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August 17, 2005 |
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Welcome to ACAAI eNews — a bi-weekly aggregated news service
from the American College of Allergy, Asthma & Immunology. To be
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Stories |
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Drugs and Devices |
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Distance Learning |
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Association
News |
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Fellows-in-Training |
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Calendar |
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Archive |
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FIT Archive |
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“No,” said 79 percent of
readers responding, their practices don’t use an electronic
medical record system. |
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Have
you ever received a request to substitute a generic
inhaled drug for a brand name medication?
If yes, have you approved it?
Would you be willing to display informational
material about this problem in your office? |
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Distance Learning |
2005 Board/Recertification Review Course:
DVDs, Audio CDs, MP3s
Link
ACAAI Tape Store
Complete Listing
Link
2004 ACAAI ANNUAL MEETING
Nov. 12-17, Boston
Link
From the 2003 ACAAI ANNUAL MEETING
Nov. 7-12, 2003, New Orleans
• Two Symposia Online
Link
• Plenary Sessions CD-ROM and DVD
Link
Patient-Centered Allergy Practice
Endorsed by ACAAI, Sponsored by Physicians Practice
Link
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Calendar |
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SEPTEMBER
The Long Island Allergy and Asthma Society's
Jointly Sponsored by ACAAI
12th Annual Scientific Conference
Sept. 16-18, Southampton, N.Y.
Contact: Robert Corriel, MD
Tel: 516-365-6077
Email
American
Society for Clinical Pharmacology and Therapeutics (ASCPT)
"Adverse Drug Events and Medication Errors: Impact on Medical
Care in the 21st Century"
Sept. 29-30,
Philadelphia
E-mail
Link
Southeastern Allergy, Asthma
and Immunology Society
2005 Annual Meeting
Sept. 29 – Oct. 1, Sea Island, GA
Contact: Jack Eades, MD
Tel: 912-303-9355
Email
OCTOBER
New Trends & Recent Applications
in Allergy, Immunology and Infectious Diseases
Co-sponsored by ACAAI
Oct. 6-8,
Taormina, Sicily
E-mail:jbella007@aol.com
or IRConsult@aol.com
Link
Update in
Allergy Immunology
Nassau
University Medical Center
Oct. 27,
East Meadow, NY
Tel: Dr. Marianne Frieri at 516-572-3214
Email
Update on Immunotherapy
and Immunomodulators
New York Allergy and Asthma Society
Jointly Sponsored by ACAAI
Oct. 28, New York, N.Y.
Contact: Dr. Beth Eve Corn
Tel: 212-241-0764
E-mail
ONGOING
World Allergy Organization Society Meetings
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Sponsored
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Top
Stories |
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Study: One in six U.S. high school students
have asthma
In a 2003 national survey of high-school students, about one
in six reported currently having asthma. Of those students, more
than one in three reported having had an asthma attack during
the previous year, said a report in the U.S. Centers for Disease
Control and Prevention Morbidity and Mortality Weekly Report,
citing the CDC's 2003 national Youth Risk Behavior Survey. More
than 13,000 students across the United States completed
questionnaires about their asthma history during the survey.
Other results:
Significantly fewer Hispanic students than black or white
students reported currently having asthma. Among those with
asthma, more girls than boys reported an episode during the
previous year, 45 percent vs. 31 percent.
Asthma linked to higher stroke risk
Asthma may be a risk factor for stroke, according to a study
in Thorax. Scientists from the University of Minnesota,
Minneapolis, examined data from the Atherosclerosis Risk in
Communities study, looking for a possible association between
asthma, coronary heart disease and stroke. Regardless of
participants’ asthma history, their rates of coronary heart
disease were not affected, the researchers report. However, any
history of asthma was associated with a 65 percent higher risk
of stroke than never having had asthma. For those with current
asthma, the risk jumped to 93 percent.
