Category Archives: Public health

Resources for reporting on compounding pharmacies

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Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Seven patients in Tennessee are sick after injections from a compounding pharmacy, health officials say. AHCJ has some presentations from a recent panel, The Boston Globe’s award-winning coverage of a similar outbreak and a questionnaire about how they reported on it and more resources for reporters who are looking into compounding pharmacies.

Presentations from a panel at Health Journalism 2013:

From compounders to drug shortages: Covering pharmacies and pharmacists
• Michael R. Cohen, R.Ph., M.S., president, Institute for Safe Medication Practices
• William Churchill, M.S., R.P.H., chief of pharmacy services, Brigham and Women’s Hospital
• John Walczyk, pharmacy manager, Johnson Compounding and Wellness Center

Keldy Ortiz wrote about the panel for Covering Health: Growing challenges to safety, adequacy of drug supply

Previous coverage

The Boston Globe‘s coverage of a fungal meningitis outbreak tied to contaminated drugs won first place in the public health category of the 2012 Excellence in Health Care Journalism Awards. See the coverage as well as a questionnaire about how they reported on the topic.

FDA regulation

In her tip sheet on the anti-aging movement, Arlene Weintraub touches on compounding pharmacies. She notes that the U.S. Food & Drug Administration has tried unsuccessfully to put a halt to improper marketing claims by compounding pharmacists and its continuing efforts in this area are well worth following. In the aftermath of the earlier meningitis outbreak traced to a compounding pharmacy, at least two legislators said they will draft legislation to give the FDA more oversight of compounding pharmacies.

On April 26, senators introduced a draft bill to make clear oversight responsibilities for pharmaceutical compounding.

Budget Victim: Inspections For Compounding Pharmacies, WBUR, May 20

The FDA has a section of its website devoted to compounding pharmacies.

Transparency

This also might be a good time to remind public officials that there is now guidance on what information should be made public when someone dies or falls ill during a public health emergency. The document – developed by leaders in public health and health-care journalism – provides a framework for releasing such information as the age and location of private individuals who have been affected by an epidemic or other public-health event.

Pharmacy industry groups

… As we gather more resources, we will add them to this post …

When disaster strikes: How will your community meet mental health needs of older adults?

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Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society. If you have questions or suggestions for future resources on the topic, please send them to liz@healthjournalism.org.

Ambulances line up in Moore, Okla., following a deadly tornado in May 2013.

Photo by State Farm.

As the residents of Moore, Okla., begin the cleanup and recovery process from the super-tornado that destroyed the town and claimed at least two dozen lives, the physical and mental health of the older population requires special handling. This is especially true for those over age 75 and the frail elderly, who are considered vulnerable and high-risk populations, according to the Substance Abuse and Mental Health Administration (SAMHSA).

Many older adults suffer from multiple chronic conditions – including diabetes, heart disease, arthritis, and dementia – and juggle multiple medications. Access to prescriptions may suddenly be cut off when someone is moved to a shelter or temporary housing. Adherence becomes an issue. Missing medical records, lack of a person’s ability to recall all prescribed medications, delays in refilling prescriptions, and stress contribute to compliance challenges.

Other physical and environmental conditions, ranging from struggles with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), to poor sensory perception, to loss of electricity and water, add to an increased sense of vulnerability, according to researchers. Temporary living conditions may exacerbate these conditions – appetite may be affected and access to some foods may be limited, which impact chronic disease management. Sleep is disrupted, mental and emotional stresses take a toll on the body and mind. Continue reading →

Tulsa reporter shares lessons from ongoing coverage of dentist

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Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Shannon Muchmore

Shannon Muchmore

As many of you know, it can be hard following an ongoing story – keeping up with the latest developments, looking ahead and staying ahead of the competition, finding the larger stories and putting it all into context.

Shannon Muchmore of The Tulsa World has been doing just that since the end of March, reporting on an investigation into a dentist whose clinics have been cited for multiple violations, many related to unsanitary practices. Hundreds of patients are being tested for HIV and hepatitis and officials say as many as 7,000 patients may have been exposed since 2007.

