Many Chronic Patients Cannot Afford Care

From the FMS Global News Desk of Jeanne Hambleton

By Kristina Fiore, Staff Writer, MedPage Today
Published: March 20, 2009

WASHINGTON, March 20 — One patient in four with a chronic condition has postponed healthcare or filling a prescription in the past year because he cannot afford it, researchers here said.

Latinos (43%) and middle-age women (39%) are among those more likely to report delaying care, according to a survey by the National Council on Aging.

Although the poor are more likely to report delaying care, 22% of patients with household incomes above $50,000 have done so, according to the survey.

Those who have put postponed treatment are also more likely to be in frequent physical pain (45% versus 28% of those who have not delayed care), to be fatigued (49% versus 28%), and to be stressed (40% versus 17%).

The survey — conducted between Jan. 5 and Jan. 30, 2009 among 1,109 adults ages 44 and up with at least one chronic condition — is a snapshot of patients living with chronic conditions such as heart disease, arthritis, hypertension, and diabetes.

The survey included an oversample of those 65 and older (n=594 total), as well as an oversample of Latinos (n=142 total). The margin of sampling error for the total results is +2.9 percentage points.

Many report dissatisfaction with the care they receive. Some 44% wish their physician had more time to spend talking to them about their condition, and 45% said they never get referrals to important chronic care resources such as counselors and health educators.

Nearly a third report leaving their physician’s office confused about what they should do regarding their care, and many say their providers aren’t doing anything to improve their care.

About 57% said their physicians have not asked whether they have help at home to manage their problems, and 45% said they rarely or never receive referrals to support services such as classes, counselors, or health educators.

Many patients are living with several chronic diseases: 68% report having two or more conditions and 20% have four or more.

Those with one chronic condition are healthier, have higher incomes, and have more support at home; while those with multiple conditions tend to have low incomes and less support.

Half of those with chronic conditions are unhappy or depressed at least occasionally because of their health problems, and 32% report having to cut back on social activities. A little more than a quarter report having to miss work.

Almost 40% of patients said they do not have the money to begin improving their health, a percentage that is particularly high among Latinos (63%), African Americans (58%), the poor (65%) and those with four or more chronic conditions (59%).

However, 70% said learning how to exercise or eat better in ways that work with their limitations would help them cope, and 68% say getting advice from others with similar conditions would help as well.

Fifty-six percent of Americans 44 and older with chronic conditions are Internet users — and of these, 63% say they would be interested in going to Web sites sponsored by health organizations to get information and support.

Even 27% of those who rarely or never use the Internet say they would be interested in going to Web sites for information and support.

Nancy Whitelaw, senior vice president of the Center for Health Aging at the National Council on Aging, said the report highlights the need to reform the healthcare system in order to support patients with chronic conditions.

“We encourage physicians not to take on the responsibility themselves, but to build a mechanism to refer patients to community-based health education programs that are effective,” Whitelaw said.

She added that physicians can help connect patients to such programs via a community agency that deals with the aging.

EDITOR’S NOTE: If it is happening in the USA, it must be happening here in the UK. This must also apply to visits to the opticians and the dentist. We can no longer afford luxuries, so health must be the next concern to be hit by the credit crunch. The offending financiers have a lot to answer for….Now is the time to make all prescriptions free before the UK falls apart at the seams. There is an old saying which tells us that health and happiness are more important than wealth. Are you listening Mr.B? You have helped everyone else – you can at least do this for the people Mr.B.! Write to your MP and put some pressure on the Government! JH

The survey was funded by the Atlantic Philanthropies and the California HealthCare Foundation.

Primary source: National Council on Aging
Source reference: “Reforming healthcare: American speak out about chronic conditions and the pursuit of healthier lives” NCOA 2009.

(http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/13358?utm_source=mSpoke&utm_medium=email&utm_campaign=DailyHeadlines&utm_content=GroupB&userid=206539&impressionId=1237776625926)

What a sleep study can reveal about fibromyalgia

From the FMS Global New Desk of Jeanne Hambleton
Courtesy Eurekalert.com

Michigan Tech, U. Michigan team up on sleep research

Research engineers and sleep medicine specialists from two Michigan universities have joined technical and clinical hands to put innovative quantitative analysis, signal-processing technology and computer algorithms to work in the sleep lab. One of their recent findings is that a new approach to analyzing sleep fragmentation appears to distinguish fibromyalgia patients from healthy controls.

