“This book was a joy to read and a joy to review. All
pharmaceutical physicians should have a copy on their
bookshelves, all pharmaceutical companies should have copies
in their libraries.”
JBM Communications to work with delegates from Anhui, ChinaJBM Research publish paper on incorrect classification, diagnosis and coding in diabetes
JBM Research provide editorial support for recent reviews on liposomal doxorubicin in breast cancer
JBM Research get another paper in top 20 electronic downloads
Latest paper from JBM Research published in Archives of Disease in Childhood
Critical Care Medicine publishes JBM Research's latest paper on dopamine infusion
JBM Research's paper on hypoglycaemia published in Diabetic Medicine
JBM Health Economics suggests that switching hypertensive patients to losartan yields cost benefits
JBM Research's paper on vertebral fracture is reviewed in IOF journal
ISMPP issues position statement in support of medical writers
JBM Communications to work with National Pharmacy Association
Landmark risk-sharing scheme for Velcade accepted by NICE
JBM Research Contributes chapter to new Pharmaceutical Medicine book
Dr Belsey speaks at Pharmaceutical Marketing Society Briefing Meeting
JBM Research paper in Alimentary Pharmacology and Therapeutics top 10 electronic downloadsJBM Health Economics works on budget impact and evidence for use of parathyroid hormone Preotact
JBM Research publishes Systematic review of oral bowel preparations for colonoscopy
JBM Toolkits endorsed by International Society for Fracture Repair
Dr Belsey gets letter published in the BMJ
JBM Research publishes paper on suboptimal management of cholesterol JBM work with IOF on orthopedic surgeons’ initiative JBM's editorial assistant helps cancer patients to 'look good feel better'JBM Research publishes paper on ‘Rule of Halves’
JBM Research reveals vitamin D inadequacy very common in older people with osteoporosis
JBM Communications are to provide a series of lectures on evidence-based medicine on behalf of Sino-Bridge International (SBI). SBI are a subsidiary of an independent parent organization based in Beijing, China, and have since 1997, been designated by the Chinese central and local governments as a facilitator for hundreds of training missions to the UK.
Dr Jonathan Belsey will lead the lectures for a forthcoming delegation from Anhui, China, consisting of hospital deans, senior physicians and professors.
JBM Research publish paper on incorrect classification, diagnosis and coding in diabetes
JBM Research working in collaboration with St George's University of London, University of Leicester and Peninsula Medical School, has had a paper published in this month's Diabetic Medicine, which investigates the accuracy of diabetes diagnostic data, and the scope for identifying errors in classification, diagnosis and coding in diabetes.
Using two sets of anonymised, routinely collected computer data from the CONDUIT (n=221,958) and QICKD (n=760,558) studies, the study classified errors as: misclassified - incorrect type of diabetes; misdiagnosed - where there was no evidence of diabetes; or miscoded - cases where it was difficult to infer the type of diabetes.
Results revealed a high prevalence of miscoding, misclassification and misdiagnosis of diabetes. In particular, 13.1% of CONDUIT and 14.8% of QICKD were incorrectly coded, 10.3% and 26.2% respectively were misclassified with almost all of these cases being people classified with Type 1 diabetes, when they should have been classified as Type 2 diabetes. With regard to misdiagnosis, approximately 5% of those with Type 2 diabetes from both samples, had no objective evidence to support a diagnosis of diabetes.
The study concludes that although 85-90% of diabetic data is fit for purpose, there is substantial scope for further improvement in diagnosis and data quality. The authors suggest that algorithms which identify likely misdiagnosis, misclassification and miscoding could be used to flag cases up for review.
Further research is now being called for, so that the study can be repeated in a more nationally representative sample, ideally using a range of different brands of GP computer systems. The search strategy also needs to be refined to include gestational diabetes.
De Lusignan S, Khunti K, Belsey J et al. A method of identifying and correcting miscoding, misclassification and misdiagnosis in diabetes: A pilot and validation study of routinely collected data. Diabet Med 2009: DOI: 10.1111/j.1464-5491.2009.02917.x
JBM Research provide editorial support for recent reviews on liposomal doxorubicin in breast cancer
JBM Research provided editorial support to Professor Bob Leonard, Hammersmith Hospital, London during his recent review of liposomal doxorubicin (Myocet™) in metastatic breast cancer.
