This Week in Managed Care: September 18, 2020

Wildfire and pandemic hazards test US mental and physical health, Managed Care Cast discusses Ochsner Health’s Connected Maternity Online Monitoring Program, and key opinion leaders preview their discussions at Patient-Centered Oncology Care® 2020.

Welcome to This Week in Managed Care, I’m Matthew Gavidia.

Concurrent Wildfire, Pandemic Hazards Test US Mental, Physical Health

In California alone, wildfires have consumed over 3.2 million acres, an area larger than all of Connecticut, with skies as far east as Baltimore, Maryland, appearing blurred while temperatures drop due to smog blocking the sun’s rays.

As the smoke threatens to worsen outdoor air quality across the country, concerns of indoor air quality are mounting due to reports detailing how insufficient ventilation systems facilitate aerosol spread of COVID-19.

The combined hazards put residents in a challenging position as they weigh exposure risks. Beyond the potential of seasonal affective disorder, prolonged isolation due to social distancing and the inability of some residents to leave their homes to exercise or socialize due to air pollution have led to an increase in patient-reported headaches and signs of depression.

Relief from the dangerous air is not expected until later this week for some western states, but meteorologists warn areas of central California, already plagued by a heat wave, may not see relief until October.

In an open letter addressed to President Donald Trump, Washington Governor Jay Inslee implored the president to acknowledge the role climate change plays in the ongoing fires—a notion President Trump has not accepted, as he continues to blame poor forest management for the infernos.

“Wildfires are not new in the Western states, yet the 21st century is quickly laying claim to the worst levels of devastation we have ever seen,” said Inslee. “It took 5 days for 2020 to become our state’s second-worst fire season on record with more than 600,000 acres burned, eclipsed only by the 1.1 million acres burned in 2015.”

For more, visit ajmc.com.

Dr Joseph Biggio Discusses Ochsner Health’s Connected MOM Program, COVID-19 Pregnancy Challenges

As COVID-19 continues to spread throughout the country, practices and health systems are transforming care to limit exposure to those who may be at greater risk of severe complications.

At Ochsner Health, the largest nonprofit academic health care system in Louisiana, providers are leveraging the system’s Connected Maternity Online Monitoring, or MOM, digital medicine program to minimize expectant mothers’ risks of contracting COVID-19.

In the latest Managed Care Cast by The American Journal of Managed Care®, we spoke with Dr Joseph Biggio Jr, MD, MS, the system co-chair of Women’s Services and system chair for Maternal-Fetal Medicine at Ochsner Health. Dr Biggio explains how the Connected MOM program functions and lays out the challenges expectant mothers face during a pandemic.

“I think as we have moved through the last 6 months,” says Biggio, “we have been able to try to adapt the care for patients in both the in-patient and out-patient setting to ensure that we are doing everything that is in our power to keep patients and their families as safe as possible.”

For the podcast, visit ajmc.com.

Patient-Centered Oncology Care® 2020

Leading up to Patient-Centered Oncology Care®, or PCOC®, 2020, The American Journal of Managed Care® has interviewed several key opinion leaders who will take part in this year’s virtual conference.

Among those interviewed include, co-chairs of PCOC® 2020 Drs Joseph Alvarnas, MD, and Kashyap Patel, MD, as well as:

• Dr Karen Winkfield, MD, panelist of the session, “Impacting Health Care Disparities in Oncology”
• Dr Harlan Levine, MD, who will present a featured discussion on “Optimizing the Impact of the Cancer Revolution”
• Antonio Ciaccia, panelist of the session, “PBMs and Access to Pharmacy Care in a Value-Based Care Environment”
• Drs David Jackman, MD, and Kerin Adelson, MD, panelists of a discussion on clinical pathways
• And Dr David Debono, MD, panelist of the session, “Precision Health and Value-Based Care”

For all of the pre-conference videos and to register for PCOC® 2020, visit ajmc.com.

Pain 1 of 3 in a Cluster of Symptoms Affecting Men After Prostate Cancer

In findings from a recent analysis, 1 in 13 survivors of prostate cancer are afflicted with pain, fatigue, and depression as one cluster of symptoms.

This cluster of symptoms is not unknown in cancer, and taken individually, they are also known in prostate cancer. The authors noted that up to 75% of prostate cancer survivors may experience cancer-related fatigue. Urethral pain is reported by 16% following radiation therapy. And on average, 18% of survivors have depression after treatment.

However, the authors sought to explore the specific association of this cluster with prostate cancer. Besides wanting to know the prevalence of this sequelae in prostate cancer, the researchers also aimed to understand more about the factors shared by these survivors.

Assessing a study cohort of survivors of prostate cancer from both Northern Ireland and the Republic of Ireland, the most common treatments received were external beam radiation therapy, by 51% of participants, and radical prostatectomy, which was administered to 28%.

In examining the cluster of symptoms:

• 24% of participants were found to experience clinically significant pain,
• 19.7% had clinically significant fatigue,
• 14.4% had depression,
• and 7.3% had all 3 symptoms.

The median health-related quality of life score was 75 of a possible 100.

“More attention should be paid to identifying and supporting survivors who experience multiple symptoms; this may help health-related quality of life improve among the growing population of prostate cancer survivors,” the authors said.

For more, visit ajmc.com.

European Committee for Research and Treatment in Multiple Sclerosis

This past weekend, the European Committee for Research and Treatment in Multiple Sclerosis, or ECTRIMS, presented its 2020 meeting in a virtual format.

AJMC.com provided full coverage of the virtual meeting, which took place September 11-13.

In addition to written coverage of late-breaking sessions, AJMC.com has a wide array of video interviews discussing topics within multiple sclerosis, such as the role of MS nurses in diagnosis and care management and the impact of comorbidities, sex differences, and genetics on MS treatment responses.

Keep an eye out for future AJMC coverage of an encore day of the ECTRIMS meeting with late-breaking abstracts and a COVID-19 session coming up on September 26.

For full conference coverage, visit ajmc.com.

Paper of the Week

And, now our paper of the week, which looks back at some of the most important papers over the past 25 years of The American Journal of Managed Care^® and why they matter today.

Health systems dealing with COVID-19–related depression, especially among seniors, may look to a paper that appeared in our February 2008 issue.

The authors of “Long-term Cost Effects of Collaborative Care for Late-life Depression” found that over a 4-year period, providing mental health services in the same setting as primary care resulted in substantial savings in the overall cost of care, even though that savings was not seen in the first year.

This method of delivering care also brought substantial clinical improvements.

For the paper, visit ajmc.com.

For all of us at AJMC^®, I’m Matthew Gavidia. Thanks for joining us!