Friday, February 22, 2008

Quick Takes

Glucosamine may not work in arthritis.

As reported in the Annals of Internal medicine, a study in the Netherlands involving 222 patients with hip osteoarthritis showed no difference in pain relief and function when taking glucosamine sulfate.

Though these results are disappointing, don't throw out your glucosamine just yet. These studies are hard to do, because measuring pain has some degree of subjectivity to it. The study was also small. An earlier Meta-analysis of several glucosamine studies found it to be affective. However, a more recent large NIH sponsored trial of 1583 patients with symptomatic knee osteoarthritis published in the New England Journal found no improvement. Given that glucosamine is relatively safe, if you have osteoarthritis and paying for this won't set you back too much, then trying it may be worthwhile. However, if you are not seeing any major improvement, there is evidence to suggest it may not work.

Just 1 in 4 know heart attack signs

Several sources are mentioning on a report from the CDC that only about one-third of U.S. adults are aware of the five major warning signs of heart attacks. This study conducted interviews over the telphone in 72,000 people and found:
48% recognize pain or discomfort in the jaw, neck, or back as a warning sign;
62%, feeling weak, lightheaded, or faint;
85%, pain or discomfort in the arms or shoulder;
92%, chest pain or discomfort;
93%, shortness of breath.

This is actually WORSE than a few years ago, when 1 in 3 Americans could recognize all of these as heart attack warnings. We need to do a better job or educating patients about the warning signs of a heart attack and what to do. In the survey 86% said they would dial 911 if they thought someone was having a heart attack or stroke. This means that 14% wouldn't know to do this!

Google gets into health care

The NY Times reported today that Google was partnering with the Cleveland Clinic and implementing Google's version of a personal health record where patients can keep track of medications, illnesses,etc. and which could be accessed by physicians and pharmacists.

There are certainly privacy issues that need to be dealt with here, but this is a step in the right direction. For patients with chronic illnesses on multiple medications, it is difficult to keep track of what medicines to take and when, let alone things like home blood pressure readings, laboratory results, medication allergies, etc. Though I think these will ultimately be helpful, Google (and others) need to make sure these integrate with Electronic Medical Records used by physicians and hospitals. In addition, the digital divide still exists in this country, so we need to make sure that the underserved have access to the Internet.
For more information on personal health records, Medline Plus has several excellent resources. If you can't wait for Google's version to come to you, you can try the Microsoft product or myPHR or iHealthRecord (this is not an endorsement, since I haven't used these myself or had feedback from any patients).

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