With cold and flu season underway, doctors say you should try soaking in Epsom salt before you reach for an expensive over-the-counter drug. This naturally-occurring mineral will ease muscle aches and help you get a good night’s rest, so you can recover faster. Some doctors say it will even speed healing by detoxifying your body and increasing your white blood cell count.

“You want to get in front of an illness,” says Dr. Theresa Ramsey, cofounder of the Center for Natural Healing in Arizona and author of Healing 101: A Guide to Creating the Foundation for Complete Wellness. “As soon as you know you’re coming down with an illness and can soak in Epsom salt, the better it will work.”

Ramsey says soaking in Epsom salt helps spur a process called vasodilation, which increases white blood cell production and helps the body fight illnesses quicker.

You can get Epsom salt – actually magnesium sulfate – for just a few bucks at your local pharmacy or supermarket, and doctors say soaking in it can help ease aches, calming the body as it fights the symptoms of a cold or flu.

“It has an alkalizing effect, which gives your immune system a boost,” says Lisa Tsakos-Trepanier, a registered nutritionist, who writes a monthly column for Tribune Media and is a regular contributor to NaturallySavvy.com.

Soaking in Epsom salt could be especially useful for people fighting H1N1, which often causes severe body aches, says Dr. Margaret Philhower, a naturopathic doctor who has a private practice in Oregon and writes for www.naturopathicexperts.com.

“Magnesium is a fantastic way to help relax the muscles and flush the lactic acid out of them,” Philhower says.

Philhower recommends adding at least 4 cups of Epsom salt per bath to help improve circulation and reduce the length of the symptoms. “Getting a virus is the body’s way to force us to detoxify, and an Epsom salt bath is one of our favorite recommendations for a gentle detoxing.”

People should consult their doctors for serious or persisting conditions. If your temperature tops 104 degrees, or if you have a history of febrile seizure, you may also want to check with your doctor before soaking in a warm bath.

A new report released today based on research by Emory University Health Care Economist Ken Thorpe, Ph.D., Executive Director of the Partnership to Fight Chronic Disease (PFCD), shows increasing obesity rates in Pennsylvania and across the country will result in higher health care spending for states and individuals. The study, which was commissioned by UnitedHealth Foundation, Partnership for Prevention, and American Public Health Association in conjunction with their annual Americas Health Rankings report, is the first to estimate obesity prevalence and costs at the state and national level 10 years from now.

The study, “The Future Cost of Obesity: National and State Estimates of the Impact of Obesity on Direct Health Care Expenses,” shows that 42 percent of Pennsylvanian’s will be obese and associated health care costs will surpass $13.5 billion by 2018.

“This study demonstrates that as policymakers seek to make health care more affordable, addressing the obesity epidemic is vital,” said Thorpe. “It threatens to ‘break the bank’ of our health care system, and family budgets, if we don’t take action.”

In 2008 approximately 33 percent of Pennsylvanians were obese, which compares to national rates of obesity. According to the study, if obesity rates in Pennsylvania over the next ten years remained at 2008 levels, residents in the state could expect to save $796 per person in health care spending.

“With obesity rates in Pennsylvania mirroring rates nationally, we face a health epidemic that could cripple our health and economy in the next ten years,” said Jessica Boyer, President of Pennsylvania Public Health Association.

At the national level, obesity accounts for nearly 10 percent of what the U.S. spends annually on health care. One-third of the increase in domestic health spending since the mid-1980s is linked to the doubling of obesity.

“As Dr. Thorpe’s research underscores, the need to address obesity and related chronic conditions, and ensure prevention is part of the solution that falls on all of us,” added Ms. Boyer.

According to the National Survey of Employer-Sponsored Health Plans, conducted annually by Mercer and released today, many employers feared that health benefit cost growth would spike in 2009 as employees, worried about keeping their jobs and health coverage, consumed more health services than usual. In fact 2009 saw the lowest annual increase in a decade, as the average per-employee cost of health benefits rose 5.5 percent to reach $8,945 after four years of increases of just over 6 percent. However, benefit cost growth outpaced inflation in 2009 by a widening margin.

