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Bleeding In Cirrhosis Patients May Be Reduced By Adherence To Practice Guidelines

Compliance with practice guideline-recommended treatment for cirrhosis is associated with a reduction in first esophageal variceal hemorrhage (EVH; bleeding), according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute. Cirrhosis is a condition in which the liver is permanently scarred or injured.

"Esophageal variceal hemorrhage is a serious complication of cirrhosis, and the mortality rate associated with it is high at 20 percent," said Jayavani Moodley, MD, of the Cleveland Clinic Foundation and lead author of the study. "This high mortality rate makes primary prevention of bleeding the best approach to improving outcomes for these patients."

In this study, doctors conducted an Institutional Review Board-approved retrospective chart review on 179 adult patients selected by computerized randomization, newly evaluated for cirrhosis at the Cleveland Clinic from 2003 to 2006. These patients were followed for 23 months; doctors assessed actual compliance rates of gastroenterologists with current practice guidelines, which recommend screening and intervention for high-risk esophageal varices. Subsequent bleeding rates were also determined.

The study authors reported that 94 percent of the patients had a screening endoscopy (EGD), with 80 percent having one within six months of the initial visit. Varices were present in half of the patients. In addition, 68 percent of all patients screened and 91 percent with large varices received a practice guideline-recommended treatment. Seven percent had an episode of EVH; 82 percent of patients without bleeding had their screening EGD within six months versus 50 percent of those with bleeding. The likelihood of bleeding at two years, as predicted by the North Italian Endoscopy Club model, was 13 percent versus 27 percent.

"Our study suggests that the significant reduction in observed bleeding rates may be related to adherence to practice guideline-recommended care. Patients who did not bleed were more likely to have received their screening EGD within the six-month window as compared to those who bled, demonstrating the effectiveness of early variceal screening," added Dr. Moodley.

The risk of developing gastroesophageal varices in patients with cirrhosis is between 50 percent and 66 percent, and 30 percent to 40 percent of patients with varices suffer a variceal hemorrhage. If untreated, variceal hemorrhage portends a 70 percent risk of death within one year.

About Cirrhosis:

Cirrhosis occurs when the liver is permanently scarred or injured by chronic conditions and diseases. The scar tissue that forms in cirrhosis harms the structure of the liver, blocking the flow of blood through the organ.

Source:

Alissa J. Cruz

American Gastroenterological Association

News sourced from:

http://www.medicalnewstoday.com

http://www.medicalnewstoday.com/articles/199205.php

Invitation to participate in discussion about Herceptin treatment

Breast Cancer Aotearoa Coalition is assisting Atlantis Healthcare to recruit women to participate in a research project.

You are invited to participate in a discussion about the information and support you have received about Herceptin treatment.
The interviews will take the form of an informal discussion covering:

your perceptions of the information and support you have received about Herceptin;
any challenges you have faced with regards to undergoing Herceptin treatment; and
the kinds of support and information you think would help women during their treatment journey.

To thank you for participating in this study, we will be offering you a a small monetary koha.

Your participation in the research is completely voluntary.

Eligibility

To be eligible to participate in this research, you will be a woman living in the Auckland region and:

be just about to start Herceptin treatment; or
are currently taking Herceptin treatment; or
have stopped your Herceptin treatment before the end of the 12-month course, or opted only for the 9-week course.

What you need to do:

To participate in this study, or for further information, please contact Kate Perry, Principal Investigator at Atlantis Healthcare on (09) 373 4907, or via email This e-mail address is being protected from spambots. You need JavaScript enabled to view it by Wednesday, 1st September 2010.

This research project is funded by Roche Pharmaceuticals.

“Congratulations to Andrew McLaren, delighted winner of a new Apple iPad”.

Andrew entered the competition to “Think like a patient” at the recent Eye4Pharma Marketing Excellence and Analytics conference held in Sydney.

$20 million investment to drive growth for Atlantis Healthcare

Atlantis Healthcare, a company focused on developing solutions to a multi-billion dollar global healthcare problem, is set to ramp up its global strategic expansion programme following the announcement of a new partnership with an international private investment company.

Younger Breast Cancer Patients Most Likely To Discontinue Treatment, Study Finds

About half of breast cancer patients do not take their medication for the recommended period of time, according to a study published Tuesday in the Journal of Clinical Oncology, USA Today reports (Szabo, USA Today, 6/29).

Getting Patients To Take Their Asthma Meds

Armed with the right information, physicians can play a stronger role in ensuring asthma patients don't waver in taking drugs proven to prevent asthma attacks, according to researchers at Henry Ford Hospital in Detroit.

Programs Try Cash Incentives To Get Forgetful Patients To Take Meds

The New York Times reports on a new approach to getting patients to take their medications consistently: financial incentives.

Health Care Quality Issues: The Disconnect Between Patients And Experts

The Kansas City Star: Improving "health literacy" could help improve patient outcomes and quality. This literacy is "the limited ability to understand the technical jargon, the orders, the prescriptions and the forms coming from doctors, nurses, pharmacists and insurance companies.

How Personalised Outreach Can Boost Adherence

Kate Reid, general manager of Atlantis Healthcare UK, outlines the benefits of an individualised approach to non-compliance.

Consumers Roundup: More Patients Choose High-Deductible Plans; Many Neglect Doctors' Medication Directions

A number of news outlets explores consumer health issues.

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