News in brief - Nov. 30, 2009

California court upholds drug treatment program

California physicians said a recent appeals court ruling preserves a voter-approved initiative allowing nonviolent drug offenders to enroll in community-based rehabilitation programs instead of facing jail sentences.

California's 1st District Court of Appeal on Nov. 5 invalidated a 2006 law permitting judges to incarcerate people who have drug relapses during treatment, saying the statute undermined the voter-backed Substance Abuse and Crime Prevention Act.

Physicians worried the law, if upheld, would have hurt the effectiveness of rehabilitation programs if courts -- not medical professionals -- could interrupt participants' treatment because of a relapse, according to a friend-of-the-court brief filed by the California Medical Assn.

At this article's deadline, the state, which supported the 2006 law, did not return calls seeking comment on the possibility of a further appeal in Gardner v. Schwarzenegger.

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Most adverse events undisclosed

Sixty percent of patients who experience adverse events in the hospital do not receive explanations about why or how the mistakes occurred, according to a study in the Nov. 9 Archives of Internal Medicine (archinte.ama-assn.org/cgi/content/abstract/169/20/1888/).

The study of 603 patients who experienced 845 adverse events, as verified by a team of clinical reviewers, found that adverse events that required additional treatment or hurt patients in good health were more likely to be disclosed.

"Hospital staff are selective about which events they disclose," the study's authors said.

The study randomly sampled adult patients at Massachusetts hospitals between April 1 and Oct. 1, 2003. The movement among doctors and hospitals to disclose mistakes has picked up since then.

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New video available on effective communication with patients

The Joint Commission and the Dept. of Health and Human Services Office for Civil Rights have released a video that explains health care organizations' obligations when communicating with patients who have limited English proficiency or hearing impairments.

The video, "Improving Patient-Provider Communication: Joint Commission Standards and Federal Laws," is available on the commission's Web site (www.jointcommission.org/patientsafety/hlc).

The video provides guidance in determining the best methods to meet special communication needs and identifies tools that health care organizations can use to build effective language access programs. It also addresses organizations' obligations to translate written documents.

HHS and the commission do not endorse one approach to ensuring language access but recommend using resources and modes of interpretation that are necessary, accessible and in working order.

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Nicotine patch and lozenge best for smoking cessation

The most effective smoking cessation treatment is the combined use of a nicotine patch and lozenge, according to findings published in the November Archives of General Psychiatry (archpsyc.ama-assn.org/cgi/content/short/66/11/1253/).

A randomized, placebo-controlled trial assigned 1,504 adults who wanted to quit smoking to various treatments: nicotine lozenge, nicotine patch, bupropion, nicotine patch plus nicotine lozenge, and bupropion plus nicotine lozenge or placebo.

Six months after quitting, participants who used the nicotine patch and lozenge displayed the highest smoking cessation rate at 40.1%.

This content was published online only.

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