Latest news with #clinicians
Medscape
2 days ago
- Health
- Medscape
Most GLP-1 Prescriptions Miss the Mark: Are Yours?
GLP-1 receptor agonists, including semaglutide, are now widely used for weight loss, offering substantial weight reduction, improved metabolic health, and reduced cardiovascular risk. However, effective treatment involves more than simply prescribing drugs, and ongoing clinical oversight is crucial. Based on recommendations published in JAMA Internal Medicine , the following five tips can help physicians avoid common pitfalls and deliver optimal patient care. Track Weight GLP-1 receptor agonists typically result in 15%-21% weight loss, depending on the drug and individual response. However, weight loss alone does not define treatment success. A comprehensive clinical assessment that incorporates both quantitative and qualitative factors is essential. Weight should be monitored monthly during the initial phase of treatment, particularly during dose titration. Once the dose is stabilized, quarterly follow-up is usually sufficient. If the weight loss remains below 5% after 12-16 weeks, this may signal an inadequate response. In such cases, clinicians should assess adherence, consider dose adjustments, or evaluate the need to switch to another GLP-1 receptor agonist. Marked weight loss should be evaluated clinically and not just numerically. Red flags include a BMI below 18.5, calorie intake under 800 kcal/d, hormonal disturbances such as amenorrhea or reduced libido, signs of protein deficiency, and psychological symptoms. In such cases, secondary causes should be investigated, dose reduction should be considered, and referral to clinical nutrition or psychosomatic medicine may be warranted. Preserve Muscle Physicians should be mindful of lean body mass loss when treating patients with GLP-1 receptor agonists. Research indicates that up to 40% of the total weight loss during therapy may be attributed to muscle loss, which is a clinically relevant concern, particularly in older adults or those with limited physical function. Targeted prevention of muscle loss is essential and begins with adequate protein intake. At least 1.0-1.5 g/kg body weight per day is recommended, with even higher amounts (> 1.5 g/kg) advised for older adults or patients who have undergone bariatric surgery. If appetite is significantly reduced, protein-rich supplements, such as shakes containing at least 20 g of protein per serving, can be a practical option. Physicians should also recommend structured and individualized physical activities. In addition to approximately 150 minutes of moderate endurance exercise per week, such as brisk walking or cycling, strength training should be incorporated two to three times weekly. This approach can limit muscle loss by up to 95%, according to studies, while also improving metabolic health. Many patients report noticeable gains in energy, mobility, and quality of life. Monitor Micronutrients GLP-1 receptor agonists reduce food intake and slow gastric emptying, which may worsen preexisting micronutrient deficiencies. Individuals with obesity frequently have deficiencies in vitamin D, vitamin B12, folate, iron, zinc, calcium, and magnesium prior to treatment. Therefore, targeted laboratory testing is recommended before starting treatment or at the latest when clinical signs of deficiency appear. High-risk patients should receive early referrals for professional dietary counselling, such as from a registered dietitian. If direct access is unavailable, the validated screening tool, the Rapid Eating Assessment for Participants — Shortened Version, offers an efficient and time-saving alternative for initial screening. Based on the test results, clinicians can recommend an individualized approach focusing on a nutrient-rich diet rather than calorie counting. Targeted supplementation may be appropriate in many cases. Manage Side Effects Nausea, bloating, reflux, and constipation are among the most common side effects of GLP-1 receptor agonists, particularly during treatment initiation or when the dose is increased. Patient education and symptom-specific interventions can significantly improve the tolerability of these treatments. For nausea: Advise small, low-fat meals; avoid fried foods; and consider ginger tea for symptom relief. For constipation: Encourage fluid intake of more than 2-3 L/d, a high-fiber diet such as oatmeal and vegetables with their peel, and short-term use of osmotic laxatives, if needed. For reflux: Recommend smaller meals, maintain an upright position after eating, and avoid spicy or caffeinated beverages. Prevent Relapse Many patients regain weight after discontinuing semaglutide or other GLP-1 receptor agonists, with studies showing an average weight regain of 7%-12% within a year. This risk highlights that obesity is not a temporary condition but a chronic disease that should be managed accordingly. Setting realistic expectations and developing long-term strategies from the start of treatment are essential. A structured discontinuation plan, such as gradual dose reduction with close follow-up, can help prevent the risk for relapse. Lifestyle interventions should also be consistently maintained, including a balanced, nutrient-rich diet, regular physical activity, and psychological support when needed. If the weight gain exceeds 5%, further treatment with GLP-1 receptor agonists may be advisable.
Washington Post
3 days ago
- Health
- Washington Post
As state battles intensify, what's next for abortion pill access in U.S.?
