Saturday, 6 December 2014

Text messaging service 'helps people take their pills'

Text messaging service 'helps people take their pills'

PillsOne third of patients do not take their medicine as directed, research suggests

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A text messaging service could help people remember to take the medicines they have been prescribed, say researchers.
A test scheme, which involved heart patients, cut the numbers who forgot or just stopped taking their pills.
One in six was helped to continue their treatment, reducing their risk of heart attack and stroke.
It has been estimated that the NHS spends more than £500m on wasted medicines and avoidable illness.

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In general, patients really valued the text messages and were disappointed when they stopped”
Prof David WaldQueen Mary University of London
Other research has shown around a third of patients do not take their medicine as directed.
Study leader Prof David Wald said text reminders could be used by GPs, hospital doctors and pharmacists for a range of different conditions, including diabetes, TB and HIV.
Professor David Wald said the service helped identify and help people who stopped taking their medication
In the study, published in Plos ONE, 300 patients who were already on blood pressure medicines or statins were either sent daily texts for two weeks followed by a fortnight of alternate days, then weekly texts for six months, or no texts at all.
Participants had to reply to say whether they had taken their medication, whether the message had reminded them to take it if they had forgotten, or whether they had simply not taken it.
Telephone support
Anyone who had not taken their medicine was flagged up by a computer and received a telephone call to offer advice.
Of those who did not receive texts, 25% stopped taking their medicine completely, or took less than 80% of it.
In the text group, that figure was 9% - 14 out of 150 patients.
There were only three patients who did not start taking the medicine again after receiving advice.
Prof Wald, consultant cardiologist at Queen Mary University of London, said there was a range of reasons why people stopped taking their medicine, including uncertainty over the need for treatment and concerns over potential side-effects, often prompted by negative reports of statins they had read in the media.
"In general, patients really valued the text messages and were disappointed when they stopped."
David Taylor, emeritus professor of pharmaceutical and public health policy at University College London, said text messaging could be coupled with each relevant prescription and prevent several thousand heart attacks and strokes in the UK annually.
It could also be used for other diseases, he said.
Maureen Talbot, senior cardiac nurse at the British Heart Foundation, added that the study was small but encouraging.
"It's crucial that heart patients take prescribed treatments to control their blood pressure and cholesterol as it helps reduce their risk of having a heart attack or stroke.
"Carrying out a larger study over a longer period would help establish the full extent of the benefits of sending this type of reminders to patients."

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Friday, 28 November 2014

yellow fever

Early sign of yellow fever could lead to new treatment

MacaquesScientists analysed the gene activity in macaques after they were infected with yellow fever

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Picking up early signs of yellow fever, an infectious disease which can be fatal, could lead to a new treatment and better diagnosis, a study said.
Writing in the journal PLOS Neglected Tropical Diseases, US scientists looked at the virus in macaques, in the first study in primates for more than 20 years.
They found out how the virus damages the body and which genes it disrupts.
The World Health Organisation (WHO) said the study was encouraging.
The virus, endemic in tropical areas of Africa and Latin America, can cause jaundice and kidney failure and mainly targets the liver.
It kills 50% of people infected if they are not treated, the WHO said. There are around 200,000 cases of the infection every year.

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This research work is at an early stage and, although encouraging, will need additional work in both animal models and on human beings ”
No approved drug
Researchers at the University of California, Riverside, gave 20 macaques yellow fever. A control group were given the virus and the vaccine, to compare the results.
The study said within 24 hours of the virus, 90% of the animal's lymphocytes, or white blood cells, had been lost in all 20 animals, leaving it vulnerable to infection.
Yellow fever does not present in humans until quite a late stage, said lead author Ilhem Messaoudi in California, and there are no approved drugs to treat it, meaning early diagnosis is crucial for survival as it allows for rehydration and supportive care.
She said it was extremely challenging to get the vaccine to people in remote areas who need it and that it was not safe for babies and the elderly.
The loss of white blood cells occurred before changes in the liver, the study found, meaning if this translated to humans, doctors could spot it earlier and the chances of survival could be improved.
'Quick analysis?'
Researchers also looked at the macaques' genes and 800 were found to have been switched on within 72 hours of the initial infection, compared to the control group.
Twenty-five percent of the monkeys survived the infection, said Ms Messaoudi. She said she would now be looking at what it was, genetically, in those animals that made them survive, with a view to developing a drug.
She said: "Can we use gene expression as a diagnostic in the clinic - could we run a quick analysis on patients' white blood cells and determine which infected person is at high or low risk?
"Supportive care would follow for all patients, but it would change the dynamics of how aggressive the treatment needs to be."
William Augusto at the WHO said: "This research work is at an early stage and, although encouraging, will need additional work in both animal models and on human beings to better estimate its implications in terms of diagnostics and antiviral therapy."

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From other news sites

A&E care 'still unsafe'

Medway Maritime Hospital A&E care 'still unsafe', CQC says

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A Kent hospital's A&E department is still failing to protect patients from "inappropriate or unsafe" care, a health watchdog has said.
The Care Quality Commission (CQC) said assessment of patients at Medway Maritime Hospital "remained flawed".
The CQC's deputy chief inspector of hospitals, Edward Baker, said it was the hospital that caused them the "most concern".
The hospital said it had made a number of changes since the CQC inspection.
Inspectors highlighted confusion over the movement of patients from the A&E department, which is in special measures, to wards in the hospital.
Inspectors found one patient was at the A&E department at the hospital in Gillingham for more than 12 hours, and was then assigned to a ward bed only to be told later it was no longer available.
Another patient remained in a trolley for nine hours, when policy said all patients should be transferred to a bed within six hours of arrival.
The report, following an inspection on 26 August, said: "We have taken enforcement action against Medway Maritime Hospital to protect the health, safety and welfare of people using this service."

