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Thursday, October 28, 2010

ActionToQuit Tobacco Cessation Summit in New England

Partnership for Prevention’s ActionToQuit summit for the New England area was held on October 19 in Framingham, Massachusetts. The event brought together organizational representatives, leaders, and advocates from six states to learn about and discuss tobacco cessation policy strategies. The summit was convened by the American Lung Association, which received a grant from Partnership for Prevention to develop an action plan for tobacco cessation in New England.

David Zauche, Senior Program Officer at Partnership for Prevention, presented on the ActionToQuit Program and addressed the impact of health reform on tobacco cessation policies. He emphasized the need to strengthen cessation coverage for Medicaid beneficiaries. As of 2010, federal health reform mandates that all pregnant women insured under Medicaid be eligible for cessation treatment at no cost to them. While this is a step forward, Partnership for Prevention advocates that this benefit be extended to all Medicaid subscribers, providing barrier free access to comprehensive treatments for all tobacco users.

The focus of this summit was the Massachusetts Medicaid benefit, which the other five New England states will attempt to replicate. Lois Keithly, Massachusetts Tobacco Cessation and Prevention Program, and Ayesha Cammaerts, formerly of MassHealth’s Office of Clinical Affairs, presented information on the outstanding Massachusetts initiative, which shed light on several previously unanswered questions:

• If a tobacco cessation benefit is offered and promoted heavily, will a large number Medicaid subscribers use it?
• If they use the benefit, will a large number quit smoking?
• If this occurs, can there be positive short term benefits as well as long term? 

The results were remarkable. Over a thirty month period 75,000 Medicaid subscribers in Massachusetts used the tobacco cessation benefit, and 33,000 quit smoking. The smoking rate for this population dropped from 38% to 28%, representing a 26% decrease. Additionally, significant decreases were seen in hospitalization rates for heart disease.

The key to the success of this program, at least in great measure, was the heavy statewide promotion of the benefit and aggressive encouragement of smokers to use it. Various media were used to reach the Medicaid population: television, radio and transit ads ran for over a year and there was direct education campaign to health care providers and medical societies. Consumer awareness of the cessation benefit in the Medicaid population reached 75%.  

While the surprising success of the Massachusetts experience is unique, many states will begin to replicate the program in the near future. At this summit, teams of advocates from the other five New England states are already busy organizing their own state summits, action plans, and advocacy campaigns.   

Posted by: Brian McCue at 12:00 AM
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Labels: ActionToQuit, AmericanLungAssociation, Massachusetts, Medicaid, tobaccocessation

Wednesday, October 27, 2010

Surgery checklist saves lives, no decrease in sodium intake named “Best/Worst News for Prevention”

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

Big VA Study Shows Surgery Checklist Saves Lives

Answering such basic questions from surgery checklists — and involving everyone as a team, even patients — saved lives in Veterans Affairs hospitals, according to one of the most rigorous studies of patient safety in the operating room.

Surgery deaths dropped 18 percent on average over three years in the 74 VA hospitals that used the strategy during the study. Surgery team members all created checklists and discussed them in briefings before, during and after surgery. That's a somewhat novel concept in a setting where the surgeon has traditionally called all the shots.

Americans Still Reaching for the Salt Shaker

Despite constant pleas by public health experts to hold the salt, the sodium intake of the U.S. population hasn't decreased over the past 46 years, according to a new review.

Most of us eat a lot more sodium than is recommended, says researcher Adam Bernstein, MD, ScD, a research fellow in the department of nutrition at Harvard School of Public Health in Boston.

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best/Worst News for Prevention” polls are snapshots taken during a brief period of time that reflect the views of Partnership for Prevention staff. The polls are not designed or intended to reflect a statistically valid representation of the population and should not be used as such. More information is available at

Posted by: Brian McCue at 12:00 AM
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Labels: best/worst, hospital, sodium, surgery

Friday, October 22, 2010

Aspirin Use for Primary Prevention Shows Big Savings

A new study printed in Current Medical Research and Opinion found that aspirin use for primary prevention of cardiovascular disease (CVD) could produce overall savings of $79.6 million dollars over 10 years for a base population of 1 million patients , while use for secondary prevention shows a savings of $32.2 million. Aspirin use for primary prevention was also shown to save $29 million in out of pocket costs, which is an immediate benefit for patients.

The study measured cost savings associated with aspirin use for the prevention of CVD. Savings are seen if this preventive service was increased to reflect current guidelines with the greatest savings for primary prevention (i.e. in those patients without CVD, but at risk).  Current clinical guidelines recommend aspirin use for the primary prevention of heart disease in men and stroke in women. 

In addition to producing millions of dollars in savings, the study reported that aspirin use for primary prevention of CVD would prevent 1273 heart attacks, 2184 angina events, and 565 ischemic strokes in a base population of 1 million patients.  Aspirin use for the primary prevention of CVD is not just financially valuable – it saves lives. 

Partnership for Prevention supports aspirin use for the primary prevention of heart disease and stroke.  Partnership convenes the Aspirin Task Force (ATF), a multidisciplinary group of experts committed to promoting aspirin use for the primary prevention of cardiovascular disease. The ATF supports the USPSTF recommendations, and encourages men and women to speak to their health care provider to decide if aspirin use is right for them.

In addition to the aspirin initiative, Partnership’s National Commission on Prevention Priorities (NCPP) has identified aspirin use for primary prevention as one of the highest value clinical preventive services.  In fact, the NCPP reports that if 90% of those who were recommendation to use aspirin did use aspirin, 45,000 lives per year would be saved.

This study, along with Partnership’s initiatives, shows the importance of aspirin use for the primary prevention of heart disease and stroke.  In particular, the study reinforces the value of utilizing preventive services to benefit our healthcare system and society as a whole.

Posted by: Brian McCue at 12:00 AM
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Labels: aspirin, AspirinTaskForce, cardiovasculardisease, heartdisease, NCPP

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