
Leslie Citrome, MD, MPH, of New York Medical College, discusses payer coverage of atypical antipsychotics with fewer metabolic side effects.

Leslie Citrome, MD, MPH, of New York Medical College, discusses payer coverage of atypical antipsychotics with fewer metabolic side effects.

A survey of patients with ADHD showed that two-thirds of those who augment their morning medication do so because it stops working, and 42% have to plan their day around their medication fading.

There is a stigma that comes with being addicted to opioids, even if they are prescribed to manage pain, that can hurt the care patients need to receive, said Arwen Podesta, MD, ABPN, FASAM, ABIHM, of Tulane University.

Payers have made tremendous progress in improving oversight of opioids and other pain medications, but what is really needed is a shift to abuse-deterrent formulations, which are more expensive, said Thomas Kosten, MD, a psychiatrist with Baylor College of Medicine.

The debate over marijuana policy tends to be dominated by people with political "skin in the game," when what's needed is a balanced, evidenced-based review, said Kevin P. Hill, MD, MHS, of Beth Israel Deaconess Medical Center and Harvard Medical School.

Experts said that the frequency and quality of social relationships have a greater effect on mortality than obesity or drinking alcohol, and this commands attention from health systems.

Right now, state policy regarding medical marijuana use is out ahead of the science, which can lead to predicaments where cannabis is prescribed in situations where it is not needed, explained Kevin P. Hill, MD, MHS, of Beth Israel Deaconess Medical Center and Harvard Medical School.

Patients with childhood trauma may have reduced response to antidepressant agents, and physician need to be given more free rein to tailor treatment approaches to treat those with major depressive disorder, said Vladimir Maletic, MD, MS, clinical professor of neuropsychiatry and behavioral science at the University of South Carolina School of Medicine.

Changes under the DSM-5 mean that certain "mixed features" create a gray area of characteristics that could signal major depression or bipolar disorder, even if a patient has not exhibited hypomania.

Screening for depression in the primary care setting can take as little as 30 seconds, but screening is only effective if it actually leads to intervention, explained Michael E. Thase, MD, professor of psychiatry and director of the Mood and Anxiety Program at the University of Pennsylvania.

Studies show that the earlier a child with attention-deficit/hyperactivity disorder is treated with stimulants, the less likely he or she is to develop a substance abuse problem later in life.

John Eikelboom, MD, of McMaster University discusses the 3 outcomes of the COMPASS trial that address the main concerns of patients.

The majority of patients with pulmonary arterial hypertension, except for a few special circumstances, will begin treatment on combination therapy, instead of monotherapy, because combination therapy has been shown in trials to ahve better outcomes, explained Simon Gibbs, MD, Reader in Pulmonary Hypertension at the National Heart and Lung Institute, Imperial College London.

The perspective of the decision maker in healthcare affects the meaning of value and the US healthcare system is still trying to figure out how to measure value, said Darius Lakdawalla, PhD, Quintiles Chair in Pharmaceutical Development and Regulatory Innovation at the School of Pharmacy at the University of Southern California.

Healthcare providers can encourage cardiac patients to adhere to exercise and diet guidelines by asking how they are doing with recommendations and emphasizing the importance of following through, explained Christi Deaton, PhD, RN, FAHA, FESC, of the University of Cambridge.

Two recent trials have demonstrate which types of patients are benefit the most from being treated with PCSK9 inhibitors, explained Steven Nissen, MD, of Cleveland Clinic.

Ilene Hollin, PhD, MPH, the National Pharmaceutical Council and University of Southern California Schaeffer Center’s Postdoctoral Health Policy Fellow, discusses what needs to be included in the next generation of value assessment frameworks in order to best identify value that is representative of all patient preferences.

Researchers have known for years: what happens to mom in pregnancy affects the baby. That holds true with prenatal exposure to air pollution, which has lingering cardiovascular effects, such as birth defects and a higher risk of obesity, explained Jeanette Stingone, PhD, of Mount Sinai Health System.

The United States can benefit from taking and adapting certain elements of European countries’ systems and methods of assessing value, says Patricia Danzon, PhD, the Celia Moh Professor at The Wharton School, University of Pennsylvania.

Patients can self-manage their cardiovascular disease and improve their quality of life by improving diet, being more physically active, taking medications as prescribed, and being partners in their care with their healthcare provider, said Christi Deaton, PhD, RN, FAHA, FESC, of the University of Cambridge.

The rivaroxaban plus aspirin combination therapy to treat patients with stable coronary or peripheral artery disease showed such benefits in the COMPASS trial that it should become the standard of care, said John Eikelboom, MBBS, MSc, FRCPC, associate professor at McMaster University.

Patients with heart failure tend to have other health issues, requiring cardiologists to understand how to care for heart failure while keeping in mind treatment for these other comorbidities, said panelists at the European Society of Cardiology Congress 2017, held August 26-30 in Barcelona, Spain.

Pulmonary arterial hypertension requires vigilant monitoring beyond just a superficial conversation, including several yearly tests and analyses, according to Simon Gibbs, MD, Reader in Pulmonary Hypertension at the National Heart and Lung Institute, Imperial College London.

The results of the COMPASS trial testing rivaroxaban plus aspirin in patients with coronary artery disease or peripheral artery disease showed such significant benefits for reducing ischemic events that it was stopped early, explained Deepak Bhatt, MD, MPH, of Brigham and Women's Hospital and Harvard Medical School.

For each level of cardiovascular risk, lifestyle factors remain a significant contributor that can be modified to reduce risk. However, some risk will remain nonmodifiable and require therapy, according to panelists during a session on cardiovascular prevention at the European Society of Cardiology Congress 2017, held August 26-30 in Barcelona, Spain.

Emergency cardiac care is an interesting challenge for digital health but it has a lot of potential if it can bring together the public and the healthcare system to create app, predictive models, and more to be able to detect stroke and acute myocardial infarction earlier, explained John Rumsfeld, MD, PhD, chief innovation officer at the American College of Cardiology.

Rivaroxaban plus aspirin has significant benefits for patients with peripheral artery disease (PAD) and stable coronary artery disease, according to the results of the COMPASS (Cardiovascular OutcoMes for People using Anticoagulation StrategieS) trial, presented at the European Society of Cardiology Congress 2017, held August 26-30 in Barcelona, Spain.

Trial results that will be presented at the European Society of Cardiology Congress 2017 in Barcelona, Spain, will open up a new window into treatment for patients at risk of major cardiovascular events, explained Steven E. Nissen, MD, of Cleveland Clinic, at the start of the conference.

A one-size-fits-all approach to value is impossible in the US healthcare system, but a pluralistic approach is extremely complex to implement, says Ilene Hollin, PhD, MPH, the National Pharmaceutical Council and University of Southern California Schaeffer Center’s Postdoctoral Health Policy Fellow.

A combination of different countries’ health systems can set an example for the United States to follow in efforts to restrain the ongoing increases in drug prices, explains Patricia Danzon, PhD, the Celia Moh Professor at The Wharton School, University of Pennsylvania.

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