The review published in The Breast, considers the efficacy and safety of Myocet, and concludes that Myocet is a viable therapeutic alternative to doxorubicin in the treatment of metastatic breast cancer, with significantly less cardiotoxicity than doxorubicin. Additionally, Myocet has a promising new role when used in combination with trastuzumab and taxanes, with early results suggesting that high response rates are achievable with acceptable tolerability and a low incidence of cardiotoxicity.
This follows the editorial support which we provided to Dr Flora Stavridi and Dr Carlo Palmieri, St Georges Hospital, London in their review of Myocet in breast cancer published in Expert Reviews of Anticancer Therapies during 2008
Leonard RC, Williams S, Tulpule A, Levine AM, Oliveros S. Improving the therapeutic index of anthracycline chemotherapy: focus on liposomal doxorubicin (Myocet). Breast 2009;18:218-224. PubMed PMID: 19656681.
Stavridi F, Palmieri C. Efficacy and toxicity of nonpegylated liposomal doxorubicin in breast cancer. Expert Rev Anticancer Ther 2008;8:1859-1869. PubMed PMID: 19046106.
JBM Research get another paper in top 20 electronic downloads
JBM Research's paper "Systematic review: Adverse event reports for oral sodium phosphate and polyethylene glycol" reached number eight in the top 20 electronic downloads between January 1st and 31st 2009, of all papers published in the journal Alimentary Pharmacology and Therapeutics. This is the second time that a JBM Research paper has reached the top 20. In February 2007, our systematic review on oral preparations for colonoscopy reached number two.
View PubMed abstract
Latest paper from JBM Research published in Archives of Disease in Childhood
JBM Research conducted a systematic review of the use of polyethylene glycol (PEG) in children with functional constipation and faecal impaction which has now been published in the February 2009 issue of Archives of Disease in Childhood. The review examined evidence that supports the change in emphasis of the management of constipation in children, from disimpacting the colon with suppositories or manual removal followed by polypharmacy with osmotic and stimulant laxatives, to widespread use of PEG-based laxatives. Since 2005 several new randomised clinical trials investigating the efficacy of PEG have been published and JBM Research sought to carry out a new literature search in order to ascertain whether more precise guidance can now be given. Seven separate randomised controlled trials of PEG versus either placebo (one) or active comparator (five) or another laxative (one), in patients <18 years with primary chronic constipation were identified, involving 594 children, ranging from two weeks to 12 months. Outcomes were assessed as either global assessments of effectiveness or differences in defaecation rates
The review found that PEG is significantly more effective than placebo, is equivalent to milk of magnesia and equivalent or superior to lactulose. PEG-based laxatives also have the advantage that in high doses they can be used for disimpaction, and do not increase gas production.
The literature review demonstrated that the evidence base for current clinical practice is improving and concluded that there appears to be a consensus amongst the studies that treatment with PEG is more effective than with lactulose, with neither agent appearing to have a convincing advantage in terms of tolerability.
View PubMed abstract.
Model suggests that raising HDL-C levels using nicotinic acid yields significant incremental
clinical benefits in statin-treated patients
A recent analysis published by JBM Research published in Current Medical Research and Opinion modelled the potential impact of nicotinic acid therapy on coronary risk in statin-treated patients with established cardiovascular disease or diabetes.
The mean 4-year risk of a coronary event was estimated using a regression model derived from the Framingham study for all patients, patients not at total cholesterol target (TC <5 mmol/l) and patients at total cholesterol and LDL-C targets (<5 and <3 mmol/l respectively) but with low HDL-C or high triglyceride. The model assumed that the addition of nicotinic acid would decrease TC by 15% and increase HDL-C by 25%.
The addition of nicotinic acid significantly reduced 4-year coronary risk in all patient groups by 14-29% (p<0.000001) - even in patients at TC and LDL-C targets. Patients with diabetes had the greatest reduction in risk. In diabetic patients not at TC goal, the model indicates that the addition of nicotinic acid to statin therapy reduces 4-year coronary risk by 29% (10.9% baseline risk to 7.7% modified risk).
