Death of the Pharma Sales Rep?

We’re not feeling a whole load of Christmas cheer among the pharmaceutical industry this festive season.

First came the news that GSK is phasing out all payments to doctors and will no longer be bonusing their reps based on sales.  Now, a new study suggests the end of the road may be nigh for pharma sales reps.

According to a survey of nearly 3,000 physicians undertaken by CapGemini and QuantiaMD, when it comes to receiving clinical and medical info, reps rank last as a resource behind print, digital media and phone links.

• 67% of physicians say digital media is their preferred source of information from drug-makers
• 40%  believe digital media has the most relevant and personalized content
• 52% believe sales reps will eventually become information coordinators
• Only a paltry 20% say reps are their favorite source of information

In parallel, more health care providers are shifting toward larger, organized health systems, which make it more difficult for reps to reach physicians for visits. Sixty four  percent of those surveyed say they restrict rep visits and 31 % of physicians in organized health systems do not allow reps any access, due to corporate policies.

Newer and younger physicians are more likely to rebuff reps – as many as 80%  impose restrictions. 90% of new physicians are joining organized health systems right out of medical school.

“Physicians today are in a time crunch, juggling more commitments than ever before and no longer have the time to dedicate to in-person meetings with pharmaceutical representatives. So the reliance on more digital channels comes as no surprise,” said Dan Malloy, Senior Vice President at Quantia. “This study supports what we’re already seeing from our 200,000 members–that a physician-centric, digital communication model is the most effective way for reaching and engaging doctors.”

On a more positive note, reps slightly edge out other resources when it comes to finding product info and patient education.

Hala Qanadilo, a principal in life sciences at CapGemini says, “While the more traditional face-to-face, in-office visits might decrease, the role of these representatives is projected to be as important as ever. Moving forward, they will need them to be the directors of multiple information sources, customizing their outreach so it is more personalized and physician-centric.”

How are you tackling the changing healthcare environment in these increasingly restrictive times?  We’d love to hear from anyone out there in Pharmaland.

Staying Safe During Holiday Travel

If you’re one of the millions of people planning to travel over the holidays, we’d like you to do it safely. Whether your plans involve car, plane or train take a minute or two to study these simple steps to stay healthy while traveling.

“One health risk to consider when traveling is simply sitting for too long,” says Clayton Cowl, M.D., an expert in travel medicine at Mayo Clinic. “Concerns like blood clots in the legs from sitting too long, becoming dehydrated from lack of fluid intake or drinking too much alcohol, and not walking much when delayed in an airport or train station can be serious. Driving for hours to reach a destination after a long day at work can be as equally worrisome due to fatigue and eyestrain.”

Blood clots can be a concern when a person sits for too long because leg muscles aren’t contracting and blood can pool and stagnate in the vessels. This can lead to deep vein thrombosis and even pulmonary embolism – a potentially fatal condition, caused by clots becoming lodged in the lungs.  When travelling by car, both driver and passengers should stop every few hours to hydrate and walk. Plan ahead, and pick some good rest stops along your route. How about a park, a mall, or a place of interest?

As an added benefit, allowing children to run or play in a safe environment while traveling will often help curb their excessive energy in a confined space and may help them relax while traveling for longer periods.

When traveling by plane, check the in-flight magazine for tips on how to exercise in your seat and on trips longer than three hours, get up at least once to take a walk to the bathroom or other end of the plane.

And regardless of how you travel, try to avoid crossing your legs while sitting for long periods, because this can inhibit adequate blood circulation.

If you’re the one doing the driving, plan to get a good night’s sleep the day before the trip, to avoid drowsiness during the journey. If possible, take turns at the wheel with other passengers. Take breaks at rest stops and chose healthy low carb meal options, to avoid crashing after a sugar high. Combining meals or rest room stops with a short walk to get fresh air and stretch can make a big difference in staying more alert and refreshed.

While we all want to just get to our destination for the holidays, budgeting a little extra time to account for unexpected weather delays and adequate driving breaks is a really smart plan.

To avoid stiffness from sitting too long, if you’re a passenger try doing some simple stretches, such as extending legs out and back several times and massaging thighs and calves.