Similar cost growth is expected in 2010; employers predicted that medical plan cost would rise by about 9 percent in 2010 if they simply renewed their current plans without making any changes. However, they hope to achieve about a 6 percent increase after making changes to plan design or changing plan vendors.

Mercer’s survey included public and private organizations with 10 or more employees and 2,914 employers responded in 2009.

“Small and large employers used different strategies to keep cost growth down in 2009,” said Beth Umland, Mercer’s director of health and benefits research. “Small employers moved employees into low-cost consumer-directed health plans and raised PPO deductibles. What jumped out among large employers was an increase in programs and policies designed to improve workforce health.”

Sharp increase in adoption of health management programs

The ongoing workforce health management/wellness movement gained momentum in 2009, as virtually every type of program – from health risk assessments to disease management to behavior modification – rose significantly. While not conclusive, survey results suggest these programs are impactful: medical plan cost increases in 2009 were about two percentage points lower, on average, among employers with extensive health management programs. And nearly three-fourths of employers that measured the return on investment say they are satisfied with the savings, lower utilization rates or improved health risks. However, only about a third of all large employers measure ROI.

“A lot more employers were willing to bet on health management in 2009,” said Linda Havlin, a worldwide partner and Mercer’s global health and benefits intellectual capital leader. “There’s growing anecdotal evidence that well-designed and communicated health management programs can improve outcomes, but we need to better understand and eliminate missed opportunities like noncompliant patient behavior.”

Currently, a fifth of all large employers – but almost half of those with 20,000 or more employees – use health management incentives. Very large employers are also increasingly willing to reward employees who demonstrate responsibility for their own health. Nearly a fourth of those with 20,000 or more employees vary employees’ premium contribution amounts based on their smoker status – 23 percent, up from 17 percent last year.

CDHPs catch on big with small employers

Small employers held down cost increases by sharply raising deductibles for in-network PPO services. Their actions drove the average PPO deductible among all employers up by about $100 for an individual and $300 for families, to $1,096 and $2,515, respectively. Consistent with past years, employers kept premium contributions relatively stable.

Compared to large employers, small employers have been slow to adopt high-deductible, account-based consumer-directed health plans. But in 2009 CDHP offerings among employers with 10-499 employees jumped from 9 percent to 15 percent. This helped drive the percentage of all covered employees enrolled in CDHPs from 7 percent to 9 percent. Enrollment in PPOs was flat at 69 percent, while enrollment in HMOs fell from 23 percent to 21 percent.

While growth in CDHP offerings in 2009 was evident only among small employers, the plans are still more common among larger employers: CDHPs are offered by 20 percent of employers with 500 or more employees, and 43 percent of those with 20,000 or more employees. However, small employers that offer a CDHP are much more likely to offer it as the only medical plan: 55 percent compared to just 9 percent of large employers with CDHPs.

A challenge for health reform: Predicting how employers that don’t offer coverage will react

National health reform may include a provision that would require employers to offer a plan or pay a penalty, and which course of action they would choose has important consequences for the future of the US health care system. In interviews with more than 500 employers that don’t offer coverage, more than two-fifths (44 percent) said they would be more likely to offer a plan to their employees if all individuals were required to obtain coverage – a provision that is also in House and Senate proposals – and 57 percent would be more likely to offer a health plan if they received an annual tax credit that would reduce the net cost of the health coverage to about $2,000 per employee.

On the other hand, less than a fourth (22 percent) say they would support a requirement to pay 4 percent of their payroll into a public or private fund to provide coverage to their employees.

With Plavix’s gurney on the golf course, Cialis’ twin bath tubs and Ambien’s rooster in the office, many drug commercials make for great water cooler conversations but do they translate into more conversations in the physician’s office? And if so, are those conversations positive or negative – improving disease awareness and brand requests, or raising concerns around fair balance statements and side effects?

As pharmas continue to make significant investment in DTC, a recent study from Verilogue revealed that the biggest DTC budgets don’t always result in positive pull-through – or pull-through at all – in the physician’s office. From this analysis, Verilogue derived three key recommendations for how pharmas can convert DTC investment into positive patient-physician interactions.