The battle for abortion access in America, now concentrated in pharmacies and mailboxes, is headed toward a new reckoning in the nation's federal courthouses. Since the fall of Roe v. Wade three years ago, the number of abortions counted annually in the United States has risen, thanks largely to the growing availability of mifepristone and misoprostol. Medication abortions account for almost two-thirds of terminations involving a clinician, recent studies show — a 10-percentage-point leap from 2020.
The Independent
6 days ago
- Health
- The Independent
Urgent care clinics are inappropriately prescribing pills, research shows
Urgent care clinics in the US are reportedly overprescribing antibiotics, glucocorticoids, and opioids for conditions they are not meant to treat, potentially causing harm. A study analyzing over 22 million urgent care visits between 2018 and 2022 found millions of prescriptions for these drugs, with a substantial number deemed inappropriate for the patients' diagnoses. Specific instances of inappropriate prescribing included 46 percent of patients with urinary symptoms receiving unnecessary antibiotics and 41 percent of bronchitis patients getting inappropriate glucocorticoids. Researchers suggest that factors contributing to this issue include clinicians' knowledge gaps, patient demand, and a lack of comprehensive information systems to support prescribing decisions. Proposed solutions to mitigate inappropriate prescribing involve implementing drug stewardship programs, utilizing electronic health records more effectively, and providing further medication education for healthcare providers.
Forbes
6 days ago
- Health
- Forbes
Powering Possibilities In Healthcare With AI And Edge Computing
Imagine a hospital where a clinician can receive critical diagnostic insights in real-time, patient care isn't hindered by geography or resource limitations, and administration is so frictionless that clinicians can focus entirely on their patients. This is not a distant dream; this is what AI and edge computing are enabling right now. The intersection of AI and edge computing is empowering providers to make faster, better decisions that improve lives. The healthcare industry generates staggering amounts of data daily, from electronic health records, real-time monitoring devices used in ICU wards, even telemetry data recorded on smart watches. The real challenge is healthcare organizations are drowning in data, but are thirsty for knowledge, and this is where AI and edge computing can make a difference. By processing data close to where it's generated, edge computing drives real-time performance, provides better access and enhances security, essential in healthcare. Combine this with AI's ability to analyze data at blistering speeds, and you get insights that improve clinical decision-making and operational choices. Predictive analytics, for instance, empower hospitals to anticipate patient surges, optimize staffing schedules, and even ensure that life-saving supplies are available when needed. Take diagnostic imaging as another example. AI-enhanced imaging tools can identify conditions such as tumors or cardiovascular abnormalities with remarkable accuracy. These tools often provide access to and enhance specialists' capacity to serve in remote settings, delivering life-saving information directly at the point of care. Personalized medicine is one of the most exciting advancements in healthcare today. By leveraging tools like the Dell AI Factory with NVIDIA, healthcare providers can implement sophisticated AI models to tailor care to the unique needs of each individual. A patient's genetic profile, combined with their medical history and lifestyle data, allows clinicians to craft treatment plans and predictive diagnostics never before possible. This approach is already transforming oncology care, where genomic analysis guides targeted therapies. Tools within this ecosystem can identify complications before they escalate, paving the way for preemptive care. And the benefits extend beyond clinical walls. Edge computing makes it possible to bridge care gaps in underserved areas, connecting patients to specialists via digital health solutions and delivering remote care. Picture a rural patient managing their chronic condition with AI-driven devices that continuously monitor their health and alert medical professionals when intervention is needed. With these tools, care becomes inclusive, accessible, and proactive. A great example of how technology drives healthcare transformation is the Guthrie Clinic. Serving a sprawling region, Guthrie implemented the Dell AI Factory with NVIDIA within its operations to great effect. One remarkable outcome was its success in reducing patient falls by 70%. Using AI-driven computer vision, the clinic tracks patient movement patterns and identifies potential fall risks. When a risk is detected, the system alerts healthcare teams, enabling immediate intervention. This proactive approach ensures patient safety and fosters trust between caregivers and those they serve. The efficiencies don't stop there. By equipping clinical teams with time-saving tools, the Guthrie Clinic improved discharge speeds, reduced readmissions and created capacity to accept 85% of hospital transfer requests. AI didn't just enhance operations, it improved quality care, making care more accessible to every patient. Watch the video to learn more about Guthrie Clinic's transformational story. While patient care is at the heart of healthcare, smooth operations are essential for providers and systems to deliver outcomes. AI and edge computing are key to achieving this balance. From optimizing workflows to forecasting resource needs, these tools allow healthcare systems to function with agility and precision. For example, predictive models powered by AI anticipate ICU occupancy