Amid a steady stream of stories, she took the time to share some of her insights into the complexities of the unfolding drama, including how her daily work life has changed, the level of risk faced by patients and some tips for other reporters.

After 5-year FOIA fight, documents show ties between researchers, officials in Lyme wars

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Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Documents obtained after a long FOIA battle reveal “behind-the-scenes maneuvers and long-standing connections between the scientists’ group and government officials” in the debate over whether Lyme disease can be chronic.

The debate, and the fight for the documents, are detailed by Mary Beth Pfeiffer in the Poughkeepsie (N.Y.) Journal and by documentary film maker Kris Newby on IRE’s Transparency Watch blog.

In 2007, in doing research for a film, Newby requested emails and resumes pertaining to three employees at the Center for Disease Control and Prevention. She writes that “For five years the agency strung me along with frivolous denials, mysterious delays, shifting explanations and false promises. In essence, the delays became an illegal, off-the-books FOIA denial.” Her account of how the CDC handled – or didn’t handle – her request is alarming.

Newby, whose film had been completed, provided the 3,000 pages of documents to Pfeiffer.

The documents show close connections between the government officials who set disease policy and researchers who have received government funds and written treatment guidelines. “As a result, physicians and scientists with opposing views on Lyme disease believe they have been marginalized in the debate.” This graphic provides a good overview of the connections and issues.

R.I. program provides care outside hospitals in effort to reduce ER use

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Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Emergency department

Photo by KOMUnews via Flickr

Using community health workers to work with frequent emergency room visitors is showing some success in reducing ER use.

The latest installment of “Cost of Diabetes,” a yearlong series by Rhiannon Meyers of the Corpus Christi (Texas) Caller-Times, looks at what Rhode Island is doing to help prevent and manage diabetes.

A “Communities of Care” program pairs peer navigators, who are community health workers, with Medicaid patients who are seen in an emergency room four or more times in a year. The peer navigators “try to figure out why [the patients] keep going to the emergency room and help them access resources they need, from housing to transportation to doctors’ appointments. The peer navigators also continuously check in with patients to make sure they are seeing the doctor as needed and taking their prescriptions to avoid unnecessary hospitalizations.”

Officials at UnitedHealthcare, which contracts with Rhode Island Medicaid, say they’ve seen a 30 percent decrease in ER use and have possibly saved up to $600,000, according to preliminary results. And those results are prompting people to look at the program as a model, said Dr. Rene Rulin, medical director of Rhode Island Medicaid at UnitedHealthcare.

(Hat tip to Keldy Ortiz.)

Las Vegas hospital sends 1,500 patients with mental health issues to other cities

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Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Nevada has been shipping mental health patients out of state as it has cut funding for mental health services, according to a Sacramento Bee investigation.

In recent years, as Nevada has slashed funding for mental health services, the number of mentally ill patients being bused out of southern Nevada has steadily risen, growing 66 percent from 2009 to 2012. During that same period, the hospital has dispersed those patients to an ever-increasing number of states.

Cynthia Hubert, Phillip Reese and Jim Sanders report that Rawson-Neal Psychiatric Hospital in Las Vegas, the primary state psychiatric hospital, put more than 1,500 patients on Greyhound buses bound for other cities.

The reporters reviewed bus receipts kept by Nevada’s mental health division. Southern Nevada Adult Mental Health Services has had a contract with Greyhound since July 2009, a bus company spokesman said. He also revealed that “Greyhound has contracts with ‘a number’ of hospitals around the country, but declined to identify them.”

Mental health professionals in other places are quoted as saying putting someone with a mental illness on a bus is risky and several said their counties don’t do it.

The Center for Medicare and Medicaid Services is investigating Rawson-Neal and the situation has prompted statements from California’s Senate president and a member of the U.S. Commission on Civil Rights.

Government officials, researcher make case for policy influencing healthy behavior #ahcj13

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Mina Kim

About Mina Kim

Mina Kim is a health reporter at KQED-San Francisco. She is attending Health Journalism 2013 on an AHCJ-California Health Journalism Fellowship, which is supported by The California HealthCare Foundation.