To avoid eyestrain and its associated annoying symptoms including sore or irritated eyes, dry or watery eyes, double vision or blurriness, increased sensitivity to light or unremitting shoulder and neck fatigue never drive if you are sleep deprived.

A short nap can significantly relieve these symptoms and non-medicated eye drops can help if eye irritation persists

Whatever your travel method, avoid dehydration. Drink plenty of water and minimize or eliminate alcohol consumption as alcohol dehydrates at a cellular level.

Above all, plan for the worst, and enjoy the best: When severe winter weather hits, many vehicles may become stranded and help may be hours or sometimes days away. Pack a simple emergency kit, including blankets, snacks, water, charging devices, flashlights and activities to keep kids amused.

Thank You for your attention. Now, please fasten your seat belts, place doors to manual and turn off all cellular devices. You’re ready for the holidays!

Bon Voyage.

Consider Smart Choices rather than Smart Toys this Christmas

Have you finished your Christmas shopping yet or are there still some people left on your nice list?!?

With only 8 shopping days left, SRxA’s Word on Health wants to help you make smart gift choices for the little people in your life.   Bridget Boyd, MD, a pediatric safety expert at Loyola University Health System offers up the following tips to ensure you bring joy, not tragedy, on Christmas morning.

“Christmas is a wonderful time of year, but it can quickly turn tragic if we’re not careful,” says Boyd. “Sometimes in our attempts to make Christmas extra special for our kids and grandkids, safety can get lost in the mix.”

Shopping for infants and toddlers can be difficult since many toys are labeled appropriate for ages 3 and up. Though it may limit the options, Boyd said following age-appropriate guidelines is important for keeping kids safe.

“Age labels are monitored closely and should be taken seriously. Choking and strangulation hazards can mean life or death to a child,” said Boyd. “Most people do follow the guideline to avoid small parts that might be choking hazards, but there are some safety tips that aren’t as obvious.”

She suggests when opening gifts to watch out for ribbons that could be a strangulation hazard and to try to keep older children’s gifts away from younger children so there is not accidental ingestion of a small part. Toys with strings are a choking hazard as well, especially those that are greater than 12 inches in length.

“If a child is under the age of 2, they are more than likely going to put whatever they are given in their mouth, so avoid items with paint, chemicals or small parts,” Boyd said. Small magnets and button batteries are some of the most hazardous. Magnets should be kept away from small children as they cause severe damage or even death if ingested.

“Button batteries are extremely dangerous so try to avoid gifts that include them. They also can be found in musical greeting cards, hearing aids and remote controls so make sure to keep an eye on your child around those items,” Boyd said. “Go to the emergency room immediately if a child has placed a button batter into their body. This includes swallowing as well as shoving up the nose or in the ear.”

Still, gift-giving safety isn’t just about swallowing hazards, it’s also thinking about the entire well-being of a child. “When thinking about what gift to give, try to find something that encourages children to use their imagination and get up and get moving,” says Boyd.

The American Academy of Pediatrics recommends children spend no more than two hours in front a screen a day. This includes video games, computers, phones and TVs. “So many young kids want cell phones, but is that really the best gift to give a child? Think about what is age-appropriate. There will be plenty of time to give phones and videos games in the future.”

And if you do give an electronic gift, supervision is key, especially if it involves the Internet.

Unfortunately, cyber predators and cyberbullying are becoming more common and pose a very real risk to children. If your child does receive a computer for Christmas, make sure you supervise their Internet use. The best place for a computer is in the family room.  There should be no screens, including computers, TVs or phones in a child or adolescent’s room. Screen time can interfere with sleep as well as distract them from participating in healthier activities for body and mind.

Whatever gifts you decide to give this holiday season, It’s also a good idea to periodically check consumer websites such as recall.gov and saferproducts.gov to ensure gifts are safe and have not been recalled.

Could salmon and sunshine prevent brain damage?

Want to keep your brain in tip-top condition? Then you may want to put mackerel and mushrooms on your menu or start eating your salmon in the sun!

That’s because a new study led by University of Kentucky researchers suggests that a diet low in vitamin D causes damage to the brain.