rates, ensuring vital equipment and staff are ready when needed. Additionally, digital twin technologies simulate emergency scenarios, preparing clinical teams for real-world challenges with confidence. Dell NativeEdge amplifies these capabilities by simplifying deployment processes. Through intuitive, zero-touch solutions, healthcare organizations can integrate AI without disruption, scaling critical functions as demands evolve. It's technology working seamlessly behind the scenes, enabling caregivers to focus entirely on patients. The integration of AI and edge computing isn't just solving today's problems, it's redefining the future of healthcare to create a reality where chronic illnesses are anticipated before they develop, operating rooms are enhanced with real-time data, and healthcare reaches patients wherever they are, without barriers. At the forefront of this transformation, Dell Technologies and NVIDIA are working together to elevate healthcare systems globally. By leveraging tools like edge computing and AI, they're helping organizations create inclusive, resilient systems that prioritize patient outcomes above all else. The future of healthcare is extraordinary, and it's happening now. Whether you're exploring ways to improve operational efficiency, enhance diagnostic precision, or personalize care, AI and edge computing hold the solutions you need. Solutions like the Dell AI Factory with NVIDIA empower healthcare providers to achieve smarter operations, better outcomes, and, ultimately, change lives. Are you ready to be part of this transformation? Download the eBook, Transforming Healthcare and Life Sciences with AI and Edge Computing, to discover actionable strategies and learn how technology can empower your care delivery. Together, we can drive progress and reimagine what's possible in healthcare.
Medscape
7 days ago
- Health
- Medscape
Technology Provides Aid in Fight Against Workplace Violence
In American hospitals, the corporate buzzword 'employee engagement' likely means something different than it does at the local widget company. No, in healthcare it first and foremost means keeping clinicians and all the caregivers in the hospital environment safe. The most recent data released from the US Bureau of Labor Statistics showed that healthcare workers accounted for 73% of all nonfatal workplace injuries and illnesses due to violence in 2018. This was a rate of 10.4 incidents per 10,000 workers, and the number of incidents showed steady increases since 2011. These figures do not account for the fraught period around the pandemic, during which time one study conducted in Egypt reported that more than half the healthcare workers who responded had been subjected to some sort of abuse on the job, whereas another conducted in Pakistan found that nearly 40% of emergency department doctors and nurses reported at least one episode of violence. With figures like these, not to mention the profession-wide burnout crisis, healthcare facilities all over the world are seeking out new approaches to keep providers safe. Northeast Georgia Health System, headquartered in Gainesville, Georgia, and Holyoke Medical Center, based in Holyoke, Massachusetts, are using a Bluetooth Low Energy ( BLE) system to do just that — and more. Tool Protects 10,000 Staff Members in Northeast Georgia With 950 beds and 10,000 medical staff members to protect at five locations, Northeast Georgia Health System Chief Information Officer Chris Paravate had a security challenge on his hands. 'When patients come to us, particularly in the emergency room and inpatient, they were not only bringing their medical condition, they're bringing everything with them. Their problems, their issues, their anxiety, their fear, their families, their socioeconomic problems come in our front door, and people are the most vulnerable when they are in that setting,' Paravate said. 'Sometimes their actions are not so favorable, and we want our patients and our employees and our staff to feel safe.' In 2021, Paravate turned to Poland-founded, New York-based and their BLE badging system to enhance security at their locations. The device contains a portable duress button that provides real-time location services, can be integrated within existing security and nursing workflows, and is able to be pressed discreetly — much more so than the old system of pulling a cord or rope to trigger an alert system, or even reaching for and pressing the emergency button on a cell phone, either of which may serve to only exacerbate a dangerous situation. Paravate said he left his first meeting with CEO and put some sample devices in the hands of one of the charge nurses on duty in the emergency department of their Gainesville facility, and the reaction was immediate. 'I said, 'Would you wear this?' And she took the badge and put it on and said, 'I'll try it. What does it do?'' Paravate said. 'I said, 'Well, it's got a button on the back, and you can press it if you need help.' She said, 'Oh, that'd be cool.'' Nurses are understandably picky about their gear and notorious for immediately sensing anything that will slow them down or get in the way of providing care. This reception was what Paravate had been looking for in a technology-based approach to workplace violence reduction. '(You usually can't take) that type of innovation and…talk with someone who has journeyed through that, who literally was 50 steps from four trauma rooms, who's sitting in the core of the third largest emergency room in the state, and…get that reaction,' Paravate said. The charge nurse wanted to know when the rest of the staff would get the same tool and how it works and wanted to know that if she pushed the button, someone would actually come help, he said. 'It was never about, well, you're gonna tag me or you're gonna track me,' he said. 