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Coverage of our peer-reviewed research and news reporting in the healthcare and mainstream press.

By meeting challenges in caring for patients with chronic obstructive pulmonary dieases head-on, primary care doctors have an opportunity to reduce the potential for unnecessary or sub-optimal care while improving patient outcomes.

This week, the top managed care news included a CMS plan for changes in drug coverage that brought a wave of criticism; a government task force recommended more people at risk for HIV take pre-exposure prophylaxis, known as PrEP; the American College of Cardiology issued an Expert Consensus Pathway on treatment of patients with type 2 diabetes and atherosclerotic cardiovascular disease.

Here are the top 5 articles for the month of November.

Despite the fact that osteoporosis is a growing public health problem in the United States and worldwide, there is poor adherence to medications to treat the problem. A recent study published in Osteoporosis International identified the factors that influence patient adherence to therapy, many of which are modifiable.

With health policy increasingly transferring to the state level, what’s the most effective way for states to cover the majority of their population through affordable health insurance leveraging public funds? On a day when the Trump administration unveiled 4 ways states can request Section 1332 waivers, some of which are aimed at avoiding key parts of the Affordable Care Act (ACA), an advocacy organization released its own proposal to cover more of the uninsured and lower health insurance costs.

A new study in Pediatrics concludes that 23%-27% of new asthma cases in children with obesity is directly attributable to obesity, and without overweight and obesity as a factor there would be 10% fewer cases of pediatric asthma in the United States.

Here are 5 interesting findings from the November 2018 issue of AJMC®.

This week, the FDA approved larotrectinib, to be sold as Vitrakvi, for the treatment of adult and pediatric patients with solid tumors that have a neurotrophic receptor tyrosine kinase (NTRK) gene infusion without a known acquired resistance mutation, are metastatic or where surgical resection is likely to result in severe morbidity, and have no satisfactory alternative treatments or that have progressed following treatment.

CMS Administrator Seema Verma announced consumers buying health insurance through the exchanges set up by the Affordable Care Act (ACA) would be allowed to have heath savings accounts, and the agency will allow states to set their own subsidies and decide what type of health plan is eligible for subsidies. In addition, waivers would be evaluated against the Hyde amendment.

Atherosclerosis and peripheral artery disease are significant long-term complications of diabetes that demand more education and quality care to prevent limb loss. The conclusion of National Diabetes Month offers an opportunity to draw attention to ways to prevent these outcomes and screen for them early.

Patients who undergo outpatient autologous stem cell transplantations (ASCTs) not only report lower costs and higher satisfaction, but they also have lower odds of developing febrile neutropenia and septicemia than patients who undergo inpatient ASCT, according to the results of a new analysis.

For the first time in a decade, the number of children without health insurance rose; CVS Health has officially acquired Aetna after New York and New Jersey provided the last 2 state approvals necessary for the merger to occur; although the Federal Bureau of Prisons has imposed a policy to provide better care and oversight for inmates with mental health issues, a new report has found that treatment has not been expanded.

The authors noted that until recently, medications to control blood glucose were not expected to offer any benefit in helping patients avoid cardiovascular events.

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States, and for COPD Awareness Month this November, The American Journal of Managed Care® conducted a Q&A with Jamie Sullivan, MPH, vice president of public policy and outcomes for The COPD Foundation, as well as Chief Medical Officer Byron M. Thomashow, MD. The COPD Foundation is a not-for-profit organization that works to improve the lives of patients with COPD.

A new study published in Nature Genetics suggests there may be new ways for personalized and precise treatment of acute myeloid leukemia (AML) that could increase the chances of survival in patients with this aggressive cancer of the white blood cells.

The lag time between the end of a performance period in the Oncology Care Model (OCM) and the release of the full report from CMS, represents a challenge for practices looking to improve.

A study published this week suggests that some anticancer treatments speed up the biological aging process, and this aging effect could be linked to the cognitive decline experienced by patients undergoing cancer treatment.

A generic competitor to the EpiPen will not cost any less than the version that is already on the market; a new service from Amazon will use machine learning to pull key information from patient records; a new report from the European Commission has noted that generic and biosimilar products will be key to curbing wasteful spending in healthcare.

CMS is moving home health agencies away from a volume-based payment model and to a new value-based payment system. The Patient-Driven Groupings Model would focus on patient needs and rely more heavily on patient characteristics in order to pay for home health services.

According to a new study, prior migraine history is associated with brain tumors. While associated with both sexes, the risk is higher among men than women.

Cognitive behavioral therapy delivered by respiratory nurses can reduce anxiety and is cost-effective in patients with chronic obstructive pulmonary disease (COPD).

Patients in low-income countries receive similar antenatal care coverage as patients in high-income countries. However, they receive inequitable quality of antenatal care for 3 essential services: blood pressure monitoring, urine and blood tests, according to a study published in Lancet Global Health.

While team-based approaches to primary care transformation provide benefit to patients with chronic illness by reducing acute care utilization, it may lead to higher use among healthier patients.

The FDA will revamp the process for approving most medical devices, which has long been criticized by experts for failing to catch problems with risky implants and related products; the $69 billion merger between CVS and Aetna is expected to close Wednesday after New York signed off on the deal; the Government Accountability Office (GAO) will investigate whether members of President Donald Trump’s private club in Florida improperly influenced the Department of Veterans Affairs.

Back pain is a leading cause of disability, and the proportion of adults over age 65 who have back pain is increasing in the United States, particularly among women. Now, research has demonstrated that persistent back pain is also linked with an increased risk of death in older women.

CMS said Monday it is easing restrictions on how Medicare Part D manages the 6 protected drug classes that must be included in those plans, is taking action on pharmacy rebates, and is allowing step therapy in Medicare Advantage (MA) plans, all in an effort to force lower drug prices.

FDA has recently approved 2 new treatments for patients age 75 and older who are newly diagnosed with AML and have other chronic health conditions or diseases that may mean they cannot use intensive chemotherapy.

Findings showed that children in primary care who received guidance on managing their weight over a year did as well as those who received treatment in major research clinics. The results are encouraging, given the rise in obesity around the globe.