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Category "Local Health"

13Nov

Opinion: Virtual walk-in clinics undermine primary care

by admin


Walk-in clinics — virtual or otherwise — erode the personal relationship and do not provide effective primary care.


noipornpan / Getty Images/iStockphoto

Despite efforts by the B.C. government to increase access to primary health care, new developments risk making it even harder to find a doctor.

B.C. is one of the only provinces that allows doctors to bill government for virtual phone or video visits without restrictions. This may make it more convenient to see your regular doctor, but a number of corporations have identified a lucrative business opportunity to operate virtual walk-in clinics.

Primary care is intended to be our first point of contact with the health care system where we see a regular practitioner or team over the course of our life.

A conclusive body of research tells us that primary care can improve health outcomes, reduce costs to the public system, and social inequities if it is comprehensive, coordinated, community-oriented, and continuous over time.

Primary care works best when there is a long-term relationship between the patient and a team of family doctors, nurse practitioners and other providers. They know our medical history and can more effectively support our health and make referrals to specialized services based on their knowledge of us as a patient. This ongoing relationship is the cornerstone of high-quality primary care.

Walk-in clinics — virtual or otherwise — erode the personal relationship and do not provide effective primary care. We need policies that make it easier to find a regular primary care provider and get timely and convenient access to continuous care, including same-day appointments and virtual visit options with our usual provider. Virtual care can be a useful tool when it supports care between patients and their regular providers.

In March, Telus unveiled its Babylon health app, which allows patients to consult a doctor through a smartphone app. This is a partnership with the U.K.-based Babylon corporation. In England, the app has undermined primary care services, and raised significant quality of care concerns.

The problem with this model of care is that it encourages one-off consultations with doctors that a patient has never seen before. It may be an attractive alternative to waiting in a walk-in clinic down the street, but it further entrenches a problematic model of episodic care.

As B.C. embarks on primary care reforms intended to improve access to regular primary care providers, these virtual walk-in clinics have the potential to undermine the government’s efforts.

How?

Telus, for example, pays doctors a guaranteed amount per hour regardless of whether they consult with patients via the app or not. This is attractive to doctors who are looking for a predictable income and don’t want to a run a business, which is required under the dominant fee-for-service payment model. This leaves fewer doctors to provide relationship-based primary care and less access to this more effective form of care.

What should be done instead?

We need to provide family doctors with opportunities to work in team-based primary care models — like Community Health Centres — where they can focus on practicing medicine, rather than running a business. This is consistent with the kind of workplaces that many family doctors increasingly expect.

Rather than allowing disruptions from companies that undermine effective primary care, the B.C. government should follow other provinces and restrict the use of virtual care to doctors who provide ongoing care at approved clinics.

Rita McCracken is a family doctor and assistant professor at the University of B.C.’s Department of Family Practice; Andrew Longhurst is a research associate with the Canadian Centre for Policy Alternatives; Ruth Lavergne is assistant professor in Simon Fraser University’s Faculty of Health Sciences; and Damien Contandriopoulos is a professor in the University of Victoria’s School of Nursing.

8Nov

Town Talk: Galas support hospitals and cancer and juvenile diabetes research

by admin


Wearing a rose-covered gown and headdress beside a rose-stuffed $408,993 Lamborghini Huracan Eco Spyder, Isabella McKinnon greeted South Asian community guests at a $742,495 B.C. Children’s Hospital Foundation benefit.


Malcolm Parry / PNG

THREE GALA NIGHT: It started at the Fairmont Hotel Vancouver when  Immigrant Employment Council of B.C. CEO Patrick MacKenzie chaired The B.C. Cancer Foundation’s Inspiration gala. With the theme Genomics: The Future of Cancer, the 15th annual event reportedly raised $3 million. As often in such roles, MacKenzie was motivated by a past cancer that carried away his wife Sarah. Dr. Janessa Laskin, the clinical head of B.C. Cancer’s genomics group, looks to her specialty curtailing such losses. “Cancer is so complicated, she said. “Genomics will change how cancer medicine is practised. It will change everything for patients, families, clinicians and researchers.”


B.C. Cancer genomics group clinical head Janessa Laskin and Inspiration gala chair Patrick MacKenzie saw the 15th annual event raise a reported $3 million.

Malcolm Parry /

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The Juvenile Diabetes Research Foundation’s Rockin’ For Research gala’s new chair, Stephanie Orr, greeted 12-time predecessor Mary Jane Devine.

