(HealthDay News) — Most women who’ve been diagnosed with breast cancer don’t go it alone.
Many breast cancer patients depend on family and friends to help them make treatment decisions, get to doctor appointments and seek out other resources. A new study finds half of women rely on three or more people to help them through it.
“People just diagnosed with cancer are often scared and overwhelmed. Having another person to help them process information is important,” said study lead author Lauren Wallner, an assistant professor of general medicine and epidemiology at the University of Michigan.
“Physicians need to recognize that women involve other people in their treatment decisions,” she added in a university news release. “These people represent an important group to provide information about treatment options.”
For the study, the researchers surveyed about 2,500 women who had recent surgery for early stage breast cancer. The women were asked to list the people who had helped them weigh their treatment choices.
Half of the women involved at least three people in their treatment decisions, and 20 percent relied on two. Almost 75 percent said supporters had talked with them about treatment and had often joined them for doctor appointments.
Only 10 percent had no one to help them make treatment decisions, according to the study published online recently in the journal Cancer.
“When considering these complex treatment options and going through these complex decisions, it’s beneficial to have the support of other people. This helps women feel supported in their decisions,” Wallner said in the news release.
Black and Hispanic women had larger support networks than white women, the study authors found.
“Minority women tend to have larger networks, so clinicians should also be aware that there could be differences in the number of people patients might be involving. And these networks go beyond just a partner or spouse,” Wallner said.
Women who had a spouse or partner also reported more support, but many who were single also had a large group of people to help them with treatment decisions. Patients with early stage cancer have some time to decide what to do, Wallner noted.
“The idea that women are discussing their options more with their family and friends, and potentially thinking through that decision more carefully is reassuring. Engaging these informal support networks could be a way to prevent women from rushing into something,” she suggested.
The study authors said women without a support network might need extra help to make informed decisions.
“It starts with something as simple as physicians asking patients who is helping them make their treatment decisions,” Wallner said. “That can then guide the conversation, such as the amount of resources the physician provides and to whom they communicate that information.”
(HealthDay News) — Smartphones are capturing all of life’s moments, and doctor visits are no exception.
At least 1 in 10 U.S. patients now records discussions at medical appointments, researchers said.
But do they have the right to do so?
The legality of these taped visits depends on where you live, said investigators from the Dartmouth Institute for Health Policy and Clinical Practice.
“In the U.S., the situation is complex,” said professor and senior scientist Dr. Glyn Elwyn.
“Wiretapping or eavesdropping statutes provide the primary legal framework guiding recording practices and protecting privacy, so a patient who would like to record a doctor’s visit should familiarize themselves with laws in their state,” Elwyn said.
There are two main differences between state wiretapping laws, Elwyn and his colleagues said in a new report.
In “all-party” states, recordings made by doctors or patients are illegal unless everyone involved is aware and provides consent.
In “one-party” states, just one person involved in a conversation needs to be aware and consent to the recording. Only in these states can patients legally record an office visit without their doctor’s consent and vice versa.
The authors said 39 states and Washington, D.C., follow the one-party consent rule; all others adhere to the all-party requirement.
How are patients using these increasingly common recordings?
After reviewing 33 studies involving audio-recorded clinical visits, the researchers found that about 7 out of 10 patients listened to their own recordings. A similar number shared them with a caregiver.
In many cases, patients used the tapes to remember important details about their office visits.
“Most people are sharing their recordings with a family member or caregiver, or they are listening to recording themselves, so they can better recall the information they received during the encounter,” Elwyn said in an institute news release.
Patients said the recordings left them feeling more satisfied with their care.
“Health care overall is moving toward greater transparency and patient recordings are going to become more common,” Elwyn said.
“That means there would be tremendous benefit to patient advocacy groups, health care organizations, providers and policymakers working together to develop clear guidelines and policies around the responsible, positive use of open recordings,” he added.
While some doctors and hospitals worry that taped appointments and procedures will be used against them, others take a more positive view. The Barrow Neurological Institute in Phoenix, for example, encourages patient-doctor recordings and rewards doctors who comply, the researchers said.
The report was published July 10 in the Journal of the American Medical Association.
SOURCE: Dartmouth Institute for Health Policy and Clinical Practice, news release, July 10, 2017
(HealthDay News) — Every minute of every day, three Americans call a poison control center because they’ve made a major mistake with their medication.