Well-structured, comprehensive health policy can change behaviors according to panelists Susan Kansagra, Manish Sethi and Giridhar Mallya. They have been working to address different health issues – gun violence, smoking, and obesity – and shared their strategies at Health Journalism 2013.

Giridhar Mallya, director of policy and planning at Philadelphia’s Department of Public Health, helped launch a campaign to combat obesity there and, after decades of rising obesity rates, the city is seeing declines. The key, Mallya said, was in treating the issue as an environmental disease rather than in individual problem, and that meant altering the environment to give people a chance at being healthy.

“Changing the context is really the sweet spot of public health,” Mallya said. “Change the context so people can default to healthy decisions.” Continue reading →

Boston program specializes in treating homeless #ahcj13

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Desiree Robinson

About Desiree Robinson

Desiree Robinson is a producer/host at WBAI-Corona. She is attending Health Journalism 2013 on an AHCJ-New York Health Journalism Fellowship, which is supported by the New York State Health Foundation.

Larry Adams, patient and chairman of the consumer advisory board of the Boston Healthcare for Homeless Program, addresses visiting AHCJ members.

Photo by Desiree RobinsonLarry Adams, patient and chairman of the consumer advisory board of the Boston Healthcare for Homeless Program, addresses visiting AHCJ members.

“I’ve been locked up in mental institutions and prison. If it hadn’t been for the team here, I wouldn’t be talking to you right now. When I’m feeling depressed, I pick up the phone and I call my psychiatrist and talk.”

These are the heartfelt sentiments of Larry Adams, patient and chairman of the consumer advisory board of the Boston Healthcare for Homeless Program (BHCHP). First of its kind in the nation, BHCHP serves 12,000 patients through over 60,000 visits a year in more than 80 locations. For more than 25 years their mission has been to provide or assure access to the highest quality health care for all homeless men, women, transgender and children in the greater Boston area.

As part of one of the field trips offered at Health Journalism 2013, journalists toured the bright and warm facility where health care teams mobilize to serve the most underserved of Boston’s residents. Continue reading →

Tipping point: Stress affects soldiers and their families #ahcj13

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Janine Weisman

About Janine Weisman

Janine Weisman is editor of the Newport Mercury. She is attending Health Journalism 2013 on an AHCJ-Rhode Island Health Journalism Fellowship, which is supported by The Rhode Island Foundation.

The physical manifestations of stress are something Kenneth Pitts, M.S., research scientist at the U.S. Army Research Institute of Environmental Medicine in Natick, Mass., knows a heck of a lot about. A U.S. Army veteran who deployed to Afghanistan, Kosovo and Panama during his 23 years of military service, Pitts opened his talk with a YouTube video portraying how to drive a Hummer in Iraq: Basically, never stop, even if that means bumping other vehicles out of the way and driving the wrong way to avoid encountering an improvised explosive device.

“They think their life depends on it,” Pitts said.

Maintaining that level of alertness has lasting physiological effects, disrupting the body’s levels of the stress hormones adrenaline, prompting the first wave of the fight-or-flight response, and cortisol, which supports the body as it takes action. Cortisol is known to increase the storage of emotional memories.

“You can maintain that 60 miles per hour but you’re going to wear out your car,” Pitts said, noting that chronic stress produces increased inflammation that is linked to heart disease, strokes and autoimmune disorders. Continue reading →

Getting past conventional wisdom in the prescription drug epidemic #ahcj13

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Alysia Santo

About Alysia Santo

Alysia Santo is a reporter at The Albany Times Union. She is attending Health Journalism 2013 on an AHCJ-New York Health Journalism Fellowship, which is supported by the New York State Health Foundation.

Drug-induced fatalities are one of the only preventable causes of death that’s rising, rather than decreasing.

That’s because deaths from prescription narcotics have exploded, and as the panelists at a Health Journalism 2013 panel explained, there are ways to get past the talking points of this “epidemic” and decipher some of the causes for the public.

Lisa Girion, an investigative reporter with the Los Angeles Times, went document diving to get to the root of the problem in a multi-part series she reported with Scott Glover called “Dying for Relief.” Continue reading →