News in brief - April 10, 2006

Addressing the metabolic syndrome information gap - Patients on newer diabetes drugs are more compliant - Telephone counseling a successful smoking cessation tool - Syphilis rates among women end 13-year decline

Addressing the metabolic syndrome information gap

Issues surrounding metabolic syndrome continue to perplex the health care community. Some see an information gap in the medical profession's understanding of current strategies for recognizing, treating and managing this syndrome. The American Medical Association and the Foundation for Better Health Care will co-sponsor the first regional forum to address recent evidence-based medical findings. The meeting, April 21-22 in Philadelphia, is planned in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education. For information or to register, call 312-464-2588 or go online (www.diabesityxchange.com).

Patients on newer diabetes drugs are more compliant

Diabetics who were prescribed newer medications were more likely to take these drugs as instructed than patients who were prescribed drugs that have been on the market for several decades, according to research published in the March Current Medical Research and Opinion.

The newer drugs can be 10 times more expensive than older ones, researchers said. But they found that the extra cost was balanced by the expense cut in other aspects of health care. Patients on newer drugs also had a slightly lower risk of hospitalization because of diabetes-related complications.

Researchers analyzed records from more than 3,000 patients in the North Carolina Medicaid program who took thiazolidinediones (TZDs) or either metformin or a sulfonylurea to control their diabetes. TZDs (pioglitazone and rosiglitazone) were approved by the Food and Drug Administration in the 1990s, while metformin and the sulfonylureas have been on the market for 50 years.

Patients who took a TZD spent an average of $76 to $150 less per month on total costs, including the price of medications, than did those taking the cheaper drugs. "Taking a TZD as instructed was the strongest predictor of a reduced risk of hospitalization and decreased health care costs in this group of patients," said lead author Rajesh Balkrishnan, PhD, Merrell Dow Professor of Pharmacy at Ohio State University in Columbus.

"We're not sure why that was so," Dr. Balkrishnan said. "It could be that the TZD helped get symptoms under control faster."

Funding for the study was provided by Takeda Pharmaceuticals which makes Actos (pioglitazone), a TZD.

Telephone counseling a successful smoking cessation tool

Smokers who receive telephone care and counseling for smoking cessation have higher rates of success than those who receive routine care by health care professionals, according to a study in the March 13 Archives of Internal Medicine.

Researchers studied 837 daily smokers (751 men and 86 women) who received care at five Veterans Affairs medical centers in the upper Midwest. The 417 individuals in the telephone protocol received seven calls over a two-month period, with additional calls as needed at the discretion of the counselor. There were an average of 7.7 counseling sessions by telephone over the following year. The 420 smokers in the standard care group were mailed self-help materials and had continued access to smoking cessation services through their medical center.

After three months in the study, nearly 40% of the telephone care group had not smoked in the previous seven days, compared with 10% in the standard care group. At the one-year mark, 13% of the telephone care group and 4% of the control group had abstained from smoking for the previous six months.

Compared with the those in the standard care group, those in the telephone group also were more likely to use other techniques to help them stop smoking, including smoking cessation counseling programs and medications.

"At a minimum, telephone care for smoking cessation should be made available to veterans who are interested in stopping smoking," the authors conclude.

Syphilis rates among women end 13-year decline

The rate of primary and secondary syphilis stayed the same from 2003 to 2004 among women, ending a 13-year decline of incidence in this population, according to a Centers for Disease Control and Prevention paper published in Morbidity and Mortality Weekly Report last month.

The paper also found that this sexually transmitted infection, which has been on the increase for the past four years overall, grew by 8% in the general population. The higher rate is being blamed primarily on significant increases among men who have sex with men.

Public health officials are calling on physicians to be vigilant about detection and case reporting of this disease in women to prevent this disease from becoming more widespread among in heterosexuals. The agency is also calling for additional educational efforts targeting men who have sex with men who do not identify as gay and who might be spreading this infection to women.