Some have taken the wrong dose. Some have double-dosed, and others have taken the wrong medicine altogether.
The result: the rate of serious mix-ups has doubled since 2000, a new study reports.
Four out of 10 mistakes involve heart medications, painkillers or hormone therapy prescriptions, including insulin. And the errors often put patients in the hospital, the study found.
“Ever more drugs for ever more diagnoses in ever more people invites ever more error and adverse reactions,” said Dr. David Katz, director of the Yale University Prevention Research Center. He was not involved with the study.
The study researchers used U.S. National Poison Data System records to track errors involving prescription or over-the-counter medications taken outside a health care facility. Most of the drugs were taken at home, meaning patients, not health care professionals, made the mistakes.
The rate of serious medication errors rose from 1.09 for every 100,000 Americans in 2000 to 2.28 per 100,000 by 2012. One-third of the cases resulted in a hospital stay, the researchers said.
“Fortunately, most do not result in the serious outcomes found in this study,” said lead author Nichole Hodges. She is a research scientist with the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio.
But Hodges said the extent of the problem may be worse than the findings suggest.
“Because this study includes only medication errors reported to poison control centers, it is an underestimate of the true number of serious medication errors in the U.S.,” she said. “Unfortunately, we can’t tell from the data whether serious medication errors are occurring more frequently, or whether they are simply being reported more often.”
Nationwide, at least 1.5 million medication errors occur every year, with poison control centers logging them at a rate of one every 21 seconds.
The study found medication errors outside a medical facility shot up across all age ranges except one: children under age 6.
Among that young group, errors rose between 2000 and 2005, then started to fall. The study pointed to less use of pediatric cough and cold medicines after 2007, when the U.S. Food and Drug Administration advised parents to stop giving those drugs to children.
Most of the errors involved taking the wrong medicine, the wrong dosage or accidentally taking a medication twice.
Two-thirds of deaths in the study involved heart medicines and painkillers combined.
Heart medication mistakes accounted for more than a fifth of errors, while hormone therapy drugs such as insulin accounted for 11 percent.
Painkillers were involved in 12 percent of poisonings, and roughly 80 percent of painkiller mistakes involved products with acetaminophen (such as Tylenol) or an opioid drug.
Hodges said most medication mistakes can be prevented.
“Keeping a written log of when medications are administered can be a helpful strategy for parents and caregivers,” she said. “This is especially important if multiple individuals are administering medication to an individual.”
Hodges said patients should to talk to their doctor or pharmacist if they have questions about their medicines. Careful storage is also important.
“Individuals who use weekly pill planners should [also] ensure that they are child-resistant and stored up, away and out of sight of children,” Hodges added.
Drug makers could help, she noted, by improving drug packaging and labeling. In particular, she said, dosing instructions should be easier for people with limited reading and math skills.
The findings were published July 10 in the journal Clinical Toxicology.
SOURCES: Nichole Hodges, Ph.D., research scientist, Center for Injury Research and Policy, Nationwide Children’s Hospital, Columbus, Ohio, and adjunct assistant professor, Ohio State University College of Medicine, Department of Pediatrics, Columbus; David Katz, M.D., M.P.H., director, Yale University Prevention Research Center, New Haven, Conn., and past president, American College of Lifestyle Medicine, Chesterfield, Mo.; July 10, 2017, Clinical Toxicology
(HealthDay News) — Seniors who believe they have a purpose in life may sleep better, researchers say.
Those who have good reasons to get up every day are less apt to have problems that keep them awake at night, such as sleep apnea and restless leg syndrome, according to a new study. People tend to have more trouble sleeping as they age, the researchers added.
“Helping people cultivate a purpose in life could be an effective drug-free strategy to improve sleep quality, particularly for a population that is facing more insomnia,” said study senior author Jason Ong. He’s an associate professor of neurology at Northwestern University’s Feinberg School of Medicine in Chicago.
The study included more than 800 people between the ages of 60 and 100 who did not have dementia. Those who said their lives had meaning were 63 percent less likely to have sleep apnea and 52 percent less likely to have restless leg syndrome. They also had a moderately better quality of sleep.
Sleep apnea is a common condition where a person’s breathing pauses several times an hour. This disruption causes excessive sleepiness during the day. Restless leg syndrome causes uncomfortable sensations in the legs and an urge to move them, often while sitting or lying in bed, the researchers said.