The model suggests that the use of nicotinic acid has a significant potential to reduce coronary risk in statin-treated patients with pre-existing cardiovascular disease or diabetes, therefore where low HDL-C has been identified, clinicians should consider the addition of nicotinic acid to statin therapy in order to address coronary risk.
View PubMed abstract.
Adding sulphonylurea to therapy in patients with type 2 diabetes uncontrolled on metformin
is unlikely to lower HbA1c by more than 1%
A recent meta-analysis published by JBM Research in Diabetes Obesity & Metabolism explored the effect of a sulphonylurea on glycaemic control and the risk of adverse events when incorporated into the treatment regimen of patients with type 2 diabetes inadequately controlled on metformin.
Six studies including 1,364 patients were identified and included in the meta-analysis. The pooled estimate of change in HBA1C from baseline was 0.9% (95% CI 0.7-1.1, p = 0.00011 versus baseline) and for change in fasting plasma glucose from baseline was 1.8 mmol/l (95% CI 1.1-2.5, p = 0.0026 versus baseline).
The meta-analysis revealed that in patients with type 2 diabetes whose control is inadequate on metformin monotherapy, the magnitude of incremental HBA1C reduction achieved by the addition of a sulphonylurea is unlikely to exceed 1%, even after titration to maximum tolerated doses. Additionally, the risk of clinically relevant side-effects such as symptomatic hypoglycaemia and weight gain is increased when sulphonylurea is added to metformin monotherapy.
For further information, see the Pubmed abstract.
Almost two-thirds of patients at high risk of cardiovascular disease have residual dyslipidaemias, despite achieving a total cholesterol target of 5 mmol/l or less
Lipid management in UK general practice aims for the achievement of total cholesterol targets in high risk individuals. A recent paper published by JBM Research in Current Medical Research and Opinion explores what proportion of the UK population with cardiovascular disease and total cholesterol levels at or below 5 mmol/l are still at cardiovascular risk because of residual dyslipidaemia.
Cardiovascular risk profiles, statin use, mean lipid values (total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride) and achievement of lipid targets were extracted from a research database of over 600,000 patients from 98 UK general practices.
Of those patients treated to a total cholesterol target of 5 mmol/l, 28% had LDL-C above the 3 mmol/l target. Amongst those with both total cholesterol and LDL-C treated to target, 22.5% had low HDL-C (defined as <1 mmol/l in men or <1.2 mmol/l in women) and 37.2% had high triglyceride. Patients with diabetes were more likely than those without diabetes to have abnormalities of both HDL-C and triglycerides despite normal TC and LDL-C.
The study revealed that overall around 60% of high risk patients have residual dyslipidaemias, despite achieving a total cholesterol target of 5 mmol/l or less and suggests that new patterns of treatment are required in order to extend lipid management beyond total cholesterol lowering.
View PubMed abstract.
Critical Care Medicine publishes JBM Research's latest paper on dopexamine infusion
JBM Research's latest paper has been published in the journal Critical Care Medicine. The study set out to establish whether perioperative low-dose dopexamine infusion is associated with a reduction in mortality and duration of hospital stay after major surgery. Studies were independently screened for inclusion, and data was extracted by systematic review and meta-regression analysis of individual patient data. Of the five studies that fulfilled the inclusion criteria, results showed that dopexamine reduced the duration of hospital stay, but there was no improvement in mortality after two weeks. However, low-dose dopexamine was associated with a 50% reduction in 28-day mortality (6.3% vs. 12.3%; OR 0.50 [0.28-0.88]; p=0.016). The study concluded that for pooled data describing perioperative dopexamine infusion at all doses, there was an improvement in duration of hospital stay but no survival benefit. But at low doses, improvements were seen in both of these outcomes. The authors stated that further clinical trials are required to confirm this observation.
View PubMed abstract.