Malcolm Parry /

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ROCK ON: Kitty-corner at the Hyatt Regency Hotel, another first-time-chair, Stephanie Orr, fronted the 20th annual Rockin’ For Research gala. It reportedly raised $965,000 for the Juvenile Diabetes Research Foundation. One attendee donated $1 million separately. Orr’s personal connection with diabetes derives from having two of her three children with that ailment. The event was founded by Loverboy guitarist Paul Dean and wife Denise on behalf of their then-four-year-old son Jake. Orr thanked guests for helping diabetic youngsters “get closer to a world without insulin injections, finger pokes, low blood sugars, high blood sugars, carb counting and constant fear of life-threatening consequences.”


Accompanied by counsellor-wife Careena, Manjot Hallen chaired the 11th annual Night of Miracles benefit for the B.C. Children’s Hospital Foundation.

Malcolm Parry /

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COMING UP ROSES: Down at the Marriott Pinnacle Hotel, yet another first-time chair, personal injury lawyer Manjot Hallen, fronted the South Asian Community’s 11th annual Night of Miracles gala. He and vice-chair Seema Lai saw the event reportedly add $742,495 to the $5.4 million previously raised for B.C. Children’s Hospital Foundation. That rosy result was reflected at the hotel’s entrance by a $408,993 Lamborghini Huracan Evo Spyder from Asgar Virji’s Weissach dealership that was literally stuffed with white and red roses. More blooms adorned greeter Isabella McKinnon, who is more accustomed to hops-and-barley fragrances at The Pint pub where she bartends. Foundation president-CEO Teri Nicholas thanked gala-goers for helping the hospital “transform care for children with presently incurable Type 1 diabetes.”


Wearing condottiere garb, Academie Duello owner Devon Boorman welcomed Halloween-made-up Tamara Lowey to his new axe-throwing program.

Malcolm Parry /

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BULL’S-EYE: Some 150 years ago, large axes felled old-growth timber at what is now downtown Hastings Street. Smaller versions now thud into targets at Devon Boorman’s Academie Duello there. Along with its swordplay, archery, dance and mounted-knight programs, the medieval-themed martial-arts organization has teamed with the Axewood concern to offer $45 chopper-chucking sessions — with no trees harmed.


TV anchor Sophie Lui’s friend Philip Meyer said that the Rosewood Sand Hill hotel he manages has set occupancy record as California fires rage.

Malcolm Parry /

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ILL WIND: The old saying aside, California’s wildfire-fanning winds did blow some good. That was to Menlo Park’s Rosewood Sand Hill hotel where former Vancouver hotelier Philip Myer is managing director. While visiting family and friend Sophie Lui here, he said, “We just had our best October ever,” meaning that fire-fleeing guests had booked all the ritzy joint’s rooms.


Eastside Culture Crawl head Esther Rausenberg’s Displacement event had photo-artist Sally Buck display her works in the old-style “flasher” manner.

Malcolm Parry /

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LOST SPACE RACE: Eastside Culture Crawl executive director Esther Rausenberg is pleased that 500 artists, craftspeople and designers will open their studios for the 23rd running Nov. 14-17. She’s dismayed, though, that a decline of affordable production spaces — often former industrial premises — is depriving artists of places to work. Seventy-five such artists are participating in the multi-venue Displacement exhibition that Rausenberg launched recently. “No artists, no city culture,” she said, hoping that community leaders, elected officials and the like will prevent that baleful outcome.


Carol Mayer toasted late husband Ken when an exhibition and auction of his photographs raised funds for Capilano University music scholarships.

Malcolm Parry /

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GONE TOO SOON: Ken Mayer’s photo-artworks were exhibited and auctioned recently at his studio in the 1000 Parker building where scores of other artists and artisans practice. Mayer, who died in September soon after a cancer diagnosis, directed that all auction proceeds would fund Capilano University music scholarships. Especially popular were his photographs of France and others inspired by 17th-century Dutch paintings that, though little demanded 20 years ago, “flew off the wall,” said wife Carol.


Nancy Greene Raine, Marielle Thompson and other Olympic gold medalists celebrated Canadian ski racing’s centenary at the Peak to Peak dinner.

