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The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

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It is estimated that as many as 10 million U.S. adults have ADHD (Attention-Deficit/Hyperactivity Disorder).  A recent research study (publication-pending) suggests that the economic burden of ADHD on America could be as high as $250 billion annually. I attended a recent briefing on Capitol Hill and interviewed one of the study’s co-authors: Tufts economist, Dr. Peter Neumann as well as congressman (and psychologist) Tim Murphy about ADHD in America.

I learned from Dr. Neumann that cost these high cost estimates are most strongly influenced by reduced productivity in adult workers with ADHD rather than direct costs of treating children with the disorder. Productivity costs include absenteeism, and reduced work output due to difficulty focusing. Dr. Neumann explained that ADHD has many “spill over effects” in that it impacts the educational system, the justice system, the healthcare system, and our work environments. Please check out our interview video for the full story.

Congressman Tim Murphy is a clinical psychologist with three decades of experience in treating people with ADHD. He is also Co-chair of the Mental Health Caucus and GOP Doctors Caucus where he regularly works to raise awareness of healthcare accessibility needs. I had the chance to interview him also at the event.

I learned from Rep. Murphy that the costs of ADHD multiply when patients are untreated.  Getting the correct diagnosis is critical, because impulsivity and problems with focusing are not always caused by ADHD. These symptoms can be caused by lead poisoning, damage to the limbic system of the brain, metabolic disorders, or even sleep apnea. Children who are inattentive should not be put on medications for ADHD without first confirming the diagnosis by ruling out other possible causes.

Rep. Murphy recommends a team approach to the management and treatment of ADHD and he believes that costs related to ADHD are escalating because some physicians are not managing children holistically, but resorting to prescribing medications without involving counselors and family directly. He sees lack of health insurance coverage for behavioral health services as a threat to comprehensive and effective ADHD treatment.

Please watch the video for the full interview with congressman Murphy.

*Please note that the panel event, and Better Health’s participation, was made possible by a grant from Shire Pharmaceuticals.

Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

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Today, most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine.  A month ago, President Obama signed his executive order, directing the FDA to take steps to reduce drug shortages as the White House stated that drug shortages have nearly tripled over the past five years reaching the stunning number of 178 in 2010.  These shortages make regular news:  Cancer patients without the chemotherapy needed to keep them alive, antibiotics unavailable to treat life-threatening infections, or intravenous nutrition to support the critically ill fighting to live while medical teams and families search for elusive remedies.

As this new reality plays out in hospitals and homes the media is provided a steady stream of drama for our morning paper or evening news.  Meanwhile, time and focus is repeatedly stolen from physicians, patients, and parents in a myriad of ways.  Currently, my medical practice- in primary care Internal Medicine- has been negatively affected by the shortage of Adderall, a medication used to treat Attention Deficit Hyperactivity Disorder (ADHD).  What this medical condition may lack in dramatic news-worthiness it more than makes up for in sheer numbers with an estimated 4.5 million Americans living with this condition today.

I had my first inkling several months ago of the affect the Adderall shortage would have on my practice after one of my patients called frustrated  that their pharmacy did not have their Adderall at the prescribed dosage.  By calling several pharmacies I was able to find their medication at a smaller dose. Advising my patient to “double-up” I wrote another prescription and had to direct my patient to return to my office to pick up the rewritten  prescription- a time-consuming process that doctors and patients can ill afford to repeat on a regular basis.

Unfortunately, this scenario -initially thought an exception- has now become the rule monopolizing my own time while draining the daily resources of my staff, nurse, and medical partner.  Most ironically though, Read more »

Study Explores New Method Of Fluorescing Cancer Cells In Tumors

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00299er743jf73u Two months ago we reported on the first ovarian cancer surgeries performed with fluorescence guidance. As described in the Nature Medicine paper, the international team of researchers from The Netherlands, Germany, and Indiana used folate coupled to fluorescein isothiocyanate (FITC) to make ovarian cancer cells glow so they could be easily identified.

Now, in this week’s issue of Science Translational Medicine, another international team from Japan and Maryland reports their development of a spray-on probe that may provide even better sensitivity and fluorescent contrast than the folate-FITC counterpart. The editors of STM summarize this work well in the following note: Read more »

*This blog post was originally published at Medgadget*

Progress In The Field Of Personalized Medicine And What We Can Expect Next

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The third edition of The Case for Personalized Medicine (PDF) was released a week ago and I had a chance to do an interview with Edward Abrahams, Ph.D. of the Personalized Medicine Coalition.  The new edition is a primer that highlights the progress in the field of personalized medicine for policymakers, researchers, and business leaders.

  • How many prominent examples of personalized medicine might we have next year?

It’s impossible for us to know how many prominent examples of personalized medicine products will be available a year from now, but we project that the rapid acceleration in the number of new products coming onto the market will continue. When we published the first edition of The Case for Personalized Medicine in 2006 – there were only 13 available products; when we published the second edition in 2009, there were 37 products available, and now, in 2011, there are 72.

  • Sometimes lecturers use two numbers: 7 billion and 3 billion referring to the mass sequencing of everyone’s DNA in the world. When could it happen, what is your estimation? Read more »

*This blog post was originally published at ScienceRoll*

Diabetes Research Institute Continues The Search For A Cure: A Reason To Believe

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The Diabetes Research Institute is one of those places that, walking through its halls, you feel inspired.  (I feel the same way when I walk through the Joslin Clinic in Boston – true diabetes magic happening there.)  The people there are focused solely on finding a cure for diabetes, and that’s a mission I can truly get behind.  Today, the DRI’s Tom Karlya is sharing some information on the Reason to Believe campaign.
*   *   *
Kerri:  Hi Tom!  You and I have worked together in the past, and I’m very familiar with your passion for finding a cure for this disease that both your kids and I share.  For those who don’t know, what is the Diabetes Research Institute and what is your role there?

Tom Karlya from the DRITom:  Thanks Kerri, over the years it has been exciting to work alongside you to help the diabetes community.

The DRI is the largest and most comprehensive research center in the world with a multidisciplinary team of scientists passionately committed to curing diabetes in the fastest, safest and most efficient way possible.  We are solely dedicated to curing diabetes by finding a biological cure – restoring natural insulin production in patients.  This has been and will continue to be our singular focus until that goal is reached.  And it will be reached.

Kerri:  I’ve heard a lot about the Diabetes Diplomats, and I know that outreach effort has engaged an amazing group of people.  Who are the Diabetes Diplomats, and what are they all about? Read more »

*This blog post was originally published at Six Until Me.*

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Latest Book Reviews

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

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