JBM Research's paper on hypoglycaemia published in Diabetic Medicine
JBM Research's review article on hypoglycaemia in type 2 diabetes has been published in the February 2008 issue of Diabetic Medicine. The article found that although differing definitions, data collection methods, drug type/regimen and patient populations make comparing rates of hypoglycaemia difficult, it is clear that patients taking insulin have the highest rates of self-reported severe hypoglycaemia (25% in patients who have been taking insulin for >5years). Sulphonylureas (SUs) were associated with significantly lower rates of severe hypoglycaemia, however it is estimated that each year >5000 patients taking SUs will experience a severe event caused by their therapy which will require emergency intervention. The paper found that the cost implications of severe episodes are considerable, and that each hospital admission for severe hypoglycaemia costs around £1000. It was also found that hypoglycaemia and fear of hypoglycaemia limit the ability of current diabetes medications to achieve and maintain optimal levels of glycaemic control. The study concludes that newer therapies which focus on the incretin axis, may carry a lower risk of hypoglycaemia, and that their use, and the more prudent use of older therapies with low risk of hypoglycaemia, may help patients to achieve improved glucose control for longer, as well as reducing the risk of diabetic complications.
View PubMed abstract.
JBM Health Economics suggests that switching hypertensive patients to losartan yields cost benefits
JBM Health Economics has had a paper published in the February issue of Current Medical Research and Opinion. The paper investigated switching strategies in the management of hypertensive patients currently taking an angiotensin receptor blocker (ARB) based regimen. A Markov model was used to assess the 5-year cost consequences of treatment based on losartan, candesartan, valsartan and irbesartan, based on expected patent expiry dates. Results showed that a losartan-based regimen represented the least costly option of the four agents tested, with median (IQR) discounted expenditure per patient for each agent as follows:
Losartan £506 (£441-£650)
Candesartan £610 (£542-£766)
Irbesartan £696 (£694-£934)
Valsartan £809 (£796-£1078)
The study concluded that switching hypertensive patients taking ARBs to the agent with the lowest current acquisition cost may yield only transient budgetary savings. However, once patent expiry is taken into account, the model suggested that maintaining or switching patients to losartan would yield considerably greater savings over 5 years.
View PubMed abstract.
JBM Research's paper on vertebral fracture is reviewed in IOF journal
JBM Research's paper on vertebral fracture has been reviewed in the International Osteoporosis Foundation journal, Progress in Osteoporosis (Vol 8(1):26-27 entry 8.1.134. The purpose of Progress in Osteoporosis is to provide the reader with a summary of the most important literature published in the preceding three to four months in the field of osteoporosis. The paper has been summarised based on the contents of the abstract which has been abbreviated to concisely survey the main theme. The full paper can be viewed here.
ISMPP issues position statement in support of medical writers
The International Society for Medical Publication Professionals (ISMPP) has issued a position statement in support of professional medical writers.
The ISMPP support the educational needs of medical publication professionals, and is an independent, non-profit, professional association. They have issued their position statement in order to define the legitimate role of the medical writer, thus clearing up some common misperceptions.
The ISMPP believes that using medical writers, many of whom have advanced degrees in the life sciences or are themselves physicians, can actually improve the efficiency and effectiveness of manuscript preparation, as they are generally more familiar with writing and publication guidelines than investigators or sponsors.
The position statement also declares that the ISMPP strongly endorses the concept of contributorship, as this gives detailed information on the roles of all who participated in planning, conducting, developing and publishing the medical research. The ISMPP propose that the contributorship model is integrated into the standard operating procedures of the diverse organizations that make up its members, and they also plan to hold a consensus summit on this, so that the standard is adopted more broadly.
The statement concludes by commending the many organizations that have worked to increase recognition and understanding of the legitimate role of the medical writer.
JBM has been involved in medical writing for over a decade. We believe that using an experienced professional medical writer has a number of advantages for our customers:
A clear focus
Statistical knowledge and expertise
Familiarly with publisher’s guidelines
Editorial know how
Rapid turnaround
Contact us if you would like to discuss any medical writing projects.
JBM Communications to work with National Pharmacy Association
Over the coming months, JBM Communications will be working with the National Pharmacy Association to produce training materials about allergic rhinitis for community pharmacists. The training will carry the prestigious NPA Training Seal and will cover burden of disease, pathophysiology, symptom recognition and management options.
