Bulletin Today
New research led by WHO suggests that people with HIV are more likely to become severely ill if they contract SARS-CoV-2 and more likely to die if hospitalized compared with other COVID-19 patients.
The research found that nearly one-half of HIV-infected males older than 65 years who were hospitalized for COVID-19 may die. After adjusting for factors such as age, sex, disease severity, and presence of other conditions, the research team estimated that HIV raises the risk of dying from COVID-19 by 30%. Results came from the WHO Clinical Platform.
Approximately 95% of people with HIV included in the analysis were from sub-Saharan Africa, the location of two-thirds of HIV cases globally.
Researchers evaluated anonymized clinical data for 268,412 people hospitalized with COVID-19 that was reported to WHO from health facilities and national health registries in 37 countries from January 2020 to April 2021. Of that group, the researchers focused on data for 15,522 people from 24 countries who were also infected with HIV. The average age of these patients was 45.5 years, 37% were male, and nearly 92% were being treated with antiretroviral drugs.
Many of the HIV-infected patients had other conditions such as diabetes, high blood pressure, and obesity. More than a third of the patients with HIV were severely ill upon admission to the hospital, and almost 25% of those who were hospitalized for COVID-19 died.
Study finds differences in opioid prescribing
Black and white patients are subject to very different opioid prescribing behaviors, says a new study published July 22, 2021, in NEJM. The study examined 310 different health systems, comparing opioid orders filled in 2016 and 2017 by more than 600,000 Medicare beneficiaries with disabilities.
White patients received pain medication for longer durations and at higher doses than did their Black counterparts, even when seen by the same provider. These results could inform guidelines for managing pain while taking racial disparities into consideration.
HHS announces phase two of HPV vaccination campaign for young adults
The HHS Office of the Assistant Secretary for Health’s Office on Women’s Health announced the launch of the second phase of the HPV VAX NOW campaign. The first phase, which began in January 2021, aimed to support health care providers who counsel young adults in 3 states—Mississippi, South Carolina, and Texas—by providing resources to promote effective HPV vaccine recommendations.
The second phase will focus on young adults aged 18 to 26 years in those same states. It is estimated that only 16% and 13% of young adults in Mississippi and Texas, respectively, have ever received a dose of the HPV vaccine, according to the most recent data. Coverage is also estimated to be low in South Carolina.
Nationwide, only about 40% of young adults have received at least one dose of HPV vaccine, and only 22% have completed the vaccine series.
“With the HPV vaccine, we have a unique opportunity to save many lives that would otherwise be lost to cancer,” said HHS assistant secretary for health, Rachel Levine, MD, in an HHS news release. “We must take every measure possible to ensure that everyone eligible for the vaccine receives it and is fully protected from the potential consequences of HPV.”
Survey: One-third of consumers would ignore laws against buying from online pharmacies
According to a new survey from the Alliance for Safe Online Pharmacies (ASOP) Global Foundation, almost half of Americans gamble with their lives to buy medication from online sources—even though the overwhelming majority of them operate illegally.
That’s just one of the alarming findings from the organization’s 2021 survey of American perceptions and use of online pharmacies, which was commissioned from Abacus Data.
Savings over safety
There are approximately 35,000 online pharmacies across the world, and 95% of them are rogue and unregulated. The products they sell are often counterfeit, tainted, or substandard and can harm patients or even kill them. Further, the survey revealed that consumers can’t distinguish safe, legal sites from sites operating in violation of U.S. law.
Respondents indicated that cost and convenience were the primary drivers of their use of unregulated online pharmacies. A false sense of security kept safety concerns to a minimum. That attitude flies in the face of APhA, ASOP Global, and other stakeholders’ warnings that the practice poses an unacceptable threat to patient health and well-being. Paradoxically, use of online pharmacies continues to accelerate—COVID-19 exacerbated the problem—despite Americans’ increasing awareness of its risks, which rose by 6 points in one year.
Misled, misinformed
United States’ drug importation policies contributed to the polled consumers’ illusion of safety. APhA has long opposed prescription drug importation schemes due to patient safety and drug supply chain–integrity concerns.
Forty-five percent of survey respondents “erroneously believe that there are safety nets in place to ensure all websites offering health care services and/or prescription medications are safe, verified, and approved by FDA or have state regulatory approval,” ASOP Global wrote in a statement.
Many falsely believe that all Canadian medicines sold over the web are authentic and legitimate. The group posited that policies like “FDA’s Importation of Prescription Drugs Final Rule, which allows for the wholesale importation of drugs from Canada, may be creating a false sense of security about the safety, access, and savings offered when buying alleged Canadian medicines online.”
Laws prohibiting individuals from purchasing drugs from Canadian online pharmacies were no deterrent for more than a third of the survey respondents. Almost 35% of those polled said they’d likely continue to buy from outlaws on the web regardless of the FDA rule that forbids it.
Education in pharmacies
Pharmacists can help ease the problem, said APhA Senior Vice President of Pharmacy Practice and Government Affairs Ilisa Bernstein, PharmD, JD, FAPhA. Bernstein sits on ASOP Global’s Board of Directors. “As trusted messengers, health care professionals play a critical role in directing Americans to legitimate online pharmacies and resources that help patients stay safe and save money.”
To steer your patients in the right direction, urge them to visit FDA’s BeSafeRx to learn how to safely buy medicine online. ASOP Global also offers helpful resources to stay safe.
FDA requests removal of strongest warning against using cholesterol-lowering statins during pregnancy
FDA is requesting revisions to the prescribing information of the entire class of statin medicines to remove the contraindication against using these medications in all pregnant patients.
A contraindication is FDA’s strongest warning and is only added when a medication should not be used because the risk clearly outweighs any possible benefit. Since the benefits of statins may include prevention of serious or potentially fatal events in a small group of very high-risk pregnant patients, contraindicating these drugs in all pregnant women is not appropriate.
FDA expects removing the contraindication will enable health care professionals and patients to make individual decisions about benefit and risk, especially for those at very high risk for heart attack and stroke. This includes patients with homozygous familial hypercholesterolemia and those who have previously had a heart attack or stroke.
FDA said patients taking statins should notify their health care provider if they become pregnant or suspect they are pregnant. Health care professionals should discontinue statin therapy in most pregnant patients or consider the ongoing therapeutic needs of the individual patient, particularly those at very high risk for cardiovascular events during pregnancy.
Because of the chronic nature of cardiovascular disease, treatment of hyperlipidemia is not generally necessary during pregnancy.
FDA said health care practitioners should discuss with patients whether to discontinue statins temporarily while breastfeeding. Statins are not recommended during breastfeeding because they may pass into breast milk and result in potential serious adverse effects.