In addition to being essential for maintaining bone health, new evidence shows that vitamin D serves important roles in other organs and tissue, including the brain.

The study, published in Free Radical Biology and Medicine showed that middle-aged rats that were fed a diet low in vitamin D for several months developed free radical damage to the brain. Additionally, many different brain proteins were damaged.  The vitamin D deficient rats also showed a significant decrease in cognitive performance on tests of learning and memory.

“Given that vitamin D deficiency is especially widespread among the elderly, we investigated how during aging from middle-age to old-age how low vitamin D affected the oxidative status of the brain,” said lead author on the paper Allan Butterfield, professor of Chemistry, director of the Center of Membrane Sciences, faculty of Sanders-Brown Center on Aging, and director of the Free Radical Biology in Cancer Core of the Markey Cancer Center. “Adequate vitamin D serum levels are necessary to prevent free radical damage in brain and subsequent deleterious consequences.”

Previously, low levels of vitamin D have been associated with Alzheimer’s disease, and it’s also been linked to the development of certain cancers and heart disease.

The elderly are particularly prone to have low vitamin D levels.

Butterfield recommends that people consult their physicians to have their vitamin D levels determined. If they turn out to be low it’s important to normalize them either through diet or sunlight exposure to help protect the brain.

low that they eat foods rich in vitamin D, take vitamin D supplements, and/or get at least 10-15 minutes of sun exposure each day to ensure that vitamin D levels are normalized and remain so to help protect the brain.
Surprisingly few foods contain vitamin D.  That’s because your body is built to get it from sunlight skin rather than from food. However, if your body has enough, it doesn’t matter whether you got it through your skin or through your stomach.

There are three vitamin D super foods:

• Salmon (especially wild-caught)
• Mackerel (especially wild-caught)
• Mushrooms (exposed to ultraviolet light)

Other food sources of vitamin D include:

• Cod liver oil
• Tuna canned in water
• Sardines canned in oil
• Milk or yogurt – fortified with vitamin D
• Beef or calf liver
• Egg yolks
• Cheese

If all that sounds a little too fishy for you, then you can boost your vitamin D from 10-15 minutes of sun exposure a day.

I’m off to get mine now!

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Keeping Extra Pounds off your Holiday List

Although by now you’ve hopefully now finished the last of the Thanksgiving turkey and pumpkin pie, the holiday eating season has just begun. And, as a result, over the next month, the average American will gain one or two pounds. While that might not sound like much, the annual weight gain adds up from year to year and can lead to significant gains as the years goes by.

So, if the seams on your favorite holiday outfit are already bursting ahead of the onslaught of holiday parties, all-you-can-eat buffets, peppermint bark and eggnog, now’s the time to consider strategies to maintain your current weight and still enjoy the season.

At this time of year, most of us are bombarded with food. High calorie treats appear everywhere you look. Tables are filled with home-made cookies, gingerbread, hot apple cider, and irresistible savory appetizers. But resist you must, says Amy Moore, Ph.D., assistant professor of nutrition and dietetics at Saint Louis University.  Here’s her advice to keep you lean this holiday season:

Be picky about your splurges. You can eat crackers and cheese any time, but the holidays are a time to sample special seasonal treats that people have spent a lot of energy preparing. So, if you’re at a holiday buffet, browse before you graze to size up your best options. If that delectable chocolate dessert beckons, enjoy a slice but pass on the brownies or soda. Allow yourself to indulge, just choose where you want to spend your calories.

Be mindful. When there’s a bowl of chips right in front of you, you are more likely to keep munching without really thinking about it. So pay attention to what you’re eating. Slow down and savor every bite, taking the time to appreciate what you’re putting into your mouth. Watch your portion size.

Plan ahead. If you know you are going to a party in the evening, eat a healthy breakfast and lunch. Don’t starve yourself; in fact, consider eating a snack to take the edge off of your hunger. Bring something healthy to potlucks so at least you can count on one healthy option being offered. Seasonal fruit such as pomegranates, clementines and cranberries are terrific holiday dishes because they are pretty, festive and, best of all, guilt free.

Conversation is calorie-free. Once you’ve taken a plate of food at a holiday gathering, step away from the table. Find a comfy space where you can talk to others. Fill up on fellowship, which is calorie-free!