Allergic rhinitis is particularly common in people with asthma; estimates suggest that around 80% of people with asthma also have allergic rhinitis. It is important to recognise allergic rhinitis in this patient group and to treat appropriately, since patients with poorly controlled allergic rhinitis are more likely to suffer asthma symptoms or an asthma attack.
Merck Sharp & Dohme Limited is sponsoring the material through an educational grant.
Landmark risk-sharing scheme for Velcade accepted by NICE
JBM Health Economics can report that NICE has accepted a proposal by Janssen-Cilag for a risk-sharing refund scheme for Velcade (bortezomib), for use in patients with myeloma on the NHS. The move is being seen as landmark because the drug was originally rejected by NICE six months ago on grounds of its high cost. The refund scheme will be put into action for those patients who do not show a “complete or partial response” after four cycles of treatment. The manufacturer will reimburse the NHS with the full cost of treatment for those patients that have a less than 50% reduction in serum M-protein. Those showing a compete or partial response (reduction of 50% or more) will have their treatment continued and the NHS will pay the cost of that treatment, it being seen as “an effective use of NHS resources” in this circumstance. The coalition of cancer charities that originally appealed against NICE’s rejection of Velcade see this move as a “significant development” as well as confirmation that the appeal process does work. Click to view JBM Health Economic's full report.
JBM Research Contributes chapter to new Pharmaceutical Medicine book
The second edition of Principles and Practice of Pharmaceutical Medicine has recently been published and JBM Research has written chapter 51, Advertising and Marketing. The book is aimed at all those working within the field of pharmaceutical medicine, and it comprehensively covers the internationally harmonized syllabus for Diplomas in Pharmaceutical Medicine that are awarded in the UK, Belgium and Switzerland, as well as being useful to those teaching masters degrees in this field. The chapter written by JBM Research looks in depth at marketing and advertising within the pharmaceutical industry. It covers regulations regarding the marketing of prescription drugs, internet marketing and marketing/advertising budgets. The book has been reviewed by the British Association of Pharmaceutical Physicians who said:
Dr Belsey speaks at Pharmaceutical Marketing Society Briefing Meeting
You need to look at clinical trials now if you have a new launch in quarter four. You will need to put together a Health economic analysis and assess the financial impact overall. The Health economic analysis is the most important part of the submission and is set against an independent health economic analysis and is assessed rigorously - it needs to prove that your product is cost effective versus current standard treatment ie show £30,000 per qualy (which is the same figure used since 2000 and is therefore getting increasingly difficult to achieve as we have had 4-5% per year health service inflation). Clinician opinion matters, although it will not make or break a submission, and can sometimes help focus efforts and offer support with co-ordinated activity.
JBM's managing director Dr Jonathan Belsey (pictured far left), was invited to speak at the latest Pharmaceutical Marketing Society Briefing Meeting, held on 27th February 2007 at Innovex. The meeting was attended by 70 delegates keen to learn more about the changes taking place in the NHS. Jonathan started by pointing out that the influence of commissioners is now much greater than it was in his day as a commissioner and that it is critical that we get in touch with them. Although the role of the rep in talking to prescribers is diminishing, their role in communicating with these people is increasing as commissioners are often ill-informed in understanding clinical issues. In summary, Jonathan stated that the following is what organisations involved in submitting information to HTA bodies need to do:
Key issues
When your turn comes, you need to:
- Read the instructions ... carefully!
- Be honest - look at the studies you have
- Co-ordinate sections and ensure there is a consistent tone to your document
- Seek external opinion - this can make a big difference
- Involve patient groups and physicians
- Devote serious money and time - if you don't have the resources internally, buy in help if necessary
In summary, you need solid data, a decent product and a good health economic analysis to stand a decent chance of getting a NICE approval.
The full meeting report can be viewed on the Pharmaceutical Marketing Society's website.
JBM Research paper in Alimentary Pharmacology and Therapeutics top 10 electronic downloads
JBM Research paper 'Systematic review: oral bowel preparation for colonoscopy', which was published in the journal Alimentary Pharmacology and Therapeutics, reached number 2 in their top 10 electronic downloads between 1st and 28th February 2007 of all papers published in the journal.
