Chemo Medication Errors Common in Outpatient Setting: Study
A new study from the U.S. Agency for Healthcare Research and Quality found that 7 percent of adults and 19 percent of children taking chemotherapy drugs in outpatient clinics or at home were given the wrong dose or experienced other mistakes with their medications.
The study, to be published in the Jan. 1, 2009, issue of the Journal of Clinical Oncology, examined data on almost 1,300 patient visits at three adult oncology outpatient clinics and 117 visits at one pediatric facility between Sept. 1, 2005 and May 31, 2006.
Fifty-five of the errors involving adults had the potential to harm, and 11 did cause harm. About 40 percent of the 22 errors in children had the potential for harm, and four children were harmed, according to Dr. Kathleen E. Walsh, the study's leader and an assistant professor of pediatrics at the University of Massachusetts School of Medicine.
Errors with adults included giving incorrect medication doses because of confusion over conflicting orders -- for example, giving one written order at the time of diagnosis and another on the day of administration. Pediatric errors included giving the wrong amount or the wrong number of doses per day for home medicines because of similarly confusing instructions.
Additionally, more than half of errors involving adults were in clinic administration, 28 percent occurred in ordering medications, and 7 percent were involved in taking drugs in patients homes. More than 70 percent of the pediatric errors occurred at home, the study found.
Walsh and her colleagues suggested that avoiding prewritten chemotherapy orders for adults in outpatient clinics may have prevented many of the errors, whereas those involving children could have been avoided by better communication and training. Specifically, the study called for more support for parents of children who use chemotherapy medications at home.
Team IDs Genes Behind Lethal 1918 Flu Pandemic
U.S. and Japanese researchers say they've isolated three genes that explain why the 1918 Spanish flu was so lethal, killing between 20 million and 50 million people worldwide, AFP reported.
"We wanted to know why the 1918 flu caused severe pneumonia," said University of Wisconsin-Madison virologist Yoshihiro Kawaoka, who co-authored the study with Masato Hatta, also of UW-Madison. "Conventional flu viruses replicate mainly in the upper respiratory tract: the mouth, nose and throat . . . The 1918 virus replicates in the upper respiratory tract, but also in the lungs, causing primary pneumonia among its victims," the authors said.
The discovery is important, because learning how the genes helped the virus infect the lungs could provide a way to identify the potential virulence of any new pandemic influenza strains, Kawaoka said. The findings could also lead to a new class of antiviral drugs, he added.
Autopsies of the victims revealed fluid-filled lungs severely damaged by massive hemorrhaging. The researchers linked the virus' ability to invade the lungs with its high level of virulence, but the genes that conferred that ability were unknown until now, AFP said.
The genes allowed the virus to reproduce in lung tissue, the researchers said. Their study was published in the Proceedings of the National Academy of Sciences.
Medicare Open Enrollment Ends Dec. 31
The U.S. Centers for Medicare & Medicaid Services (CMS) is reminding beneficiaries to review their prescription drug coverage and health-plan needs for 2009 before the annual enrollment period ends on Wednesday, Dec. 31.
Kerry Weems, CMS acting administrator, said Monday that many beneficiaries will see changes in their current choices, "so it's important that people with Medicare take advantage of the enhanced tools CMS has provided to review the coverage and costs of their health or drug plans for next year."
Medicare's open enrollment period began Nov. 15 and runs through Dec. 31, according to Weems. For Medicare Advantage (MA) plans only, beneficiaries can make one change -- enrolling in a new plan, changing plans or canceling a current plan -- between Jan. 1 and March 31, 2009. However, the Medicare Advantage open enrollment period cannot be used to start or to stop Medicare drug coverage, or to enroll or "disenroll" in a Medicare Medical Savings Account plan, Weems said in an agency news release.
To help clients make the best choices, CMS urges enrollees to use the online tools available at www.medicare.gov (the Medicare Prescription Drug Plan Finder or Medicare Options Compare for health coverage) to review options for the coming year. In addition, the 2009 Medicare & You handbook, mailed to beneficiaries in October, includes tips on selecting a plan and an overview of plan options, Weems said.
Those without a computer can get the information by calling 1-800-MEDICARE. Weems said callers should first prepare before dialing by writing down any questions they have, along with information about their current health or prescription drug plan; have their Medicare card handy; and a list of current medications used in front of them for reference.
More than 4,000 customer service operators will provide help in English and in Spanish from six toll-free Medicare call centers across the United States, Weems said
George Francis, U.S.'s Oldest Man, Dies at 112
George Francis, believed to be the oldest man in the United States and whose life spanned both world wars, man's walk on the moon and the election of the nation's first black president, died of congestive heart failure Saturday at a Sacramento, Calif., nursing home. He was 112.
"He lived four years in the 19th century, 100 years in the 20th century, and eight years in the 21st century. We call him the man of three centuries," his son, Anthony Francis, 81, told the Associated Press.
Francis, who even in his prime weighed little more than 100 pounds, was born in New Orleans on June 6, 1896. His son said that Francis tried to enlist in the U.S. Army during World War I but was turned down because of his stature. "We always attributed his longevity to his mental and physical toughness," his son said.
As an African-American in the South, the elder Francis grew up under the Jim Crow-era's segregation laws. But Francis maintained a passion for politics, his family said. He voted for Franklin Roosevelt in the 1930s and for Barack Obama in 2008.
In an interview with the AP after Obama's victory, Francis, who used a wheelchair, said he felt like jumping up and down. "He is going to give black men a break in the world, and give them a better opportunity to live and make more money," he said. "For people who say voting doesn't matter, I think that's crazy."
Francis quit school after the sixth grade, became an amateur boxer as a young man and later worked as a chauffeur, an auto mechanic and a barber. He and his wife, Josephine Johnson Francis, had a son and three daughters. His wife died of cancer in 1964.
With Francis' death, Walter Breuning of Montana, who is 112 years, 98 days old, becomes the country's oldest living man, according to UCLA gerontologist Dr. Stephen Coles, who maintains a list of the world's oldest people. Francis, he told AP, lived 112 years and 204 days.
Gertrude Baines of Los Angeles, now 114, is the nation's oldest living person. The world's oldest person is Maria de Jesus of Portugal, who is 115 years, 109 days old. Japan's oldest person is Tomoji Tanabe at 113 years and 101 days, Coles said.
Francis is survived by 18 grandchildren, 33 great grandchildren and 16 great-great grandchildren, according to AP.