AMA wants to increase screenings for HIV, STIs, and viral hepatitis
Amid the pandemic, clinical visits for HIV, sexually transmitted infections (STIs), and other evidence-based preventive services in the U.S. declined.
The American Medical Association (AMA) announced a new initiative aimed at addressing this issue by helping physicians and other health care professionals increase routine screenings for HIV, STIs, viral hepatitis and latent tuberculosis (LTBI).
As part of this effort, the AMA, with the support of the Centers for Disease Control and Prevention (CDC), worked to understand key barriers and drivers for implementing routine screening and developed a toolkit to provide best practices and strategies to enhance screening programs. The AMA is collaborating with several community health center sites that will test the quality improvement strategies outlined in the toolkit to determine their impact on routine screening, as well as provide overall feedback on the toolkit before it is disseminated more broadly.
“Routine screening and early detection of HIV, STIs, viral hepatitis, and LTBI are critical to ensure patients receive treatment and also lower their risk of transmitting these infectious diseases to others,” said AMA President Jack Resneck Jr., M.D. “Given that access to preventive services were interrupted by the COVID-19 pandemic, many individuals may not even be aware they have an infection and are at risk of contributing to new infections. We know that social inequities and stigma continue to be barriers to screening. We believe this new toolkit will help increase screenings and prevent further spread of these infectious diseases. Additionally, with the monkeypox virus outbreak declared a public health emergency, the overlap in populations disproportionally affected, and the benefits of a syndemic approach, we look forward to the opportunity to work with the clinic sites in addressing this public health threat.”
Survey: Cancer the “top driver” of employer health care costs
Cancer has overtaken musculoskeletal conditions as the top driver of large companies’ health care costs, according to the Business Group on Health’s 2023 Large Employers’ Health Care Strategy and Plan Design Survey. While the top three conditions fueling health care costs remained the same from last year – they include cardiovascular disease, in addition to cancer and musculoskeletal conditions – 13% of employers said they have seen more late-stage cancers and another 44% anticipate seeing such an increase in the future, likely due to pandemic-related delays in care. A total of 135 large employers across varied sectors, who together cover more than 18 million people in the United States, completed the survey between May 31, 2022, and July 13, 2022.
Other top areas of concern included:
- After experiencing no increase in actual health care cost from 2019 to 2020, employers experienced a significant return to rising costs, with a median 2021 cost increase of 8.2%.
- Despite rising costs, employers expect to cover 82% of the cost of employee coverage in 2022, up from 80% the year before (employer support for family coverage remains at 80% of premium). As costs increase, employers have been reluctant to shift costs to employees in the short-term and are looking at fundamental delivery system reforms, such as advanced primary care and centers of excellence for specific health conditions, to address unsustainable health care expenses and prescription drug costs.
- Large employers overwhelmingly (99%) said they were concerned about prescription drug trends. In 2021, prescription drugs accounted for a median of 21% of employers’ health care costs, with more than half of pharmacy spend going to specialty medications. Employers have opportunities to bring down costs through pharmacy program tactics, including biosimilar coverage, site of care and case management, among others.
- Long-term mental health issues, both observed and anticipated, are the leading health-related impact of the pandemic, employers said, with increases in medical services due to delayed care a close second. Some 43% have already seen this trend and another 39% anticipate such increases. In response, employers plan to keep many pandemic-related health and well-being offerings in place for the foreseeable future; 85% will do so for mental health.
First-in-human trial shows promise for treating heart rhythms
A first-in-human multicenter trial involving Mayo Clinic used a new ablation technique for patients with ventricular tachycardia, an abnormally rapid heart rhythm that is a leading cause of sudden cardiac death worldwide.
The trial tested needle ablation using in-catheter, heated, saline-enhanced, radio frequency energy, also known as SERF, to substantially increase heat transfer, compared to conventional ablation methods. The new process produces deeper, controllable lesion scars at sites inside the heart muscle. The catheter can accurately control the ablation size and treat tissue that is deeper in the heart wall, which is where life-threatening arrhythmias that cause ventricular tachycardia are often found.
Therapies of medication and traditional ablation, which uses heat or cold to scar small areas of heart tissue, may not be enough to prevent ventricular tachycardia. Therefore, many patients also have an implantable cardioverter-defibrillator (ICD) to address dangerous arrhythmias. While an ICD shock corrects the heart’s rhythm, it does not prevent arrhythmia. In the trial, researchers used several methods to directly eliminate abnormal heart tissue that causes life-threatening rhythm.
“This preliminary trial is important because it suggests that there is a new way to treat problematic ventricular tachycardia by reducing or eliminating the shocks that ICDs deliver. It appears to be effective in achieving this goal,” says Douglas Packer, M.D., a cardiac electrophysiologist at Mayo Clinic, first author and principal investigator of the study. “For clinicians, it provides hope that treatment in the electrophysiology lab may be effective, even if other treatments failed. For patients, it provides hope that their quality of life can be improved.”
The innovative catheter was developed by Michael Curley, Ph.D., of Boston-based Thermedical Inc., with funding from the National Institutes of Health (NIH). Dr. Curley is senior author of the research findings that are published in Circulation: Arrhythmia and Electrophysiology.