Joseph W. Burns, a research scientist and engineer at the Michigan Tech Research Institute (MTRI); Ronald D. Chervin, director of the University of Michigan’s Michael S. Aldrich Sleep Disorders Laboratory; and Leslie Crofford, director of the Center for the Advancement of Women’s Health at the University of Kentucky, report the results of their study in the current issue of the journal Sleep Medicine.

MTRI, a freestanding research institute acquired by Michigan Technological University in 2006 and based in Ann Arbor, specializes in remote sensors that collect data, and in signal processing, using algorithms or computer programs to analyze and correlate the information the sensors gather. MTRI has developed an ongoing collaboration with the University of Michigan’s sleep laboratory, one of the nation’s leading clinical and research centers specializing in sleep medicine.

This several-year collaboration provided MTRI’s first opportunities to apply quantitative analysis, remote sensing technology and computer algorithms to clinical challenges, said Burns. “In this case, our analyses of sleep stage dynamics suggest potential clinical relevance,” he noted. Newly explored measures of sleep fragmentation seem to correlate—at least in this study—with levels of pain reported by fibromyalgia patients.

Burns, who has a PhD in electrical engineering, finds that more and more of his research is taking a biomedical turn. He and his team are working with Chervin to use signal-processing technology to record and analyze the brain waves and biophysical responses of children and adults with a variety of sleep disorders. They hope it will help them better understand conventional sleep patterns, as well as diagnose and treat sleep disorders.

They presented the results of research related to assessment of sleep-disordered breathing and sleep fragmentation at Sleep 2008, an international sleep research conference, in Baltimore in June.

Patients who may have sleep disorders often undergo complicated and expensive tests in sleep laboratories, Chervin explained. These studies collect an assortment of biophysical data that reflect brain, cardiovascular and muscle activity throughout the night. Up to now, these data had to be analyzed manually by highly trained technicians.

“We are collaborating to find new ways to analyze routinely collected data in a way that will be meaningful to the patient’s health and will help us understand how sleep disorders affect brain functions,” he said.

Automated analysis of data potentially can provide improved assessments and reduce the cost of sleep studies, Burns noted. For example, MTRI and UM have developed an automated technique for assessing the severity of sleep-disordered breathing, using just two signals—brain waves and respiration—instead of the dozen or more signals typically needed for standard visual scoring of a sleep study.

“It may even become possible for people to take sleep tests—simpler and more effective than some of those currently available—at home where they can sleep in their own familiar bedrooms,” he suggested.

Both partners are reaping the benefits of the collaboration, Burns said. Not only can automated technology improve clinical research; what the MTRI scientists have learned about biomedical techniques such as brain mapping is informing their more traditional work on radar and optical sensing technology.

Michigan Tech and UM have patented the new algorithm for assessing sleep-disordered breathing, which enables them to study what the extra work of breathing does to the brainwaves of patients with sleep apnea, a sleep disorder in which breathing stops briefly many times during sleep. Sleep apnea has been linked to excessive daytime sleepiness, cognitive changes and other health effects, and to hyperactive behavior in children.

The universities have filed an application for another patent for an algorithm that helps automate the assessment of patients with REM Sleep Behavior Disorder. People with this neurological condition act out their dreams during Rapid Eye Movement (REM) sleep, which can cause them to harm themselves or a bed partner while they are asleep.

Burns and Chervin published the results of that study in the December 2007 issue of the journal Sleep.

The team plans to investigate other sleep disorders and to continue to develop automated processing techniques to improve the performance and efficiency of sleep disorder diagnosis and assessment.

Michigan Technological University is a leading public research university, conducting research, developing new technologies and preparing students to create the future for a prosperous and sustainable world. Michigan Tech offers more than 120 undergraduate and graduate degree programs in engineering, forestry and environmental sciences, computing, technology, business and economics, natural and physical sciences, arts, humanities and social sciences.

Internationally renowned for patient care, research and education, the University of Michigan Health System has been a leader in American medicine for more than a century and a half. UMHS includes the U-M Medical School, three nationally ranked hospitals, 40 outpatient health centers, and a number of specialized programs for treatment and research in cancer, cardiovascular disease, geriatrics, depression, diabetes, vision, women’s health, organ transplant and other specialties. Its biomedical research community is one of the nation’s largest, winning more than $342 million in funding each year while generating more than 120 newly disclosed inventions annually.

Contact: Jennifer Donovan – jdonovan@mtu.edu – 906-487-4521 – Michigan Technological University