Malcolm Parry /

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PEAK PERFORMERS Olympics and Paralympics gold medallists Molly Jepson, Kathy Kreiner, Ashleigh McIvor, Marielle Thompson and Nancy Greene Raine joined other top skiers, coaches and guests at Blue Water Café recently. The B.C. Alpine organization’s 14th annual Peak to Peak dinner-auction there celebrated 100 years of Canadian ski racing and helped fund national-level programs. Sun Peaks skiing director Greene Raine said she and mayor-husband Al are busy with further development of a multi-purpose centre there. Meanwhile, $850,000 would acquire their 4,000-square-foot home beside Kamloops’ Rivershore golf course’s third green.


Vancouver Heritage Foundation head Judith Mosley and board chair David Dove fronted a fundraiser at the Hotel Vancouver’s Panorama Roof.

Malcolm Parry /

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TIME WAS: The Vancouver Heritage Foundation’s annual City Drinks fundraiser took place recently where much drinking was once done: the Fairmont Hotel Vancouver’s Panorama Roof. Foundation executive director Judith Mosley and board chair David Dove had civic historian John Atkin entertain guests with a video-supported recounting of the hotel’s eight decades. The foundation has a publication grant to record Vancouver’s early history, and has developed a heritage guide program for schools, Mosley said.

DOWN PARRYSCOPE: With permanent occupancy of his 92-year-old Mar-a-Lago approaching, Donald Trump may appreciate that the 126-room “cottage” was designed not by then-reigning Palm Beach architects Addison Mizner and Maurice Fatio but by Joseph Urban moonlighting from creating sets for the Ziegfeld Follies revues of revealingly clad showgirls.

malcolmparry@shaw.ca
604-929-8456

4Nov

Vancouver city council to consider regulations on sale of vape products, ads

by admin

1Nov

Town Talk: $3.8 million raised for ‘Brain Breakthrough’ campaign

by admin


Naz Panahi and Devi Sangara chaired the $3.8-million Night of a Thousand Stars to benefit VGH & UBC Hospitals’ Brain Breakthrough campaign.

Malcolm Parry /

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ALL BRAINER: Multi-time chair Devi Sangara and second-timer Naz Panahi fronted VGH & UBC Hospital Foundation’s recent Night of a Thousand Stars that reportedly raised $3.8 million in stately style. With the $60-million Future of Surgery campaign wrapping up, this year’s focus was the Brain Breakthrough drive that reportedly has $10 million of its $35-million goal in hand. Good news for the hospitals’ head of neurology, Philip Teal, and the one in three Canadians facing brain disorder or injury. The campaign should keep six-year development director Angela Chapman hopping when she succeeds foundation president-CEO Barbara Grantham in January. The Ismaili Muslim Community of B.C. received the foundation’s Leadership Award for its “significant contribution to our hospitals and health-care system.” Duly honoured, the Ismaili Council for B.C. president, Samir Manji, noted the award’s first-time recognition of a religion-based community.


At the Henriquez Partners’ 50th-annivery event, founding architect Richard Henriquez showed a global-location device he designed and made.

Malcolm Parry /

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HAPPY 50TH: The Henriquez Partners celebrated a half-centennial recently with guests jam-packing the architectural firm’s Georgia-at-Seymour underground offices. Large posters of 10 major projects covered a wall near founder Richard Henriquez’s office. Ever whimsical, he put the first tree atop a tower (Eugenia Place, 1991), and designed the ship-shaped 46-unit Dockside building beside Coal Harbour. Richard’s self-made gadgets include a compass-linked globe’s articulated hand that points directly to specified world locations. They include one in Poland where pilot-father Alfred crashed a Lancaster bomber in 1944, thus orphaning three-year-old Richard. His own son, Gregory, escaped that trauma and heads the partnership today.


Amelia Tai and Angela Jang joined other Arts Umbrella students creating sketches of guest activities at the million-dollar Splash fundraiser.

Malcolm Parry /

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HAPPY 40TH: That’s for Arts Umbrella, the children’s arts organization that Richard Henriquez’s wife Carol and friend Gloria Schwartz founded. Launched three years later, the Splash gala and art auction reportedly raised $1.075-million at its recent annual running. Christie Garofalo and Bruce Munro Wright co-chaired again, and — smart idea — Arts Umbrella students reflected donating artists’ works by sketching guests’ activities at a pre-auction reception.


Katerina Tokmak accompanied husband and Turkish consul general Mehmet Taylan Tokmak at his nation’s 96th Republic Day celebrations.