Only an association was seen between having purpose and sleep quality. And while the study focused on seniors, the researchers said the findings probably apply to others.
“Purpose in life is something that can be cultivated and enhanced through mindfulness therapies,” Ong said in a university news release.
He also said clinicians prefer non-drug solutions to improve sleep, a practice recommended by the American College of Physicians as a first-line treatment for insomnia.
The study was published July 9 in the journal Sleep Science and Practice.
(HealthDay News) — Financial stress during pregnancy could increase the risk of having a smaller baby, a new study suggests.
Researchers call this “pregnancy-specific distress.” And it “includes concerns about labor and delivery, about relationships changing, about working after the baby arrives, paying for medical care, and whether the baby will be unhealthy,” said study senior author Lisa Christian in an Ohio State University news release.
She is an associate professor of psychiatry at the university’s Institute for Behavioral Medicine Research.
Previous research has shown that lower-income mothers are more likely to have smaller babies and worse birth outcomes. For this study, the researchers wanted to identify the specific factors responsible for this increased risk.
Their study included 138 pregnant women with an average age of 29. The women were between five and 31 weeks pregnant when they completed questionnaires to assess their mental health and any concerns they had about having a child.
After birth, the babies’ medical records were checked to see what impact mom’s money concerns and other worries might have had on her baby’s weight.
The study found a link between distress in pregnancy and a baby’s weight, though it did not prove a cause-and-effect relationship. In addition, the study authors noted there were only 11 low birth weight babies in the study. They suggested a larger study should be done to confirm their findings.
Still, “there is an opportunity here to look for interventions during pregnancy that could help mitigate the effects of financial strain on birth outcomes,” said lead author Amanda Mitchell, a postdoctoral researcher in Ohio State Wexner Medical Center’s Stress and Health in Pregnancy Research Program.
Programs to improve access to housing, jobs and support for low-income women are important, but low-cost stress-reduction techniques such as meditation and breathing exercises could also help reduce risk, according to Mitchell.
“It’s important for all women who experience pregnancy-related stress to seek out help coping with that stress,” she said. “And ob-gyns and other medical providers should also talk about stress during their visits with expecting moms.”
The study was published recently in the journal Archives of Women’s Mental Health.
(HealthDay News) — No doubt that work, school and outside activities can make it hard to schedule regular family dinners. But research has shown that eating together on a regular basis helps to bond families and build good communication.
For children, the benefits range from better grades to getting along well with others. Kids and adults alike are also more likely to eat healthy meals and less likely to be overweight.
When busy schedules make it hard for everyone to sit down to dinner, use other meals to build togetherness. For instance, get everyone up 15 minutes early for a breakfast sit-down, or plan a regular weekend brunch where everyone pitches in. When dinner has to be fast food, eat at the restaurant instead of doing a pickup so you still have the chance to sit and talk, even if only for a few minutes.
There are also plenty of ways to build togetherness in addition to mealtime. Schedule regular outdoor activities, like a weekend walk on a nature trail or an afternoon at the playground. Make plans for a regular indoor activity, like family game night. Or, find a hobby everyone could enjoy. Perhaps take a vote on the activity, and then let each family member choose a role that will keep them involved.
The goal: Building togetherness, whether at the dinner table or beyond.
(HealthDay News) — Sizable numbers of adults with risk factors for heart attack — such as smoking, obesity or physical inactivity — aren’t inclined to do anything to improve their health, a large, new study finds.
Among those at greatest risk, meaning they having five or more risk factors, almost 1 in 5 did not feel they needed to make any changes, the study revealed.
Researchers can’t say exactly why this disconnect exists.
“Our study suggests that the link between risk perceptions and behaviors is complex,” said Dr. F. Daniel Ramirez, the study’s lead author. He is a research fellow at the University of Ottawa Heart Institute in Ontario, Canada.
But Ramirez and his co-authors don’t think indifference is simply due to a lack of education or appreciation of health consequences.
As study senior author Dr. Benjamin Hibbert explained in an American Heart Association news release, “Effectively convincing people to adopt and sustain healthy lifestyle changes requires a better understanding of what makes them tick.”
Among people in the study who perceived a need to improve their physical health, more than half cited barriers to change. The most common were lack of self-discipline, work schedule and family responsibilities.
Cardiologist Dr. Vincent Bufalino, a spokesman for the American Heart Association, said conversations about reducing risk factors occur in examining rooms across America every day.