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Verilogue’s analysis tracked brand requests coupled with a reference to specific promotional campaigns across 12,500 doctor-patient conversations from 2008 and covered 20 disease states and 46 different branded prescription medications. Overall, DTC pull-through in conversations in the doctor’s office is low – 3% (n=392) – and specific patient requests for advertised medications are even lower – .002% (n=23). Most significantly, the most frequently pulled-through brands from Verilogue’s database fail to align with the brands with the biggest DTC ad spend:

Brand analysis: How does DTC come up in patient-physician conversations?

Most of the time, DTC is referenced by the physician to try to increase patient acceptance for already-chosen medicines. Unaided (spontaneous) patient mentions or actual patient requests for medication are rarer. Regarding five of the top DTC brand spenders of 2008, here is how their DTC campaigns influenced the doctor-patient conversation:

1) Advair
Patients most often brought up side effect concerns arising from fair balance statements in Advair TV commercials; for instance: “I saw on TV that Advair can cause pneumonia in some patients.”

2) Plavix
Although frequently mentioned and discussed by physicians, Plavix’s DTC campaign was not mentioned by patients in Verilogue’s database.

3) Cymbalta
This is the most mentioned DTC campaign out of the five top spenders. Approximately half of the patients expressed positive sentiment about the ad (e.g. they reflected on other depression symptoms, for instance: “That commercial they have out showing depression and how it affects everything else. It’s not just that person that feels that way. Your whole family that’s around you.”), while the other half expressed negative sentiments (e.g. “No, I don’t want to take Cymbalta. And I don’t like the commercials, and plus I’m on Zoloft and that’s it. I don’t want any more of those drugs.”)

4) Lyrica
The main outcome of the campaign was increased awareness about fibromyalgia in addition to the brand. (e.g. “Do you do a lot of patients with fibromyalgia? That’s how I found about a neurologist when I seen it on TV for that Lyrica. And they sent me some stuff in the mail.”)

5) Ambien
This is the most likely to be requested out of the top five spenders. However, like Advair, patients commonly expressed side effect concerns arising from fair balance statements in Ambien TV commercials, both positive (e.g. “But I saw where it is Ambien that helps you get to sleep and stay asleep. I saw the commercial for it. You think that’s a good one for me?”) and negative (e.g. “Yeah, I saw the commercial. I think it’s, uh, Ambien that says you might go out and eat and not remember. I thought great all I need.”)

DTC Recommendations: How can pharmas get the most bang for their buck?

Verilogue’s study revealed three key recommendations for every pharma in creating effective DTC ads:

1) Validate patient experiences
In order to drive greater patient awareness and more robust, meaningful discussions about a disease, akin to Cymbalta DTC pull-through, pharmas should structure DTC to validate patient experiences with health conditions. Use DTC as a tool to engage patients in constructing the meaning of – rather than simply mirroring experiences with – a health condition. Tactics to support such a strategy might go beyond traditional TV spot advertising to include embedded marketing where health conditions and treatments are woven into the lives of television/film characters, among other relevant tactics.

2) Better prepare physicians for the fair balance fight
While there’s no way around the regulatory mandate for fair balance statements, pharmas can better prepare physicians to address patient side effect concerns arising from DTC promotion. This might include providing physicians with tools (visual aids, stories/narratives, etc.) to put side effects into perspective by couching potential side effects in incidence scales/descriptions or in risk-benefit scenarios.

3) Connect meaningfully with patients
The most frequently pulled-through DTC campaign was Boniva’s “Rally with Sally,” which employed a well-known and trusted “friend” to deliver messages to the targeted middle-aged woman audience. This tactic was markedly different from tactics in other campaigns where messages are delivered by physicians and actors portraying patient family members, for example,“I know [Boniva]. Yes. Sally’s on the commercial.”

New data confirms the rate of chronic kidney disease is inching upward, keeping pace with the rising rates of diabetes. In late September, the U.S. Renal Data System published its 2009 Annual Data report, which shows the incidence of chronic kidney disease in the U.S. Medicare population is now 9.8%, up from 8.7% reported in last year’s data analysis.