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We realise the challenges before us”
Dr Phillip BarnesMedway NHS Foundation Trust
An earlier inspection at the hospital, which was put into special measures in July 2013, found a "crisis situation" with bloodstained walls, overcrowding and potentially life-threatening unsafe practices.
'Lack of leadership'
The CQC wrote to Medway NHS Foundation Trust in July, resulting in an action plan being devised.
In its latest report, the commission said: "The pace of change remained slow; the ability to introduce change was hindered by the continued lack of leadership within the department.
Medway Maritime HospitalThe hospital trust has been in special measures since July 2013
"However, we were reassured that the trust was in the process of appointing experienced nurses to lead the workforce as well as commissioning external specialists in emergency medicine to help improve the safety of the department.
"We have judged that the trust continues to fail to ensure that patients are protected from the risks of receiving care or treatment that is inappropriate or unsafe."
The trust said: "Two new emergency care consultants took post in September and October, there is now a dedicated head of nursing in the department and three new emergency care matrons will all be in post by 2 December."
A spokesman said work was under way to "improve patient flow" and "alleviate congestion in the emergency department".
A new children's emergency department is due to open in December.
Dr Phillip Barnes, acting trust chief executive, said: "We realise the challenges before us and are fully committed to providing the high quality of care our patients deserve."

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More than 70% of fresh chickens being sold in the UK are contaminated with the Campylobacter bug

Supermarket chickens: 70% affected by food bug

fresh chicken

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More than 70% of fresh chickens being sold in the UK are contaminated with the Campylobacter bug, the Food Standards Agency (FSA) has revealed.
The figure is higher than in previous tests, which suggested a 59% contamination rate.
The highest rate was found in chickens being sold by Asda. Tesco was found to have relatively low rates of contamination.
Asda said it was disappointed, but was working hard to find a solution.
It is the first time that individual retailers have been named by the FSA, in an attempt to improve standards.
The agency said the results showed that there was still "a long way to go" before consumers are protected from the bug.
However, it reassured consumers by saying that Campylobacter is easily killed by thorough cooking.
Campylobacter is the biggest cause of food poisoning in the UK, responsible for 280,000 cases a year, and around 100 deaths.
Poultry is responsible in the majority of these cases.

Consumer advice on chicken

chicken pieces
  • Cover it in the fridge
  • Place it on the bottom shelf
  • Do not wash raw chicken
  • Wash utensils after preparation
source: FSA
Low risk
In its latest study, the FSA tested just under 2,000 fresh chickens.
When measured at the highest levels of contamination, it found that Asda was the worst offender, with 28% of its chickens having a concentration of more than 1,000 colony-forming units per gram.
Marks and Spencer was the next worst, with 22% of its birds contaminated.
Tesco, with an 11% contamination rate, was the only one of the major retailers with a better record than the industry average.
"These results show that the food industry, especially retailers, need to do more to reduce the amount of Campylobacter on fresh chickens," said Steve Wearne, the director of policy at the FSA.
"If chicken is cooked thoroughly and preparation guidelines are properly followed, the risk to the public is extremely low," Mr Wearne added.
Other advice from the FSA includes:
  • Covering raw chicken and storing it at the bottom of the fridge, so juices cannot drip on to other food
  • Not washing raw chicken, which can spread germs through splashing
  • Washing utensils and surfaces used to prepare raw chicken
Some experts believe roasting chicken inside a bag is also useful, as it eliminates skin contact.

Supermarket chickens: rates of contamination

Retailer% samples with Campylobacter% samples with high-level Campylobacter
Asda
78%
28%
Co-op
73%
19%
M&S
67%
22%
Morrison's
69%
21%
Sainsbury's
69%
14%
Tesco
64%
11%
Waitrose
69%
16%
Others
76%
25%
Source: FSA
New technology
Asda said it welcomed the transparency of the FSA's findings, but said it was already working on new technical solutions to reduce contamination.
"We take campylobacter seriously and it goes without saying that we're disappointed with these findings," said an Asda spokesperson.
"There is no 'silver bullet' to tackle this issue, but along with other retailers, we're working hard to find a solution," he added.
Among the new solutions being worked on is SonoSteam, being trialled by Asda across its poultry suppliers.
The technology uses steam to kill bacteria on the surface of the chicken during processing.
Marks and Spencer has developed a five-point plan of interventions along the food chain to tackle the issue.
The British Poultry Council said there was little statistical difference between the retailers, which have "levels in the same range".
Professor Chris Elliott, director of the Institute for Global Food Security, who led a government inquiry into food safety, said he was satisfied that enough was now being done to tackle the issue.
"I'm not aware of any region in the world working harder to find solutions to this problem but in my opinion, having looked at all the evidence, there is no quick fix," he said.
Further tests will now be carried out by the FSA, particularly on chickens sold by smaller retailers and butchers.

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