash is an acceptable alternative to medicine take-back programs. For this method, FDA recommended mixing uncrushed tablets or capsules with an unpalatable substance such as kitty litter or used coffee grounds, placing the mixture in a container such as a sealed plastic bag, and throwing the container in the household trash. Before throwing away empty medicine bottles or packaging, scratch out prescription labels so they cannot be read.

New mammogram advice hasn’t yet changed screening rates

Mammography rates in women 40 years to 49 years old did not significantly change after 2009, when the U.S. Preventive Services Task Force (USPSTF) recommended that screening for that age group should be optional, according to research published in the Journal of General Internal Medicine.

The researchers, led by Lauren Block, MD, reviewed data collected in the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System surveys on women 40 years to 74 years old who were not pregnant and who reported data on their mammogram use, totaling about 480,000 women. Reported prevalence of mammograms in women aged 40 years to 49 years and 50 years to 74 years, respectively, was 53.2% and 65.2% in 2008 and 51.7% and 62.4% in 2010. Researchers concluded that there was no significant decline among the younger group relative to the older group.

Block and colleagues cited the USPSTF’s 2009 recommendation that the breast cancer screening decision for women in their 40s should be “an individual one and take patient context into account, including the patient’s values regarding specific benefits and harms.” Based on the lack of an observed reduction following this policy change, they concluded that “patients and providers may have been hesitant to comply with the 2009 recommendation,” although they also hypothesized that “the impact on actual practice may not yet be evident.”

Bed sharing quintuples SIDS risk, study says

Parents sharing a bed with a younger infant may increase the child’s risk of sudden infant death syndrome (SIDS) by five times, according to researchers from the London School of Hygiene & Tropical Medicine.

In the study, published online in BMJ Open, researchers examined the records from nearly 1,500 cases of SIDS and about 4,500 control cases across five major studies. They found that risk of SIDS among low-risk breastfed babies younger than 3 months increased with bed sharing, even if the parents did not smoke and the mother had not consumed alcohol or drugs. The researchers noted a fivefold increase in SIDS compared with room sharing, where the baby slept in a crib in the parents’ room.

The researchers estimated that 81% of SIDS cases in infants younger than 3 months with no other risk factors could be prevented if the children did not sleep in the same bed as the parents. They also determined that risk of SIDS decreases as babies get older, peaking at between 7 weeks to 10 weeks old.

“Health professionals need to make a definite stand against all bed sharing, especially for babies under 3 months,” said lead researcher Bob Carpenter, PhD, in a news release. The authors said that infants could still be brought into the parents’ bed for comfort and feeding during the night, but that they should be placed in a crib next to the parents’ bed to sleep.

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