Diabetes, the leading cause of kidney disease, moved closer to affecting one in four Medicare beneficiaries nationally: the newest data shows 24.8% have this disease, up from the 23.6% reported a year earlier. The Texas Department of State Health Services estimates more than 1.8 million Texans have diabetes.

Dallas-based nephrologist Roberto Collazo-Maldonado, MD, is not surprised by the data.

“Because Texas has a big problem with diabetes,” Dr. Collazo says, “more people will get kidney disease. If we find it early, we can effectively treat kidney disease to prevent and avoid dialysis. That is, if we find it early.”

The American Diabetes Association recommends people with diabetes check their kidneys with an annual microalbumin test. However, fewer than 40% of Texas Medicare beneficiaries with diabetes received this screening in 2007, according to claims data from the Centers for Medicare & Medicaid Services.

“I regularly see patients who discover they have kidney disease when they come to the hospital for emergency treatment because their kidneys have failed,” Dr. Collazo continues. “This is too late. People with diabetes must check their kidney health every year.”

Why preventive testing is critical for people with diabetes

“It’s optimal to treat kidney disease before the damage is apparent to the patient,” says Dr. Collazo. “In the earliest stages, it’s unlikely the patient will experience obvious symptoms that would prompt a doctor’s visit.”

The urine microalbumin test looks for traces of albumin, a protein, in a patient’s urine. Damage impairs the kidneys’ ability to filter the blood for proteins, which then “spill” into a patient’s urine. This is an early marker of kidney disease.

“Getting a microalbumin test is very easy. It’s just a urine sample. No needles and no pain,” says Dr. Collazo. “If we find kidney disease at the early stages, we can treat it and most likely avoid dialysis. Not everyone with kidney damage progresses to kidney failure, but first you have to get tested regularly and then get timely treatment to prevent that outcome.”

People with diabetes and minorities at higher risk

Up to 40% of people with diabetes will experience kidney problems in their lifetime. Minorities with diabetes are also disproportionately affected: African-Americans are four times more likely than Caucasians to experience kidney failure, and Mexican-Americans with diabetes are twice as likely as non-Hispanic whites to have diabetes.

Accounting for 44% of new cases, diabetes is the leading cause of kidney disease, the U.S. Renal Data System reported in 2007. The second leading cause is high blood pressure.6 Other risk factors are age, obesity and a family history of kidney problems.

A new survey finds that 54 percent of Americans say they do not consistently take prescriptions as instructed even though 87 percent believe prescription medicines are important to their health – pointing to a growing public health problem.

The survey examining prescription adherence was released today by Prescription Solutions, a pharmacy benefit management organization and a UnitedHealth Group, and the National Council on Patient Information and Education (NCPIE).

Poor adherence to medications – the extent to which people take their medications as prescribed by their doctor – can have adverse effects on people’s health. It diminishes the ability to treat chronic conditions like diabetes, heart disease, cancer, asthma and many other diseases; and it can result in suffering, an increase in hospitalizations and even death.

Non-adherence with prescription medications also is a key source of unnecessary cost in the U.S. health care system. According to a recent New England Healthcare Institute (NEHI) study, otherwise avoidable medical spending resulting directly from non-adherence accounts for up to $290 billion per year, or 13 percent of total health care expenditures.

The Prescription Solutions/NCPIE survey found that nearly 60 percent of respondents believe that when people take their prescription medications as instructed, it will lead to better health and it can help lower costs to the health system.

“The hidden health, financial and productivity costs of people not following their medication regimens as instructed are profound, making prescription non-adherence a national health problem,” said Jacqueline Kosecoff, chief executive officer of Prescription Solutions. “The survey clearly shows that people need and want more information, guidance and help understanding and using prescription medicines.”

Feeling Better and Side-Effect Concerns Are Top Reasons for Non-Adherence

Of those surveyed, 37 percent said they did not finish taking all the prescription medicine as instructed, and 31 percent said they skipped doses. Twenty-three percent said they did not refill their prescriptions as instructed.

When asked why they did not follow their doctors’ instructions, 59 percent said that they started to feel better and didn’t think it was necessary to keep taking the prescription medicine. Four in ten (37 percent) said they were concerned about side effects, while 25 percent said that they weren’t feeling any better so they didn’t think it was necessary to keep taking the prescription medicine. Nearly a quarter (24 percent) said they stopped taking the medicine because it was too expensive.

