Assessing the Effectiveness of Phone Call Proactive Naloxone Co-Prescribing Enrollment

Opioid use is increasing at never-before-seen rates. As a result, it is imperative that medical facilities educate and provide resources for those who may be at risk of an opioid overdose. With our study, we aimed to see the demographics of our population here at Rowan Medicine and identify associations of those participating in our naloxone co-prescription program. Majority of enrollees in our program were aged 50 or older and identified as Caucasian. A large proportion also reported being unable to work. Given this information, improvements in our naloxone coprescription program may include spreading more awareness of the benefits of naloxone to minority populations, as well as to the younger population at risk of an opioid overdose

What Motivates Patients to Enroll in a Naloxone Co-Prescribing Program?

Patients were contacted via phone call to establish knowledge of and prescription status regarding naloxone. They were then invited to enroll in a research study consisting of two online surveys. The patients who had been prescribed naloxone by the time the study had started ranked being persuaded by a medical professional as being the most important reason for accepting the naloxone prescription. Insufficient data collected during the six-week time frame to draw statistically significant conclusions about what motivates patients to receive naloxone co-prescriptions. Correlations seen in this study are interesting and warrant further investigation

Antitumor Activity of Metformin Combined with Locoregional Therapy for Liver Cancer: Evidence and Future Directions

This article aimed to examine the effect of metformin use on improving outcomes after liver-directed therapy in patients with HCC and identify future directions with the adjuvant use of and potential therapeutic agents that operate on similar mechanistic pathways. Databases were queried to identify pertinent articles on metformin’s use as an anti-cancer agent in HCC. Eleven studies were included, with five pre-clinical and six clinical studies. The mean overall survival (OS) and progression-free survival were both higher in the locoregional therapy (LRT) + metformin-treated groups. The outcome variables, including local tumor recurrence rate, reduction in HCC tumor growth and size, tumor growth, proliferation, migration and invasion of HCC cells, HCC cell apoptosis, DNA damage, and cell cycle arrest, showed favorable outcomes in the LRT + metformin-treated groups compared with LRT alone. This systemic review provides a strong signal that metformin use can improve the tumor response after locoregional therapy. Well-controlled prospective trials will be needed to elucidate the potential antitumor effects of metformin and other mTOR inhibitors

Out-of-Pocket Expenditures for Imaging Examinations: Perspectives from National Patient Surveys Over Two Decades.

PURPOSE: Using national surveys, we longitudinally studied imaging costs-and specifically those paid out-of-pocket (OOP) by patients-over two decades. METHODS: Using 2000-2019 Medical Expenditure Panel Survey (MEPS) data, we identified all imaging-focused encounters (mammography, radiography, ultrasonography (US), and computed tomography (CT) & magnetic resonance (MR) [surveyed together in MEPS]) and calculated mean overall and OOP encounter costs. Effects of sociodemographic, personal, and clinical factors were measured using logistic regression and generalized linear modeling. RESULTS: We identified 102,717 patients (mean 45.6 years; 64.8% female; 58.8% white) undergoing 229,010 imaging-focused encounters. Between 2000 and 2019, mean costs of mammography, radiography, and US increased 14.5%, 24.5%, and 40% while total mean cost of CT/MR decreased by 15.1%. OOP costs were incurred by 51%. Overall mean OOP costs increased 89.8% from 2000 to 2019. Mean OOP costs for mammography decreased by 32.9%; mean OOP costs for radiography, US, and CT/MR increased 81%, 123.2%, and 61%, respectively. Patients were less likely to incur OOP costs when older, of racial/ethnic minorities, female, or recipients of public only (vs. private) insurance. Among those with OOP costs, the presence of comorbidities, lack of insurance, younger age, and history of cancer significantly increased OOP costs. CONCLUSION: Mean overall patient OOP costs for imaging examinations increased significantly and substantially over the last two decades. Lack of insurance, younger age, history of cancer, and other comorbidities were associated with higher OOP costs. As diagnostic imaging utilization increases, patient financial hardship considerations merit further attention

Safety and Short-Term Efficacy of Intravascular Lithotripsy for Treatment of Peripheral Arterial Disease: A Systematic Review

Objective Intravascular lithotripsy (IVL) is an emerging treatment for calcifications in patients with peripheral arterial disease (PAD). The objective of this article is to evaluate the safety and efficacy of IVL for PAD management by performing a systematic review of existing literature