Malcolm Parry /

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HAPPY 96TH: Recently installed consul general Mehmet Taylan Tokmak, fellow nationals and guests celebrated Turkish Republic Day’s 96th anniversary recently. The event commemorated Mustafa Kemal ending six centuries of the Ottoman caliphate and launching a secular republic named Turkey that still recognized Islam as its state religion. Tokmak previously headed a foreign-affairs department in capital Ankara and was a Turkish embassy counsellor in Prague. His Czech-born wife, Katerina, although not a diplomat, has comparable attributes as a lifeguard and 100- and 400-metre hurdler.


Arts Umbrella’s Splash fundraiser co-chair Christie Garofalo attended with husband and mining executive David fully suited in Prince of Wales check.

Malcolm Parry /

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BON APPÉTIT: Splash co-chair Christie Garofalo’s mining executive-husband David wore a suit cut from the popular cloth commemorating the Prince of Wales who became King Edward VII. Apparel aside, the trim Garofalo couldn’t consume even a fraction of that mountainous 1901-1910 monarch’s daily diet. It entailed porridge-eggs-bacon-haddock-woodcock breakfasts, kidneys-tongue-macaroni-spuds lunches, multi-confection high teas, 12-course course dinners with steak, crayfish and truffle-stuffed game birds in Madeira sauce, caviar at any time, grilled oysters or a roast chicken at bedtime, and champagne, claret, brandy and cigars along the way.


Restaurant entrepreneur Yuri Fulmer founded Goodly Foods that makes nourishing soups from surplus produce and creates jobs for the hard-to-employ.

Malcolm Parry /

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SOUP’S ON: The 127-year-old Terminal City Club may have served enough soup to fill Lost Lagoon. But the tomato, beet and squash varieties dished out recently were different. Using surplus produce, they were created by Goodly Foods that restaurant-biz entrepreneur-philanthropist Yuri Fulmer founded in 2017. With the H.A.V.E. Culinary Training Society’s co-operation, the project produces nutritious food while providing paycheques to hitherto-employment-challenged participants.


Danika Sung, Audrey Law, Stella Watson and Chloe Beck enjoyed the puppies-and-kittens Cuddle Lounge when the Offleashed gala raised almost $780,000 for the B.C. SPCA’s cruelty investigation branch.

Malcolm Parry /

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Darlene Poole hurried from late husband Jack’s Canadian Olympics Hall of Fame induction to join B.C. SPCA head Craig Daniell at the Offleashed gala.

Malcolm Parry /

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PUPPY LOVE: Tracey Wade recently chaired her fifth Offleashed gala that reportedly raised a record $777,192 for the B.C. SPCA. It will help expand the privately funded cruelty investigation branch that costs $3.5 million annually, said B.C. SPCA CEO Craig Daniell. Featuring puppies and kittens available at the SPCA shelter, a Cuddle Lounge was sponsored by Darlene Poole. She had hurried from Toronto where late husband and 2010 Winter Olympics Bid Corp. head Jack Poole was inaugurated into the Canadian Olympics Hall of Fame exactly 10 years after his death.


Boobyball décor duo Shelby Blair and Gillian Brown flanked organizer and soon-to-be-mother Kelly Townsend at the breast cancer benefit’s third running.

Malcolm Parry /

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BABY BALL: Swimwear sales representative Kelly Townsend took the charitable plunge again recently by heading a sold-out third running of Boobyball. The event reportedly raised $54,000 for the Rethink Breast Cancer organization that “responds to the unique needs of young women.” Its new-for-B.C. Stretch Heal Grow retreats at Emerald Lake serve those receiving or having completed breast-cancer treatment. Townsend’s own growth includes her first child, a boy, due Jan. 11.

SETTING IT STRAIGHT: The Sleep Out fundraiser for Covenant House Nov. 21 will again entail women sleeping outdoors as well as men.

STILLBIRTH OF A NATION: Seventy-nine years before British Prime Minister Boris Johnson began fighting to leave Europe, predecessor Winston Churchill and France’s Paul Reynaud issued a diametrically opposite but short-lived Declaration of Union. With Nazi invasion imminent, they proclaimed that “France and Britain shall no longer be two nations, but one Franco-British Union.” Citizens of each would have become full citizens of the other.

