Chains are quick to ignore patient privacy

When the police go to a library to ask for a patron’s borrowing records, they have to pry them from a librarian with a warrant — and even then it’s gonna be trouble.

Pharmacists, though? They apparently hand patient medical records over when police ask nicely. That’s the finding of a congressional investigation into how quickly chain pharmacies were willing to hand over sensitive information.

Three of the country’s biggest chains, CVS Health, Kroger and Rite Aid, instruct pharmacy staff to respond to law enforcement demands immediately.

[…]

Five other chains, Amazon, Cigna, Optum Rx, Walmart and Walgreens Boots Alliance, require legal professionals to review law enforcement demands before responding, but they don’t require warrants unless state law mandates it.

The thing is, HIPAA doesn’t require a warrant to release the records — and that’s something legislators are now looking at. In the meantime, it seems librarians are more protective of privacy than chain pharmacies. (Note: That’s chain pharmacies, not necessarily pharmacists. It’s the pharmacy policies that are the issue here.)

Smoking shrinks your brain

The headline says it all. A new study out of Washington University found that smoking isn’t just horrific for the lungs and heart, it also has significant effects on the brain, leading to smokers having higher rates of dementia.

What’s notable in the study is the link to genetics: “What researchers found was that genetics leads to a predisposition to smoking, which ultimately leads to decreased brain volume.” I.e., genes don’t directly affect the brain shrinkage they measured.

The worse news:

While quitting smoking will stop further brain shrinkage, the damage already done is irreversible, the study says. To prove their point, researchers analyzed people who had quit smoking years before and found that their brains remained permanently smaller than the brains of those who had never smoked.

Morning sickness: Cause (and cure?) discovered

Morning sickness is all about the hormones. That part isn’t surprising, but what’s newsworthy is that USC researchers say they’ve discovered exactly which hormone it is — and (potentially) what can be done about it.

The hormone is called GDF15, and it’s produced by the fetus; it surges in the first trimester.

“[T]he baby growing in the womb is producing a hormone at levels the mother is not used to. The more sensitive she is to this hormone, the sicker she will become. Knowing this gives us a clue as to how we might prevent this from happening.”

Some women are especially sensitive to GDF15 and can have morning sickness that requires hospitalization. (Looking at you, Catherine, Princess of Wales.) Other woman have a genetic blood disorder that gives them chronically high levels of GDF15 so they escape morning sickness.

What can be done? One idea is to exposing moms-to-be-to-be to GDF15 before they get pregnant so their bodies have time to adjust. Another idea is to lower or block GDF15, because what could go wrong when messing with hormones during pregnancy?

Regardless, as always, more research is needed.

New compounding PGY1 residency

Hey, newly minted pharmacists (and P4 students)! There’s a new option for your PGY1 residency: one in community pharmacy compounding out of Kennesaw-based Innovation Compounding.

Innovation is part of the Revelation Pharma network which just launched the Revelation Pharma PGY1 Community-Based Pharmacy Residency, which … well, the name says it all if you read it slowly.

It…

… offers additional training opportunities in sterile and nonsterile compounding, clinical research and formulation development, business administration, and pharmacy advocacy.

There are only two positions a year, and the deadline for the next one is January 16, 2024. You can check out the details, requirements, and so on over at Revelation Pharma.

Diabetics’ adherence issues

When someone with type 2 diabetes has to go beyond metformin, it turns out that whatever comes next is entirely hit-or-miss. Almost 64% of patients end up modifying that treatment by changing drugs or increasing the dosage (found a Northwestern study) — but almost 40% simply stop taking the new meds.

Detail: Patients given sulfonylureas were the least likely to change, while those given GLP-1 RAs were the most likely to quit.

This, the Northwesterners say, is a wakeup call that something’s got to change so patients get the right drug and the right dose the first time.

Asthma without inhalers

What if most asthma patients didn’t need inhaled steroids (and their side effects)? Apparently, researchers at London’s Kings College found, they don’t. All they may need is benralizumab.

The findings […] demonstrated that 92 per cent of patients using the biologic therapy benralizumab could safely reduce inhaled steroid dose and more than 60 per cent could stop all use.

The downside is that benralizumab (aka Fasenra) needs to injected every month or two rather than be carried in a pocket. On the other hand, “Approximately 90% of patients experienced no worsening of asthma symptoms and remained free of any exacerbations throughout the 48 week study.”_