Water is calorie-free, too. So, drink up. Alternate a glass of water with every alcoholic beverage to pace yourself as you celebrate and prevent a next day hang-over. Consider creating a wine spritzer by adding flavored sparkling water to your wine. Instead of drinking lemonade or soda with a meal, choose water. Not only does water fill you up, it’s also good for your digestive system, skin, muscles and kidneys.

In addition to watching what you eat and drink, you should offset holiday calories by becoming more active. Saint Louis University associate professor of physical therapy and athletic training, Ethel Frese, DPT, offers the following tips:

Be realistic.  Becoming more active is a great way to mitigate a few extra calories, but it is not license to add massively to your diet. So, suppose you splurged and ate a 350 calorie pastry, on top of your normal daily calories. If you want to burn off all of the excess, you’ll need nearly an hour of intense exercise. While it’s not necessary to count every calorie, it is good to have a rough idea of how your calorie intake corresponds to your exercise, and know that it can take more exercise than you might think to balance out your food intake.

Everything counts. That said, don’t be discouraged. Exercise offers many overall health benefits, and burning off even an extra hundred calories a day makes a significant difference. In some cases, extra activity may be a natural part of your routine this season. Walking from the back of a packed parking lot at the mall and scouring stores for the perfect gift provides good exercise. House cleaning for company can burn calories, as can shoveling snow, playing with children and putting up decorations.

Fight the urge to hibernate. If rainy or snowy days tempt you to stay at home watching movies and reading books, be sure you don’t make a habit of avoiding outings. Bundle up and get out for fresh air and exercise. Run errands, stop by to see friends and neighbors, drop off canned goods at a food pantry, check out an exhibit at a museum or build a snowman!

Be consistent. The secret to success is to add a little bit of exercise each day. The effort really does add up, and you’ll find that daily activity makes you feel healthier, more alert, and happier in general. You’ll enjoy the season more without the sluggish feeling brought on by too many sedentary hours. Even if you don’t burn off all of the extra calories through exercise, you’ll limit the damage and in January, you’ll appreciate having only one pound to lose, instead of five.

Remember that the secret to controlling your weight is balancing the calories you take in (food) with the calories you burn. “Even the healthiest eaters need to exercise and the best exercisers need nutrition,” says Moore. “Nutrition and exercise provides the one-two punch of holiday weight management.”

Make your weight management mantra for the season to maintain not gain.

Sniffing Out Leukemia?

OK Ladies – here’s a question for you.   If you suffer from seasonal allergic rhinitis who do you go and see?

(a)  An allergist

(b)  An oncologist

(c)  A hematologist

If you answered (a) you’re probably feeling pretty confident right now.  After all the more common term for seasonal allergic rhinitis is hayfever and that’s something best managed by an allergist.  Right?

Not so fast! Maybe (b) or (c) would have been better choices.  You see, a team of scientists looking into the interplay of the immune system and cancer have just found a link between a history of airborne allergies – in particular those to plants, grass and trees – with risk of blood cancers in women.

Notably, the study did not find the same association in men, which suggests a possible gender-specific role in chronic stimulation of the immune system that may lead to the development of hematologic cancers.

The findings were published online last week ahead of the December print issue of the American Journal of Hematology.

“To the best of our knowledge, ours is the first study to suggest important gender differences in the association between allergies and hematologic malignancies,” says Mazyar Shadman, MD, from the Fred Hutchinson Cancer Research Center.

According to Shadman, who led the research, the immune system’s potential role in the cause of cancer is a focus of intense scientific interest. “If your immune system is over-reactive, then you have problems; if it’s under-reactive, you’re going to have problems. Increasing evidence indicates that dysregulation of the immune system, such as you find in allergic and autoimmune disorders, can affect survival of cells in developing tumors.”

The study included a large sample of men and women aged 50-76 years old from western Washington from the VITamins And Lifestyle (VITAL) cohort study. Participants answered a 24-page questionnaire that focused on: (i) health history and cancer risk factors, (ii) medication and supplement use, and (iii) diet. Participants provided information on age, race/ethnicity, education, smoking, diet (fruit and vegetable intake), and other lifestyle characteristics, self-rated health, medical history, and family history of leukemia or lymphoma.