JBM Health Economics works on budget impact and evidence for use of parathyroid hormone Preotact
Following a full submission to the Scottish Medicines Consortium (SMC), parathyroid hormone (Preotact) has been accepted for restricted use within NHSScotland for women with severe osteoporosis and at least two prior vertebral fractures or equivalent high risk. It is restricted to initiation by specialists experienced in the treatment of osteoporosis following assessment of fracture risk including measurement of bone mineral density. JBM Health Economics worked with Nycomed to produce an economic evaluation examining the cost-effectiveness of Preotact in women at a high risk of vertebral fracture defined as women aged over 65 with two or more prior vertebral fractures and a T-score < -2.5. PTH was compared to three treatment strategies: no treatment, alendronate and teriparatide. Markov modelling techniques were used to construct the model to provide incremental cost-effectiveness ratios for Preotact. A budget impact was also provided, estimating the number of women suitable for treatment and the costs of treatment.
JBM Research publishes Systematic review of oral bowel preparations for colonoscopy
JBM Research's most recent paper has been published in the latest issue of Alimentary Pharmacology and Therapeutics. A systematic review was carried out on high quality, controlled trials comparing efficacy and tolerability of two or more bowel preparation regimens for colonoscopy. Polyethylene glycol and sodium phosphate were the most frequently investigated preparations. The study found no significant efficacy difference between the two, however, sodium phosphate was better tolerated. The study concluded that no single bowel preparation emerged as consistently superior, and stated that new preparations are required that combine better efficacy and tolerability, as well as rigorous new validated study designs, which would allow unequivocal comparisons to be made. View PubMed abstract.
JBM Toolkits endorsed by International Society for Fracture Repair
JBM's 'Toolkits', which were developed to facilitate the development of osteoporosis services within the NHS, have been endorsed by the International Society for Fracture Repair (ISFR). The toolkits provide advice and practical support for establishing osteoporosis services. The materials also included an accompanying CD-ROM which contained further support materials, a business case template and reprints of key clinical papers.
One in four patients presenting to hospital with a non-vertebral fracture already have
a pre-existing vertebral fracture
JBM Research has published a paper in Osteoporosis International which assessed the prevalence of vertebral fracture in patients presenting to a Fracture Liaison Service (FLS) with a non-vertebral fracture. We used vertebral morphometry to identify vertebral deformity and found that a quarter of patients already had a vertebral fracture when they presented with their first non-vertebral fracture - and 45% of those had more than one. Furthermore, patients with a history of one or more non-vertebral fractures prior to the one which they presented to the FLS with were significantly more likely to have a vertebral fracture than those presenting with their first non-vertebral fracture (43% versus 20%, p=0.008). Given that previous fracture increases the risk of future fracture, and that risk is further increased with the number of previous fractures, this will help to target treatment to the patients at the highest risk of future fracture.
Our work supports the recommendation to perform vertebral morphometry in patients who are referred for DXA after experiencing a non-vertebral fracture. The Number need to Screen using vertebral morphometry in this way, would be seven to identify one patient with a previously undiagnosed vertebral fracture – or 14 to identify one patient with two or more previously undiagnosed vertebral fractures. View PubMed abstract.
Dr Belsey gets letter published in the BMJ
Following his recent involvement with the BBC's Thoroughly Modern Medic series, Dr Belsey felt compelled to write in response to a letter published in the BMJ, which stated that belittlement and harassment of medical students was a source of medical education. Dr Belsey's letter, published in BMJ 2006;333:920, supported that written by Aref-Adib. Following his experience of subjecting six third year medical students to a week of 1950s' style ward-based teaching, in Thoroughly Modern Medic, Dr Belsey said that despite the students appearing to have a good grasp of basic skills required in taking a patient's history and carrying out an examination at the onset of the series, by the end of a week of being put on the spot and being forced to face the shortcomings of their thought processes, the students dramatically transformed their approach to the the task. This resulted in them being able to present the information clearly and systematically, and to arrive at a rational and justifiable differential diagnosis.