'It was, 'Wow, you'd invest in technology for me to ensure that I was safe.'' Paravate had also been looking for a system that could be used for multiple purposes. At Northeast Georgia Health System, they are using the badging system to track patients to accurately deploy physician resources as well. For example, it can ensure that physicians only round on patients who are in their rooms so as not to waste providers' time when they could be caring for others. Paravate said these data are being used over time to forecast and anticipate staffing needs. Overall, Northeast Georgia Health System reported an estimated $10.2 million return on investment in the first year of deployment of the badging system's initial use case, which is a factor of 20x on their initial spend. What Is BLE? Bluetooth is the wireless technology familiar to most people for its use in earbuds, car stereos, and the like. This 'digital handshake' enables a variety of wireless devices to connect and interact using radio waves to transmit information. When two Bluetooth-enabled devices are in proximity, they can detect each other and initiate a connection. That's called pairing, where devices exchange unique security codes to establish a secure link; once paired, they remember each other for future connections. Instead of maintaining a continuous connection, BLE devices send small packets of data intermittently, sleeping when not transmitting or receiving data to conserve power. These devices manage their transmissions through a system of what are called advertising channels — not advertising like on television but advertising in the 'Hey, it's me, I'm here,' sense: A peripheral device, like a sensor in a badge in this case, will 'advertise' its presence by periodically sending out small data packets. A central device, such as a smartphone, can then listen for these advertisements and initiate a connection if it needs more information. Once a connection is established, BLE maintains its energy efficiency by using a pared-down client-server architecture known as the Generic Attribute Profile. The peripheral device acts as the server, holding data in a standardized format of services and characteristics. The central device, or client, can then read or write these data as needed. Using asynchronous communication, the client only requests data when necessary, and the server only sends updates when new information is available. With BLE's very fast connection setup times and short data packets, this ensures that the radio is active for the minimum possible duration, extending the battery life of devices so that they often last months or even years on a single coin cell battery. The Competitive Landscape in BLE Several of competitors in the staff duress badging sector include BLE in their badging makeup. These competitors include the following companies: AiRISTA Flow, which specializes in RTLS solutions across many industries. Their products include BLE-based tags and infrastructure for healthcare. They focus on improving operational efficiency, patient safety, and asset utilization. BeaconTrax, a Canadian company that specializes in beacon-based technologies powered by BLE that offers staff distress systems for the healthcare industry. Its systems include panic buttons and wristbands. BlueUp, an Italian company that designs and produces Local Positioning Systems based on BLE technology, as well as a wide range of other systems. They offer solutions for localization, tracking, and asset management in healthcare facilities, as well as for manufacturing and logistics operations, and their products include badges and wearable devices. CenTrak, which has a wide range of tags for both patients and staff, some of which include BLE in their technology package, often combined with Wi-Fi and their proprietary Gen2IR for accuracy. They offer solutions for staff duress and patient management among other functions. Lansitec, which offers a range of Bluetooth beacons, including badge-style transmitters, that are suitable for hospital asset tracking, staff location, and more, as well as a wide variety of other products. They emphasize features like adjustable transmit power and Angle of Arrival support for precise location. MeshTrac, which offers BLE beacon-based tracking systems for patients and assets in healthcare, emphasizing real-time visibility, enhanced patient safety, and workflow optimization. Minew, a significant manufacturer of BLE beacons and tags, including badge-style wearables designed for people management, staff tracking, and safety applications in various industries, including healthcare. Like Lansitec, they offer both standard and Angle of Arrival versions for improved accuracy. Stanley Healthcare (AeroScout), a multinational company that is increasingly implementing BLE in its solutions, including for staff safety and for patient management. Real-Time Location Services 'Real-time location services' is the name of the technology that makes locating a staff member in trouble, or determining that a patient is not in their room, possible. Real-time location services can be handled in a variety of ways in the healthcare: infrared, active and passive radio frequency identification (RFID), Wi-Fi, and ultra-wideband are all alternatives to BLE. They each have pros and cons: While ultra-wideband is highly accurate, it's also generally much more expensive to deploy than BLE because it requires dedicated infrastructure and doesn't mesh as well with other systems; Wi-Fi, meanwhile, is cost-effective and easy to integrate but less precise and consumes more power; infrared systems can only achieve room-level accuracy because they generally can't penetrate walls; passive RFID tags are generally only useful for choke points like entries and exits, and active RFID tags require a battery but maintain a persistent signal so are less energy efficient than BLE.