History of asthma and allergies was also taken, including allergies to plants, grasses or trees; mold or dust; cats, dogs or other animals; insect bites or stings; foods; and medications.  Of the 79,300 VITAL participants who filled out the questionnaires, more than 66,000 individuals were selected after eliminating those who had a prior history of malignancies other than non-melanoma skin cancers and missing information on baseline cancer history.

Participants were then followed for eight years until they either withdrew from the study, moved away, had a cancer diagnosis other than hematologic malignancy or non-melanoma skin cancer, or died.

Incidence of hematologic malignancies and other cancers was identified via the Surveillance, Epidemiology and End Results (SEER) cancer registry of western Washington.

Of the participants, 681 developed a hematologic malignancy during the follow-up period. These participants were more likely to have two or more first-degree relatives with a family history of leukemia or lymphoma, to be less active and rank their health status as low.

A history of allergies to airborne antigens was associated with a higher risk of hematologic malignancies. The most statistically significant association was seen with allergies to plants, grass and trees.

There was also an increased risk of plasma-cell neoplasms for participants who reported a history of allergies to cats, dogs or other animals. Plasma-cell neoplasms are conditions, both cancerous and noncancerous, in which the body makes too many plasma cells.

When stratified by gender, the incidence of blood cancers in response to these allergens was increased in women but not in men. The reason for this is as yet unknown.

However, Shadman and colleagues warn, “Given the limited number of cases within each sub-type of hematologic cancer, the risk estimates need to be interpreted with caution … and the possibility of chance finding due to multiple testing should be recognized.”

Even so, if you’re a women with allergies, you may want to keep a close eye on your blood work.

Don’t end up Black & Blue this Black Friday

Congratulations!  You survived another Thanksgiving.  Hopefully the only thing that ended up being stuffed this year was your turkey.

However, the holiday hazards aren’t over yet.  Experts warn that the stress that accompanies Black Friday shopping can add costs, far greater than those we ring up at the mall.

While retail stores are raking in the money, shoppers are probably having a more negative experience. Although we all love a Black Friday deal, “it is more like Red Friday for the consumer, as the shopper goes into debt to pay for purchases,” says Nancy Barton, professor in the School of Physical Education and Tourism Management at Indiana University-Purdue University.

Besides overspending, four people have died and dozens of injuries have occurred in the Black Friday shopping frenzy in the past four years.

Who can forget the images of the trampled Walmart worker in Long Island; the collapsed man bypassed by shoppers at a West Virginia Target and a shooting at a Toys R Us over an item brawl.

Clearly, both consumers and stores are clearly unprepared for the post-Thanksgiving stress and excitement.

“Some have argued that we are wired for desire as a result of our dopamine reward pathways.” Barton adds, “When we are overstimulated by a novel experience or unlimited choices on Black Friday, a craving (for more) and insatiable desire is triggered.”

The key to combating these desires relies on the executive, thinking part of the brain. However, this control can be hindered if you are stressed out, tired and hungry, arguably the three main traits of an all-night Black Friday shopper.

How can you avoid these stressors?  How about? :

Opting out of Black Friday shopping. Think of another way to give a gift. How about buying an “experience” for your loved one(s)?  After all, there is plenty of evidence that it’s experiences, rather than things that make us happy. What about a family gym membership? Not only will you stay healthy, but the family that works out together, is more likely to stay together

Paying It Forward. Instead of spending, how about giving? Think about those who are less fortunate than you and do something for them. Visit an elderly neighbor living alone; volunteer at a local hospital / animal shelter, soup kitchen. Your smile and touch may be the greatest gift of all.

Trying some self-reflection. The perfect antidote for ungrateful feelings is to practice gratefulness.  List three things that you are grateful for. Embody the feelings of gratefulness. Positive emotions and satisfaction with what you already have will start to unfold as you reflect on your list.

Whatever you end up doing today – please stay safe.

Happy Thanksgiving

Today, we are thankful to have you visit our  blog.

We wish you a wonderful day of family, faith, friendship, food, and football.

Come back and visit us tomorrow and every day for the latest in health news and views.