JBM Research publishes paper on suboptimal management of cholesterol
JBM Research has published a paper in the Journal of Public Health, which reported on the Primary Care Data Quality (PCDQ) programme's effect on cholesterol management in cardiovascular disease. The study looked at general practice data from 99 practices, 5% (n=29,915) of which had cardiovascular diagnoses. Results showed that where the PCDQ programme was deployed, mean cholesterol fell from 4.75 mmol/L to 4.64 mmol/L, and patients achieving cholesterol target rose from 45.3% to 53.2%. The authors concluded that diagnostic coding and the number of patients who had their cholesterol measured and treated increased, and that there was no significant change in dosage used, or inequity between the different groups prescribed statins. View PubMed abstract.
JBM work with IOF on orthopedic surgeons’ initiative
JBM has recently committed some pro-bono time to the International Osteoporosis Foundation’s Orthopaedic Initiative (IOI). Orthopaedic surgeons are often the first, and sometimes the only, physicians seen by patients who have suffered a fracture. Therefore, they have a unique opportunity to help to optimise the management of patients with fragility fracture. The aim of the IOI is to engage orthopaedic surgeons and to ensure that they recognize fragility fractures and initiate appropriate treatment.
The IOI are currently producing a comprehensive educational slide resource for orthopaedic surgeons covering pathophysiology, burden of disease and the acute management of fragility fracture. The first topic was clinical pathways for fragility fracture patients including secondary prevention edited by Professor Ghassan Maalouf, Saint George Hospital, Beirut, Lebanon. Working with Synthesis Medical Ltd, JBM produced a comprehensive bibliography from the peer-reviewed literature, together with a fully referenced executive summary to support the slide resource. The materials will be hosted on the IOF website in the near future and will also be widely distributed at International meetings. Contact Tricia Dixon at JBM for further information.
JBM's editorial assistant helps cancer patients to 'look good feel better'
JBM's editorial assistant Rachel Fleetwood has recently become a Look Good Feel Better (LGFB) volunteer at Addenbrookes Hospital, Cambridge. LGFB was set up in 1993, to help women with cancer, by providing free beauty/make-over workshops at over 30 hospitals across the UK. The workshops help to combat the visible side effects of treatment. During each session, all of the ladies receive a fantastic kit containing skincare products and cosmetics, and they are guided through a step-by-step skincare and make-up routine by trained beauty therapists, which includes lots of hints and tips specific to their situation. The workshops provide a chance for the ladies to meet others in similar situations, and they leave the sessions looking fabulous and feeling ten feet tall! Rachel runs her own image consultancy business as well as working at JBM, and will be helping out at future workshops, offering practical help with make-up application, and also offering style advice for those whose body shape has changed as a result of their illness.
JBM Research publishes paper on ‘Rule of Halves’
JBM Research’s paper on the ‘rule of halves’ has been published in the British Journal of Cardiology. In 2002, the Primary Care Data Quality (PCDQ) programme reported that only 50% of patients with coronary heart disease (CHD) achieved the national target for total cholesterol of 5 mmol/L. The paper looks at progress made since then, after analysis of general practice data from 2002-2005. Findings show that overall, 53.1% of patients with cardiovascular disease had total cholesterol below 5 mmol/L. Patients with CHD achieved better cholesterol control than those with stroke or peripheral vascular disease. The paper concludes that the ‘rule of halves’ still applies to the management of cholesterol, and that there remains scope for improved management of cholesterol in primary care.
JBM Research reveals vitamin D inadequacy very common in older people with osteoporosis
JBM have recently published a series of papers looking at levels of vitamin D in patients with osteoporosis around the UK. The work was carried out in Glasgow, Medway, Belfast, London, Southampton and Carshalton and revealed that low levels of vitamin D were extremely common in the elderly population particularly so in patients with fragility fracture. Patients with hip fracture had the lowest level of vitamin D with one audit in Glasgow revealing that 98% of patients had vitamin D levels below a threshold of 70 nmol/l. The work achieved a high level of press coverage with articles in local and national press, including The Times, and was presented at the National Osteoporosis Society meeting in Harrogate.
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Dr Belsey steps back in time!