“Some folks are totally motivated and they’re all over it: watching their diet, on their exercise program, mindful of their blood pressures and [blood] sugar,” he said. “Then there’s the folks that, you know what, no matter what we say, we can never quite move them on behavior.”
The challenge is changing behavior, said Bufalino, who is president of Advocate Medical Group in Downers Grove, Ill.
“Putting a stent in someone [is] the easiest thing. Now we have to change the way you’ve been living the last 25 or 30 years,” he tells patients. “That’s hard.”
Ramirez said little information exists on what really motivates people to adopt healthy behaviors. Hoping to shed some light on the topic, he and his team examined a database of more than 45,000 adults participating in the 2011-2012 Canadian Community Health Survey.
The survey gathered data on eight “modifiable” risk factors for heart attack: smoking, high blood pressure, diabetes, obesity, stress, excess alcohol consumption, lack of physical activity and poor diet.
Along with high cholesterol, which was not part of the study, these factors account for 90 percent of heart attack risk, the study authors noted.
Researchers calculated the number of risk factors per person based on survey responses. They also asked people if they thought there was anything they could do to improve their health.
Overall, almost three-quarters of respondents agreed there were ways to improve their health. The vast majority of these people identified a specific behavior change as being most important. Common responses included exercising more, losing weight, eating better, and quitting or cutting back on smoking.
The number of people acknowledging a need to make health changes increased with the number of risk factors they reported. Among those with three or more risk factors, nearly eight in 10 said they needed to change their health habits.
After adjusting for factors such as age, education, income and having a regular health care provider, older and white people were more likely than younger people and minorities to say they needed to improve their health.
Bonnie Spring is director of the Center for Behavior and Health at Northwest University’s Feinberg School of Medicine in Chicago. She isn’t “overly surprised” that some people have trouble perceiving that lifestyle changes can improve health.
Study participants seemed to be “connecting bad habits to weakened will, rather than poor health,” Spring said.
Lack of education is rarely the root cause of unhealthy behavior, she explained.
However, “increasing people’s confidence about being able to change” might help, Spring said.
The study found that people with diabetes or high blood pressure were no more likely to perceive a need to change than people without those conditions.
Perhaps that’s because these medical conditions are not visible to others, unlike smoking, obesity and physical activity, Spring reasoned.
If that’s true, “it sounds like positive social norms for healthy lifestyle may be starting to take effect,” she said.
The study was published May 3 in the Journal of the American Heart Association.
SOURCES: F. Daniel Ramirez, M.D., research fellow, University of Ottawa Heart Institute, Ontario, Canada; Vincent Bufalino, M.D., national spokesman, American Heart Association, and president, Advocate Medical Group, Downers Grove, Ill.; Bonnie Spring, Ph.D., professor, preventive medicine, and director, Center for Behavior and Health, Northwest University Feinberg School of Medicine, Chicago; May 3, 2017, news release, and May 2017, Journal of the American Heart Association
(HealthDay News) — Hundreds of new genes tied to the start of puberty have been identified.
Researchers analyzed data from nearly 369,000 women and pinpointed 389 genetic signals linked to the timing of puberty. That’s four times the number that had been known.
The study also found new genetic evidence linking earlier puberty to increased risk in later life for several cancers that are sensitive to sex hormones. Those include breast, ovary and endometrial cancers in women, and prostate cancer in men.
“Previous studies suggested that the timing of puberty in childhood was associated with risks of disease decades later, but until now it was unclear if those were circumstantial observations, for example, secondary to other factors such as body weight,” said study senior author John Perry. He is a senior investigator scientist in the epidemiology unit at the University of Cambridge in England.
The genetic influences remained after the researchers compensated for body weight. This is important because body weight influences the timing of puberty as well as the risk of some cancers.
“Our current study identifies direct causal links between earlier puberty timing itself and increased cancer risk,” Perry said in a university news release. “This link could possibly be explained by higher levels of sex hormones throughout life, but we need to do more work to understand the exact mechanisms involved. We aim to understand these disease links and thereby contribute to the prevention of diseases in later life.”
The start of puberty, which is when sexual maturity begins, varies widely from person to person but tends to be similar within families.
Earlier puberty may have some advantages, such as for boys playing competitive sports, but it appears to have mostly negative effects in later life, according to the researchers. Among them: higher risks of heart disease and some cancers.