Holiday Hellth!

For many of us the holidays mean family, feasting and fun.  But for our nation’s 18 million health care workers  – 28% of whom will be working on Thanksgiving, all celebrations will be placed on hold while they help those who are sick or injured.

And, as Christmas approaches, things don’t get any better.  The number of 911 calls and hospital visits spike as the temperatures plummet. For example, around 5,800 people are treated for holiday decorating injuries alone, each year. On top of this, the number one day for cardiac deaths is December 25th with December 26th and January 1st coming in a close second and third.

To raise awareness of the strain put on healthcare workers during the holiday season and some ways they can address it, Carrington College, has released these infographics:

Whatever you end up doing tomorrow, let’s not forget to say a word of thanks to our healthcare professionals. And if you do end up in their care be thankful they’re there.

Soap vs Sanitizers

You squirt it on your hands as you enter the grocery store, and then again on your way out. You have bottles in your car, on your desk and in your home too – and you use them often.

And no, you’re not a germophobe, it’s just that your hand-sanitizer habit is helping to protect you from colds and flu and other nasty’s, that are wet, sticky and not yours!

And even if it doesn’t, it’s harmless. Right?

Not so fast! Word on the street has it that despite how clean your hands feel after using a hand sanitizer, they’re actually still dirty.  Worse still, they’re potentially toxic and might actually lower your resistance to disease.

So are these rumors true?!  Let’s take a look at the evidence.

When it comes to safety and effectiveness, the main concern with hand sanitizers is triclosan, – the main antibacterial ingredient used in non-alcoholic hand sanitizers.

“There’s no good evidence that triclosan-containing products have a benefit,” says Allison Aiello PhD, associate professor of epidemiology at the University of Michigan. In fact, hospitals in Europe and the United States, won’t even use them because it’s thought that they don’t reduce infections or illness.

Dr. Anna Bowen, an epidemiologist at The Centers for Disease Control and Prevention, says, “Triclosan-containing products don’t provide any disease protection beyond what you get from washing with soap and water.”

Research has shown that triclosan can disrupt the endocrine system, amplifying testosterone. In animal studies, it reduced muscle strength. It may also harm the immune system. Whether these findings add up to human toxicity isn’t established yet, but the FDA is currently reviewing the issue.

A more established concern: “When you expose bacteria to triclosan, it can elicit antibiotic resistance,” says Aiello. “Once the resistance is transferred, pathogenic bacteria can become resistant to many types of antibiotics.”   She also points out that quaternary ammonium, another antibacterial found in nonalcoholic hand sanitizers, has been shown to elicit antibiotic resistance.

The main concern with triclosan, that it’s an anti-bacterial, meaning it doesn’t protect against viruses or fungi.  Which means, colds and flu are not destroyed because they are caused by viruses, not bacteria.

Alcohol-based sanitizers, on the other hand, are fairly effective and safe. Those that contain  60% alcohol are good at killing bacterial pathogens and can also kill some viruses though not all of them.  Norovirus, for example, the bug responsible for the recent cruise-ship outbreaks is not affected.

“If you can’t get to a sink quickly, an alcohol-based sanitizer is a good alternative to washing with soap and water,” says Aiello.

One caveat: They don’t work on visibly dirty hands.  The alcohol can’t get past the dirt.

So how does soap and water match up?   First, they are both safe and effective. That’s right. Good old-fashioned hand washing before you prepare food or after you go to the toilet has been shown to drastically reduce the risk of diarrhea.

“Hand-washing campaigns reduce absenteeism in schools,” says Bowen, “and that means parents miss fewer days of work, too.”

But, and it’s a big but – you have to wash your hands correctly.

According to the CDC you need to wash for about 24 seconds to remove bacteria and viruses from your hands. You need to cover all parts of your hands, front and back and under your nails and then dry your hands well.

How long is 24 seconds? Apparently it’s about as long as it takes to sing two verses of Happy Birthday.  However, as I always tell my infection control students, if you’re in public, sing it with your inner voice …or you could have more than germs to worry about!

Bottom line –  soap and water beats sanitizers hands-down.  Suds up and stay safe this cold and flu season.