More than half of Americans sensitive
to at least one allergen
Among Americans from 6 to 59 years old, more than half have
a reaction to at least one of 10 common allergens during a skin
test, making them more likely to have asthma, hay fever or
eczema, says a study in the Journal of Allergy and Clinical
Immunology. Researchers from the National Institute of
Environmental Health Sciences and the National Institute of
Allergy and Infectious Diseases based their findings on the
third National Health and Nutrition Examination Survey.
Conducted from 1988 to 1994, the survey included skin tests on
about 10,500 people. Of those, 54.3 percent had a positive
response to at least one allergen.
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word from Dr. Daniel Ein, vice president
ACAAI Representative to CHASM
Many of you have
heard about CHASM (Consumers Health Alliance for Safe
Medication), but as your representative to the
organization, I would like to give you some additional
information to better prepare you to protect yourself and
your patients.
CHASM, founded by AAN/MA under the leadership of Nancy
Sander, is a coalition of patient advocacy groups,
professional societies and pharmaceutical firms concerned
about nebulizer medication safety, especially those which
are mass manufactured under the guise of compounding. Both
the College and the Academy are members of CHASM.
Drugs have sterility, potency and compatibility
problems.
Traditional compounding, the putting together of
pharmaceutical ingredients by a pharmacist for a specific
patient as ordered by a physician’s prescription, and
designed for unmet patient needs, is a time honored and
necessary part of the practice of pharmacy. Normally,
compounding is regulated not by the FDA, but by state
boards of pharmacy.
Unfortunately, some large-scale manufacturers are putting
together drugs in large quantities in anticipation of a
physician’s prescription and claim they are compounding,
not manufacturing. This puts them outside the scope of FDA
regulation and under state boards, which are understaffed
and under-funded and, in most cases, cannot provide the
necessary oversight. You could say, “So what? What harm
does this do, and don’t these companies render a valuable
service?” The harm is that there are no, or inadequate,
quality control standards leading to sterility problems,
potency problems (usually below strength); drugs are
advertised as FDA-approved when they are not; and, drugs
are combined without proper information about their
compatibility.
For example, certain drugs prepared for nebulization (albuterol,
ipatropium and budesonide) have been combined without
regards for their stability or compatibility when mixed
together. Non-standard strengths of drugs are often used.
Some of these companies advertise generic, FDA-approved
budesonide aerosol solution. The problems with this are
that there is no FDA-approved generic budesonide in the
United States, and budesonide is notoriously insoluble in
water. Concentrated ethanol is used instead, which is very
irritating to the lungs and, in any event, should not be
used in our children.
Injuries have occurred.
Serratia marsescens pneumonia has been reported as a
result of contaminated aerosols. And other injuries have
been reported. Lawsuits are pending in various
jurisdictions because of injuries sustained by these
drugs.
We don’t know how many patients have been harmed as a
result of these misleading practices, but CHASM is
collecting data about patients who have suffered declining
health while using these products. Sadly, when patients
are not responding as expected or are doing poorly,
physicians are often unaware that adulterated or
under-potency nebulizer medications are a causal or
contributing factor.
You could be liable.
The problem is aggravated by the misleading sales
techniques used to promote these drugs. You may get a fax
in your office from a durable medical equipment supplier
asking if a generic drug may be substituted for one you
prescribed. Unless you read the request carefully, you
might not know that what is being proposed is the
substitution of a mass-manufactured generic. If you
approve the substitution and something happens to the
patient, YOU ARE LIABLE, not the pharmacist.
Call to action.
So, what is being done to fix this problem and protect our
patients? CHASM has discussed the problem with the FDA,
and it is sympathetic to, and shares, our concerns. A
number of members of Congress have been educated about the
dangerous practices these companies engage in and at least
one representative has promised to hold public hearings.
Our AMA representatives are submitting a resolution to the
AMA House of Delegates at its next meeting in November.
The resolution seeks the AMA’s help in getting the Centers
for Medicare & Medicaid Services (CMS) to stop reimbursing
non-FDA approved drugs and start educating physicians
about the risks to their patients and themselves.
