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Pharmacists Help Control Hypertension

Teaming physicians with pharmacists who counsel patients and make medication recommendations shows promise in the treatment of uncontrolled hypertension, according to the Center for the Advancement of Health. In a study of 95 men and women whose blood pressure remained uncontrolled after three physician visits in the previous six months, researchers found that those who received diet and exercise counseling and medication advice from a pharmacist were more likely to achieve blood pressure control than were patients who received medical care alone.

"A team approach between physicians and pharmacists may have positive effects even in high-risk minorities in whom control of hypertension is especially difficult to achieve," Dr. Paul Bogden, of the University of Hawaii, Honolulu, and colleagues report in the November issue of the Journal of General Internal Medicine. Forty-nine of the 95 patients were randomly assigned to meet with a pharmacist before their regular physician visit. The pharmacists counseled them on diet, exercise, and other lifestyle factors, as well as on the importance of following their prescribed medications. Pharmacists also reviewed patients' medication regimens and made recommendations to their physicians about less expensive or better formulations.

Overall, 55 percent of those who saw a consultant pharmacist achieved blood pressure control, compared with 20 percent of those who received medical care alone. The pharmacist intervention was also shown to be effective among Hawaiians of mixed ancestry: eight of 13 mixed-ancestry patients in the intervention group achieved blood pressure control, compared with only two of 11 in the regular medical care group.

Interestingly, even patients who had no change or decrease in their blood pressure medication appeared to benefit from the pharmacist's intervention, the researchers say. "In these patients, compliance, changes in diet, reduction in alcohol consumption, and weight reduction may have been important," the researchers say, noting that changes in these risk factors may have resulted more from the greater individual attention that the pharmacists were able to give the patients than from their pharmacological expertise.
See related articles in the AgeVenture archives.
"Pharmacists Monitor Patient Blood Pressure"
"Diet & Lifestyle May Lower Blood Pressure"
"HOT Therapy Lowers Blood Pressure"
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New Anesthetics Foster Surgery Trend

New anesthetic agents and improved surgical techniques now enable patients to wake up and recover from anesthesia in a fraction of the time of traditional medications. "These recent medical strides have made it safe for some types of surgery to take place in doctors' offices", says Dr. Jeffrey L. Apfelbaum, at the recent annual meeting of the American Society of Anesthesiologists. Dr. Apfelbaum estimates that seven to ten percent of surgery is already being performed in office settings, and he says the trend is growing. As a case in point, a University of Chicago study involving five community hospitals found that 15 to 40 percent of of patients who underwent outpatient surgery with new, short-acting anesthetics were able to safely bypass the recovery room altogether.

The trend toward office-based surgery is also being fueled by the anesthesiologist's ability to deliver comprehensive, state-of-the-art anesthesia care in office settings without compromising patient safety and comfort. "As with outpatient surgery, office-based surgery began with minor procedures such as the removal of moles but is quickly progressing to major procedures, including gall bladder removals, breast augmentation surgery and pacemaker placements", says Apfelbaum. It's hard to say where the trend will stop. "It took a long time for patients and third-party payers to accept ambulatory surgery, and yet today, 70 percent of surgery is performed on an outpatient basis."

Another contributing factor to this trend is the fact that many procedures today are performed with regional anesthesia instead of general anesthesia. This technique numbs only a specific region of the body, allowing pain relief up to 36 hours after surgery. The technique also improves patient comfort by replacing or reducing the need for narcotics, which can impede recovery because they can cause drowsiness, nausea, and other adverse side effects.

Dr. Apfelbaum believes this new surgery trend will be driven by safety and patient demand. Patients will begin to feel more secure about the procedure if they learn to ask their surgeon three important questions. First, ask whether the surgery will be done in the hospital, outpatient surgical center, or in the doctor's office. Second, ask what method of anesthesia will be used (local, general, regional block). Third, ask if there will be an anesthesiologist available who will continually monitor your vital signs throughout the procedure. The American Society of Anesthesiologists is the nation's leading professional association of anesthesiologists, and is headquartered in Park Ridge, Illinois.
See related articles in the AgeVenture archives.
"AGS Launches Pain Management Guidelines "
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Keeping Mature Minds Mentally Alert

Contrary to traditional wisdom, older people can frequently choose to keep their minds sharp, says John W. Rowe, M.D., Mount Sinai Hospital during an interview with New Choices magazine. Rowe aptly summarizes current research findings into the following tips on how to keep your mature mind sharp. See related articles in the AgeVenture archives.
"Estrogen May Slow Memory Loss"
"Brain Booster"
"Double Your Brain Power, plus the Brain Quiz"
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Teeth Tips Address Elder Dental Concerns

Older adults have special oral health needs and concerns, but with the right care and hygiene habits, they can keep smiling through the years. The University of Michigan School of Dentistry faculty have identified the following tips to address the many aspects of oral health in older people. See related articles in the AgeVenture archives.
"Seniors Attentive to Dental Hygiene"
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Pfizer Funding Fosters Elder Care Innovations

The National Council on the Aging, in partnership with Pfizer Inc, awarded five community-based organizations $25,000 each to create new, innovative programs to serve the needs of the nation's swelling ranks of family caregivers.

Family caregivers are persons who assist older people with tasks of every day living. NCOA and Pfizer began the Innovations in Independent Living Program to enable older people to live independently in their own homes rather than seeking institutional care. Caregivers are often untrained persons who find themselves helping an older friend or relative -- but they have special needs that often go unaddressed in the equation of care for an older person.

Five programs were selected from 250 applications across the country. The five community organizations will use the $25,000 Innovations in Independent Living grant to start the following new programs. Pfizer is a research-based, global health care company. Pfizer discovers and develops innovative, value-added products that improve the quality of life of older people around the world and help them enjoy longer, healthier, and more productive lives. The company has three business segments: health care, animal health, and consumer health care. Products marketed by Pfizer are available in more than 150 countries.
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Center for Assisted Living Launches Website

The American Health Care Association's (AHCA) assisted living component, the National Center for Assisted Living (NCAL), has launched its new web site. Internet users can now access information that describes the services offered by and issues affecting assisted living providers.

"The Center was designed to meet the information and education needs of assisted living providers," said NCAL Executive Director David Kyllo. "This new web site, located at www.ncal.org, offers quick access to consumer information, statistics, leading policy issues and news about assisted living services."

The NCAL web site offers a user friendly format and a variety of destinations. Internet users can learn about assisted living facts, statistics, trends and philosophy as well as tap into state-by-state law summaries. A consumer guide and information on finding a facility is also available. Other subject areas include long term care insurance; the latest topics and news stories about assisted living; and materials describing professional development products, seminars, conferences and conventions. The site features links to related interest areas.

NCAL is the assisted living component of the AHCA -- the nation's largest long term health care association. AHCA is a federation of 50 affiliated associations, representing more than 11,000 non-profit and for-profit assisted living residences, nursing facilities and subacute care providers nationally.
See related articles in the AgeVenture archives.
"Assisted Living Agency Expands Into Europe"
"National Assisted Living Week"
"Assisted Living is a Booming Industry"
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