DOWN PARRYSCOPE: CBC Radio listeners who once waited expectantly for 5:40 p.m. Fridays will lament the death of erudite, entertaining and ever-informative movie reviewer Rick Staehling.

malcolmparry@shaw.ca
604-929-8456

29Oct

Bank pledges $2 million for Indigenous health care at St. Paul’s Hospital

by admin


Dr. Jeff Reading, the inaugural FNHA Chair in heart health and wellness at St. Paul’s Hospital.


Allan Tung

Features of First Nations cultures that help promote their health and wellness will be embedded into the planned new St. Paul’s Hospital, thanks to a $2-million donation from BMO Financial Group.

The pledge, announced Tuesday by the St. Paul’s Foundation, will also be used to further work started in 2015 when the First Nations Health Authority Chair in heart health and wellness was established as a $2.5-million 10-year partnership of the health authority, St. Paul’s and Simon Fraser University.

Grand Chief Edward John said then that it was his 1998 heart attack that was the seed of the program focused on the cardiac health of B.C. First Nations people. His medical experiences helped him understand more about medical gaps for Indigenous Peoples and the need for culturally informed care.

In 2016, Jeff Reading was named the First Nations Chair in heart health and wellness and has led research into issues like the obstacles to timely care for First Nations individuals living in B.C.

Broek Bosma, chief development officer at the St. Paul’s foundation, said Reading will decide how to use the new BMO funds, but the pledge — over an unspecified time period — will be spent on salaries, research and design features in the new hospital. On the third floor of the existing St. Paul’s is an All Nations Sacred Space where First Nations patients can participate in smudging ceremonies and other customary healing practices. The new hospital will also have such features.

Reading has created what is called the first Indigenous Health Education Access Research and Training Centre at St. Paul’s (I-HEART). Its goal is to improve the health of Indigenous people by encouraging healthy diet, exercise and recreation, and by helping individuals manage chronic illnesses like diabetes, obesity, lung and kidney disease.

In 2017, Providence Health Care signed a commitment with the First Nations Health Authority to improve Indigenous health services. The hospital set up a team to advocate for patients. It also helps provide them with traditional items like blankets, foods like bison, salmon, and berries for ceremonies and gatherings, and traditional medicines for healing ceremonies. The hospital also has a rooftop garden with a section for traditional medicinal plants.

pfayerman@postmedia.com

Twitter: @MedicineMatters

 

29Oct

B.C. school trustees ask for provincial, federal aid to stomp out student vaping

by admin


Vaping has become a major problem in B.C. schools, reports the trustees’ association.


Dax Melmer / Postmedia News files

British Columbia’s school trustees are asking for help to stop students from vaping.

Stephanie Higginson, the president of the B.C. School Trustees Association, says her members report that their schools are spending more time policing vaping and more students are breaking the rules around vaping.

Higginson says members approved a motion at the association’s provincial council meeting urging federal and provincial governments to make funding available for vape education and cessation for students.

She says council members also want vaping product advertisements, promotions and sponsorships to align with current tobacco legislation.

Higginson says a solution should be part of a larger mental-health support strategy that the association been advocating for and they know that kids who have access to such supports are less likely to vape.

The motion will be presented to B.C.’s ministries of Health and Education and to provincial health authorities and Higginson says it will also be presented to the Canadian School Board Association to advocate for support on the federal level.

 

22Oct

Vaccine delayed a bit, but few flu cases being reported yet in B.C.

by admin


The flu shot is coming to a pharmacy or health unit near you … soon.


PASCAL POCHARD-CASABIANCA / AFP via Getty Images

Pharmacies across B.C. are now offering flu shots but public health clinics won’t start administering them until early November because of “minor delays and shortfalls.”

Waiting until early November shouldn’t cause problems if last year’s experience is any indication. At this time last year, there was a very low level of influenza being detected across the province. Indeed, cases were markedly lower than the same periods in 2014 to 2017, according to data from the B.C. Centre for Disease Control. That began to change in early December. Cases of the flu typically peak in early January for children and adults.

Heather Amos, a spokesperson for the Centre for Disease Control and the Provincial Health Services Authority, said there’s nothing unusual about the fact that big flu vaccine shipments aren’t here yet.

“The timing of the delivery of the flu vaccine, and the quantity of vaccine available can, and does, vary from year to year due to a variety of factors related to the manufacturing, testing, and regulatory processes.”