The study also identified unusual variations in two so-called imprint genes — ones that are active only when inherited from one parent but not the other.
“We identified rare variants in two genes, which both lower the age of puberty when inherited from your father, but have no effect when inherited from your mother. This is intriguing as it suggests that mothers and fathers might benefit differently from puberty occurring at earlier or later ages in their children,” joint senior author Ken Ong said in the news release. Ong is head of the MRC Epidemiology Unit’s Growth and Development program at the university.
The study was published April 24 in the journal Nature Genetics.
(HealthDay News) — Doctors should screen all pregnant women for preeclampsia, a serious complication tied to high blood pressure, according to the U.S. Preventive Services Task Force.
Expectant mothers should have their blood pressure checked throughout their pregnancy — even if they have no signs or symptoms of preeclampsia, according to the task force’s final recommendation released Tuesday.
The USPSTF, an independent panel of experts, makes evidence-based recommendations about preventive medical services.
Preeclampsia typically develops after 20 weeks of pregnancy. It’s a leading cause of premature delivery and low birth weight in the United States, the task force explained.
“Preeclampsia can progress quickly and lead to severe complications for both the mother and infant,” said task force member Dr. Maureen Phipps.
“It is critical that women be screened for preeclampsia during every clinical visit throughout their pregnancy,” Phipps said in a news release from the panel.
After reviewing existing evidence, the task force concluded that blood pressure screenings are a safe and effective way to help prevent serious complications that can stem from preeclampsia.
Pregnant women with the condition can have a stroke or seizures. They could also have organ failure. This pregnancy complication can also be dangerous for babies, inhibiting their growth in the womb or resulting in low birth weight, early labor or death, the panel noted.
Preeclampsia could also cause the placenta to detach from the uterus.
Delivery is the only treatment for this complication, often before the baby’s due date, the task force said.
“If a pregnant woman has high blood pressure during a clinical visit, she should receive further testing and evaluation,” said task force vice chair Dr. David Grossman. “Several high blood pressure measurements are needed to diagnose preeclampsia.”
The USPSTF recommendation was published online in the Journal of the American Medical Association.
SOURCE: U.S. Preventive Services Task Force, news release, April 25, 2017
(HealthDay News) — In rare cases, seizures that cause convulsions and a loss of consciousness can raise the odds of sudden death in people with epilepsy, neurologists warn.
These attacks are known as generalized tonic-clonic seizures, according to a new guideline from the American Academy of Neurology (AAN) and the American Epilepsy Society.
Just how rare is sudden death linked to these seizures? According to guideline researchers, these tragedies occur in 1 in 1,000 men and women each year and only 1 in 4,500 children annually.
Still, although rare, it’s crucial that the possibility of sudden death linked to seizures and risk factors for these events “are communicated to persons and families affected by epilepsy,” said guideline author Dr. Cynthia Harden. She’s with Mount Sinai Health System in New York City.
“Our guideline brings clarity to the discussion, giving health care providers practical information they can use to help people with epilepsy reduce their risk,” Harden said in an AAN news release.
Epilepsy experts agreed that patient education is key.
“Better understanding of this information may help to encourage people with epilepsy to take their medications regularly, promote a healthier lifestyle, and consider all potential medical and surgical treatment options to achieve seizure freedom and lower their risk,” said Dr. Meghan Fleming. She’s an epilepsy specialist at Lenox Hill Hospital in New York City.
The new guideline found that people with three or more tonic-clonic seizures a year are 15 times more likely to die unexpectedly than people who do not have these types of seizures.
“Educating health professionals and people with epilepsy about [the risk of sudden death] is an important first step,” said Harden.
“This guideline makes the conversation much easier with information that may motivate people to take their medications on time, to never skip taking their medications and to learn and manage their seizure triggers so they can work toward reducing seizures. People who follow their medication schedule or pursue other treatments such as surgery may be more likely to become seizure-free,” she said.
The AAN also advises doctors to work with their patients to prevent seizures, weighing the risks and benefits of medication or surgery.
Dr. David Friedman directs the Comprehensive Epilepsy Center at NYU Winthrop Hospital in Mineola, N.Y. He agreed that the guideline “emphasizes optimizing seizure control” as a means of avoiding the very rare but potential risk of death.
The new guideline was presented April 24 at the AAN’s annual meeting, in Boston. It was also published online in the journal Neurology.