“Poor medicine adherence – dubbed by NCPIE over two decades ago as ‘America’s other drug problem,’ – appears to be as pervasive and costly in terms of health and economic consequences today as in years past,” said Ray Bullman, executive vice president of NCPIE. “These survey findings underscore the challenge of non-adherence and the need for frequent and ongoing communication between consumers and their health care providers about medicines so that consumers recognize the value of medicines properly used and can derive the maximum benefit – and the minimum risk – from their prescription medications.”

Data Suggest Refill Reminders, Regular Check-Ins, Easier-to-Read Instructions Would Aid Adherence

When asked what would help them take their medications as instructed, 39 percent cited refill reminders. Twenty-five percent of respondents said they would do better at taking their prescription medicines as instructed if someone were to follow up with them or encourage them along the way; this could include a loved one, caregiver or health care provider, for example. More than a third (34 percent) said that they would adhere better if they were provided easier-to-understand instructions about how to take their prescription medicines. Nearly half said lower cost for prescription medicines (49 percent) and fewer side effects (48 percent) would help them better take their medications as instructed.

Most Americans Are Reading Prescription Medicine Instructions; Men and Women Differ

Among additional findings of the survey, when it comes to reading the instructions that come with their medicines, 73 percent said they read both the label and the information on the medicine insert. Women are more apt to read both the label and the printed information on the insert (82 percent) compared with men (63 percent). Only 2 percent say they don’t read any of the materials.

In addition, when they’ve experienced a prescription medicine side effect, women are far more apt to talk to their doctor or pharmacist (72 percent) versus men (57 percent), further illustrating gender differences when it comes to problem solving through information seeking.

The Road to Better Adherence

“As our aging population grows, more people are taking multiple medications, and we have to employ a variety of pro-active and responsive strategies to help people improve their adherence,” said Joseph Addiego, M.D., senior vice president and chief medical officer for Prescription Solutions. “Prescription Solutions is doing its part to serve the needs of our customers and the entire health care system by offering an array of clinical programs that support people in adhering to their prescriptions so they can improve their health – ultimately leading to lower costs for everyone.”

Prescription Solutions and NCPIE both offer tips for consumers when it comes to taking prescription medications, including:

• Ask your doctor or pharmacist about instructions for use and possible side effects whenever a new medication is prescribed.
• Share information with your health practitioners about all the other medications, vitamins and herbal supplements you are taking to avoid negative drug/drug interactions and reduce the potential for side effects.
• Keep a current list of all medications you are taking, both prescription and over-the-counter and share this with your doctor at each visit.
• Read carefully the information that comes with your medication and save it for future reference.
• Call your doctor, pharmacist or pharmacy benefits manager if you are experiencing side effects from your medication.
• Consider cost-saving and convenient options like mail order and use generic alternatives where appropriate.

The Grocery Shopping Network announced today the addition of UCook, an iPhone app that empowers shoppers with the digital weekly specials circular from their favorite grocer, and a rich interactive recipe database with nutritional information, plus a shopping engine. The first version is free and is connected to a growing list of grocery stores across the country that is powered by GSN’s web services solutions.

Andy Robinson, Grocery Shopping Network CEO, has high hopes for the new addition to the Apple app store. “The new UCook app will give the grocers we serve a new way to provide value to their mobile customers. Not only does this app give shoppers great recipes, but it also gives them quick and easy access to weekly specials in their grocery store. Our grocery partners are excited to offer this solution to the public at no charge. ”

The UCook app can be found in the iTunes App Store. UCook boasts over 60,000 kitchen-tested recipes with photos and nutritional information. The UCook app also gives shoppers an easy to use shopping list which keeps track of sale items and recipes for purchase at their local grocery store. (The same features and recipes are also available at the GSN-powered grocery store website.)