The World Health Organization is the body that recommends which strains of influenza should be targeted in vaccines each year and this year, the recommendations were delayed, which affected manufacturing. That has led to a nationwide delay in the distribution of vaccines. Typically, flu patterns in the southern hemisphere predict the subsequent composition in vaccines and the severity of flu in the northern hemisphere.

Children are given a quadrivalent vaccine that protects against four types, and there is shortage of the quadrivalent vaccine. Public health officials will have sufficient supplies of the trivalent vaccine, which protects against three types, to compensate and those vaccines “should offer a similar level of protection for the types of flu expected to circulate this year, so this shortfall is not expected to be clinically significant.” 

“Despite some minor delays and shortfalls, which are normal and expected, we anticipate this year will be similar to most years in terms of our total quantities of vaccine and the timing of distribution.”

Ninety per cent of the vaccine supply is expected to be shipped to B.C. by the middle of November. Priority will be given to long-term care facilities, hospitals, physicians and pharmacies. And then public health clinics.

An emerging trend is individuals getting their flu shots from pharmacists; the majority of pharmacies now offer vaccinations.

A poll conducted by London Drugs of 624 adults reflects that pattern. The survey, conducted by Insights West on behalf of London Drugs, showed that among those who plan to get a flu shot this year, half will go to a pharmacy. That’s an increase of eight percentage points over last year. By comparison, only six per cent said they would go to a public health flu clinic, down from 10 per cent last year. Another 15 per cent said they’d go to their doctor’s office and 16 per cent said they will get it at their workplace.

Many companies have notified employees that previously scheduled flu clinics have been postponed because of manufacturing and shipping delays.

London Drugs has 82 stores across B.C. Publicly funded vaccines for those eligible are available at all locations now. The remainder of the supply for those who don’t qualify as high risk individuals and therefore must pay about $20 is expected later this week, according to a spokesperson. 

pfayerman@postmedia.com

Twitter: @MedicineMatters

17Oct

Fewer B.C. residents were prescribed opioids last year: report

by admin

Fewer people in B.C., Saskatchewan and Ontario were prescribed opioids last year compared with 2013 and the number of patients who began treatment on the pain medication decreased by nearly 10 per cent, the Canadian Institute for Health Information says.

The institute said in a report released Thursday that eight-per-cent fewer patients, or about 220,000 people, in those provinces are taking prescription opioids while about 175,000 fewer people were started on the drugs.

Patients who began taking opioids were prescribed smaller doses for shorter duration and when it came to long-term opioid therapy, fewer people were prescribed the medication for a period of 90 days or longer before sometimes being switched to other types of drugs to manage pain, the agency said.

It said initiatives including national prescribing guidelines introduced in 2017, along with prescription-monitoring programs to help reduce harms related to the overdose crisis, likely influenced prescribing trends.

“Despite overall decreasing trends in the prescribing of opioids, opioid-related harms and deaths have continued to rise across the country in recent years,” the report says.

Michael Gaucher, director of pharmaceuticals for the agency, said only the three provinces provided complete data for opioid prescribing for the six years covered in the report but they represent a large portion of Canada’s population.

Some chronic-pain patients have been concerned about being cut off opioids they need, and Gaucher said that is a valid issue to consider because opioids are an effective treatment.

“The concern with prescription opioids goes deeper than the person (taking them) and there can be others in the household that can access them,” he said.

Dr. Norman Buckley, scientific director of the Michael G. DeGroote Institute for Pain Research and Care at McMaster University in Hamilton, said “it’s unfortunate” that data for Quebec and Alberta, for example, couldn’t be included in the report.

He said doctors in Quebec generally prescribe fewer opioids than other provinces and are known for getting a substantial amount of education on pain management while physicians in Alberta and B.C. have access to real-time prescription monitoring systems for patients.

“You could make the argument that having a concerted pain strategy actually also leads to less reliance on opioids,” he said from Hamilton.

Buckley, who often treats pain patients referred to him by other doctors, said it’s important for patients to know they need to be tapered off opioids slowly.

“It’s about correct prescribing or optimal prescribing rather than trying to drive the dose down. What you need to be looking at are things like measures of function, and those typically don’t come through on large-scale administrative health data,” he said. “You can’t tell, if people’s doses came down, did they stop going to work, for example, or did they start relying on more assistance for home care?”

Buckley said one of his patients, a man in his late 50s, had been prescribed opioids for 10 years due to a variety of workplace injuries but decided to taper off due to his concerns about long-term use. His dosage was gradually reduced over a year-and-a-half, Buckley said, adding his pain wasn’t any better but his “mental energy” improved somewhat.