CHASM also has spoken to CMS to make them aware that they
are reimbursing manufacturers of these non-FDA approved,
inadequately controlled, unsterile, under-potency
preparations. Nothing gets the attention of these
manufacturers faster than the possibility they won’t get
paid for their “products.”
CMS is interested in patterns of alleged abuse or fraud.
For example, the medication switch occurs most often when
the purchase of a new nebulizer is involved, the switch
takes place through excessive fax requests from a
pharmacy, or the patient was prescribed an FDA-approved
brand or generic medication and the patient received a
different medication with or without the promise of "no or
low co-pays" or "free nebulizer" inducements. CMS is also
interested in promotions to patients or prescribers.
Please, if you are aware of these actions, let us know so
that we can pass this on to CMS. You can contact me at
dein@mfa.gwu.edu or
Sandra Fusco-Walker of AAN/MA at
sfwalker@aanma.org
or 800-729-3804.
We are already seeing some results of our efforts to
improve quality. The International Academy of Compounding
Pharmacists is pushing back. It is encouraging its members
to improve manufacturing processes. It also is raising
large sums of money to combat what it sees as negative
press.
In the meantime, I urge you to be careful about what you
sign in the rush of getting through your busy days. Read
everything before putting your name on a faxed scrip
request. Warn your patients not to be fooled by durable
medical suppliers wanting to give them free nebulizers if
they buy their drugs. Finally, help us educate our
legislators and regulators, our colleagues and our
patients about this threat to their welfare.
Dr. Daniel Ein
Vice President, ACAAI |
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Drugs
and Devices |
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NIH seeking pediatric study
participants with allergic disease
Physicians at the NIH in the National Institute of Allergy and
Infectious Diseases, in Bethesda, Md., are conducting a
research study to evaluate children with allergic diseases and
collect medical data and biological specimens from them
periodically to learn more about the diseases and gain
information that may be useful in developing new treatments.
Patients 6 months to 18 years of age with a possible diagnosis
of asthma, rhinitis, anaphylaxis, hives, atopic dermatitis,
food allergy, stinging insect allergy and other allergic and
inflammatory diseases may be eligible for this study.
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Association
News |
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New programs
added to ACAAI Annual Meeting, Vade Mecum
 New
programs have been added to the ACAAI Annual Meeting, Nov.
4-9, 2005, at the Anaheim Convention Center and the Hilton
Anaheim Hotel, in Anaheim, Calif. The theme is Vade Mecum
– a concise source of practical information and guidance you
can take with you.
A special presentation by INTERASMA, “Current Global Issues in
Asthma” (7 a.m. on Friday, Nov. 4), will focus on
epidemiology, airway remodeling and advances in monitoring
inflammation in asthma.
Topics presented at a dinner symposium, entitled “Clinical
Challenges in Recognizing, Diagnosing & Treating Anaphylaxis”
(6 p.m. on Tuesday, Nov. 8), will include the definition and
epidemiology of anaphylaxis, a review of its mechanisms and
pathophysiology and treatment.
The symposium is followed by an educational “Walk Through the
Parameters: Anaphylaxis” staged at the Disney Animation
Studio. Faculty with expertise on anaphylaxis will be
stationed where attendees may seek individual consultation
regarding the standards in patient care based on the Joint
Task Force parameter. The program – available to the first 250
physicians on a first-come, first-served basis – will be
featured in conjunction with “An Evening of Disney Animation.”
This evening of education and artistry and imagination is
supported by a grant from Sepracor Inc.
Register today for the allergy-immunology Vade
Mecum, including the Rhinosinusitis Collegium on Nov. 3,
and the ACAAI Annual Meeting, Nov. 4-9, 2005.
Join the “Committee of 200” and sponsor a FIT Travel Grant
The ACAAI seeks Fellow-in-Training Travel Grants for the
Annual Meeting. Thanks to the generosity of members, a record
230 FITs attended last year’s Annual Meeting on Travel Grants.
This year, the ACAAI Committee of 200 hopes to again
bring more than 200 Fellows to the Anaheim meeting, Nov. 3-9.