This application’s store footprint is expanding rapidly, empowering shoppers at major grocery chains across the country including Apple Market, Cashwise, Coborns, Country Market, Country Mart, CV’s Family Foods, D’Agostino, Festival Foods, Food City, Foodland, Giant – Carlisle, Haggen, Homeland Stores, Hy-Vee, Kings Super Markets, Lucky Supermarkets, Martins, Plumb’s, Remke Markets, SaveMart, Scolari’s, Strack & Van Til, Top Food & Drug, Ukrops, United Supermarkets, Ultra Foods, and many more.

When a medical bill arrives in an Ohio resident’s mailbox, its side effects usually include procrastination, confusion and concern. That’s the conclusion of an Intuit survey that asked Ohioans how they feel about healthcare finances.

The Healthcare in Ohio survey, found Ohioans confused about what they were being asked to pay and why they owed that amount. Fifty-five percent said they stumbled over the medical jargon and codes included in their healthcare paperwork. This confusion has led, in part, to a quarter of Ohioans letting at least one medical bill go 90 days past due or be sent to a collection agency in the past year.

The survey also shed light on the anxiety facing Ohio residents from Aberdeen to Zoarville trying to get a handle on their healthcare finances. Forty-three percent felt that healthcare costs had drastically increased in the past year, and nearly 70 percent expressed concern about their ability to manage medical bills for themselves and their families. As a result, three-quarters of respondents routinely put off opening their medical mail, which includes bills and explanation of benefits statements.

“Our findings in Ohio are a prime example of how medical bills stand apart in the family budget,” said Peter Karpas, president and division general manager of Quicken Health Group. “No other payment seems to cause so much concern and angst. And because medical bill amounts can be significant and often arrive when people are stressed, this is the one bill that must be clear, understandable and easy to pay.”

These challenges are driving development in consumer-oriented medical management tools, including two online tools from Intuit: Quicken Health Expense TrackerSM, which helps patients understand what they owe and why. It also provides guidance on what to do if something is wrong, and helps consumers conveniently pay online. A second tool, Quicken HealthSM Bill Pay, makes it easy for doctors to provide their patients with a more understandable medical bill that can be conveniently paid electronically – resulting in less confusion and faster payments. More than two-thirds of survey respondents said they would use a product that would help them understand their medical bill and the amount they’re being asked to pay.

“There’s a connection between the unfamiliar language, on one hand, and delinquent bills on the other, Karpas said.

“Additional research has shown that 40 percent of patients don’t pay their medical bills, simply because they either don’t understand what they’re being asked to pay for or don’t believe they are responsible for the amount due. As many as half of those bills are written off as unpaid debt and that can drive up healthcare costs for everyone,” he added.

The Ohio study also found that people don’t use technology to pay medical bills as frequently as they do to pay other debts. While Americans routinely pay many bills electronically, 68 percent of Ohio respondents still pay their medical bills by paper check—a source of higher processing costs for a sector that is trying to keep costs down.

Science now offers us ever more advanced ways to understand and control pain. But with those new treatments come new questions about the use (and misuse) of state-of-the-art technology and how far pain management can and should go. Is pain a symptom or a disease? How much pain should be relieved? Can reducing pain be inappropriate or detrimental? Can technologies capable of scanning the brain tell us whether a patient is really experiencing pain? And what questions arise in confronting (and treating) pain in animals and other non-human beings?

On November 13, the Center for Neurotechnology Studies at the Potomac Institute for Policy Studies will present the lecture “From a Neuroscience of Pain to a Neuroethics of Care” by Prof. James Giordano, internationally known for his work on the neuroscience and neuroethics of pain. The program will address the neuroscientific progress achieved during the Congressionally-designated Decade of Pain Control and Research, and discuss the ethical implications of this knowledge for medicine, and society at large. Researchers are now looking ahead to a Decade of the Mind, and this lecture raises questions about whether what we know about pain will both guide and be guided by what we seek to learn about the mind, and the nature of self and others.

What: CCNELSI Lecture: “From a Neuroscience of Pain to a Neuroethics of Care”

Who: James Giordano, Ph.D.

Where: Potomac Institute for Policy Studies, 901 North Stuart Street, Suite 200, Arlington, VA, 22203

When: November 13, 2009, 3:30 – 6:00 pm

More info: www.ccnelsi.com