“He also finds he’s edgier than he was so his wife has been in once or twice to say, ’Look, he gets grumpy a lot more than he used to but he’s probably a bit more mentally active.’ ”

The patient also received physical therapy, one of the ways the national guidelines advise doctors to treat pain beyond opioids, but many provinces don’t cover such costs, Buckley said.

“A lot of people don’t have that. This is one of the push-pull parts (of the issue). Optimal pain management includes more than medications. It includes education, sometimes cognitive behavioural therapy and exercise,” Buckley said. “But a significant portion of the country can’t access those through their provincial health-care systems.”

Buckley suggested all provinces provide complete opioid prescribing data to the Canadian Institute for Health Information so a fuller picture of what’s happening across the country is available.

Related

16Oct

First case of vaping-related illness confirmed in B.C.

by admin


The first probable case of vaping-related illness in B.C. has been confirmed.


Gabby Jones/Bloomberg via Getty

The first probable case of vaping-related illness in B.C. has been confirmed.

In a news release Wednesday, provincial health officer Bonnie Henry confirmed a patient suffering an illness sought care and that the illness was linked to vaping.

Several other patients and their illnesses are being investigated by health officials, with Henry suggesting it’s possible those cases may be linked to vaping as well. Henry did not say whether the cases involving the vaping of nicotine cartridges or cannabis-oil cartridges.

“These are the first cases of vaping-related illness in B.C., but we fully expect there will be more as this is quickly emerging as a significant public-health issue,” Henry said. “Vaping is turning back the clock on decades of effective anti-smoking efforts and creating a new generation of young people addicted to nicotine.”

Related

Last month, Henry issued a notice that required doctors to report cases in which patients had a history of using e-cigarette or vaping devices within the past 90 days, had abnormal X-ray results, and whose illnesses couldn’t be linked to other causes.

Those reports are being forwarded to the B.C. Centre for Disease Control and will be investigated by the public-health authority. Cases confirmed to be linked to vaping will be shared with the public.

Vaping has come under the spotlight recently, with at least 450 cases of acute vaping-related illness and 13 deaths reported in the U.S. to date.

While officials are still studying the cause and working to determine the exact reason vape users have been suffering breathing problems, it’s believed a contaminant created during the vaporization of oils in e-cigarettes has damaging effects on lungs. It remains unclear whether the illnesses are linked to vaping nicotine cartridges or THC cartridges.

B.C. Health Minister Adrian Dix has also promised to dramatically reduce the number of vendors that can sell e-cigarettes and vaping products in a bid to bring the problem under control.

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16Oct

HPV immunization program in B.C. cuts rates of pre-cancer in women: study

by admin


Dr. Gina Ogilvie


Francis Georgian / PNG

Rates of cervical pre-cancer in women have been cut by more than half in British Columbia and the province’s school immunization program for the human papillomavirus is being given credit for the results.

A study published in the Journal of Infectious Diseases says those who took part in the program to prevent the sexually transmitted infection had a 57 per cent reduction in incidence of pre-cancer cells compared to unvaccinated women.

The program has been in place in public schools for 12 years and the first groups of women who were vaccinated in Grade 6 entered into the cervix screening program, allowing researchers to compare outcomes with those who hadn’t been vaccinated.

Dr. Gina Ogilvie, a senior research adviser at B.C. Women’s Hospital, says the study adds to the growing body of evidence highlighting the positive impact of the vaccine.

HPV is common in both men and women.

It can be easily spread through sexual contact and while most HPV infections clear up on their own, some pre-cancerous lesions can develop into cancer if not treated.

The Canadian Partnership Against Cancer says HPV immunization is offered to children in all provinces and territories, generally between grades 4 and 7.

B.C. Health Minister Adrian Dix says the lower rates of pre-cancer shows the importance of having children immunized early.

“The dramatic success — pre-cancer rates dropping by over half, shows us the importance of having children immunized early to protect their lives,” he said in a statement on Wednesday.

HPV has been identified as the cause of almost all cervical cancers.

The province implemented a voluntary publicly funded school-based HPV immunization program in 2008.

Education Minister Rob Fleming said the study reinforces the importance of such school-based programs.

“The decline we are seeing in HPV-related cancer rates highlights how strong partnerships between school districts and health authorities can significantly improve the well-being of B.C. students.”

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