Please consider sponsoring a Fellow at one of the following
levels:
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| Platinum
Level |
$1,000
contribution |
| Gold
Level |
$750
contribution |
| Silver
Level |
$500
contribution |
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Sponsors receive
appropriate recognition at the convention with a Committee
of 200 ribbon attached to their name badge and
acknowledgement in the Program Guide. In addition, their names
will be published in the post convention issue of the ACAAI
newsletter.
Please contact Dianne Kubis at
diannekubis@acaai.org
or call her at (847) 427-1200.
 ACAAI
seeks new Editor-in-chief for AllergyWatch
The American College of Allergy, Asthma and Immunology invites
applications for the position of Editor-in-Chief of
AllergyWatch effective January 1, 2007, for a four-year
term.
Applicants should be an ACAAI Fellow and ABAI certified and
(as applicable) re-certified. Qualifications include a record
of significant scholarly achievement, with accompanying
familiarity with the development of literature in the field;
recognized reputation among scholars and practitioners;
administrative, managerial and editorial skills; capacity for
detail work; and strong interpersonal skills.
The new Editor-in-Chief will work with the current
Editor-in-Chief, Emil J. Bardana, Jr., M.D., during 2006 and
assume full responsibility on January 1, 2007. The
Editor-in-Chief will work with the Associate Editor and a
panel of Assistant Editors.
Applications must be received no later than September 23,
2005. More information and application instructions are
available
online.
Allergy Practice Tip: Stay in
the Paint
Advice from The Patient-Centered Allergy Practice
You aren’t doing patients any good wandering to the supply
closet or across the hall to your office to answer calls. Set
yourself up to work from the exam room areas and the halls
immediately adjoining them. Consider making part of the
nurses' station a spot where you can return a quick call or
dictate, for example. Stay where you can be of the most help
to your patients. For more advice on workflow in an allergy
practice, visit
www.PatientCenteredAllergyPractice.com
These tips are drawn The Patient-Centered Allergy Practice,
a CME Series in Practice Management, supported through an
educational grant from sanofi-aventis Group and
endorsed by the American College of Allergy, Asthma &
Immunology.
Completed you’re A/I Training? Continue your ACAAI
membership at a reduced rate!
If you have completed your fellowship training, your ACAAI
membership will continue through 2005, including the Annual
Meeting in Anaheim, Nov. 4-9. In October you will receive an
invoice for your 2006 membership at a reduced rate
of $75. Second year membership is also reduced
at $115. After your third year out of training, you will be at
full dues, which is currently $280.
Your ACAAI member number issued when you joined as a
fellow-in-training does not change after you complete your
training. If you need your member number to access
Annals
Online or to register for a free
Medem
practice Web site (a benefit of $195/year), it appears on most
mailings you receive from the College.
Please contact Jean Lynch, director of Membership Services, at
jeanlynch@acaai.org
or call (847) 427-1200, if you have any questions about
membership or need your member number. Also, please provide
your change of address, phone, fax or e-mail (so you will
continue to receive ACAAI eNews) and your practice Web
site URL. All members’ contact information and Web link are
included in the
Allergist Locator on the College’s public Web site,
visited by more than 7,500 people each week.
Your FIT
representatives are also available to answer your
questions. |
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Fellows-in-Training |
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Welcome to the Board Review Corner prepared by Dr. Thao N.
Tran, Senior Representative of ACAAI’s fellows-in-training (FITs)
to the Board of Regents. The Board Review Corner is your chance
to test your Board preparedness.
To refer to a previous Board Review Corner, click the “Archive”
link in the left column.
Immunology Review Corner: Chapter 53 of the 6th
edition of Middleton’s Allergy Principles and Practice,
edited by N. Franklin Adkinson, et al. Review questions were
written by fellows-in-training Drs. Thao Tran, Karla Lowe and
Michael Norvell.
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