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Greetings!
Spine & Joint Care Program
On March 31,
ODS members became eligible to participate in the new Spine & Joint Care
Program, a musculoskeletal and pain management coaching benefit.
ODS takes a highly integrated approach to medical management, leveraging
cross-referrals from Care Coordination, Case Management and Behavioral Health
to identify members who may benefit from health coaching. We also use medical
and pharmacy claims data as part of our multi-faceted approach. We work closely
with ODS internal stakeholders, including representatives from Marketing,
Pharmacy, Professional Relations, Claims and Customer Service to facilitate the
best possible care and provide the best coaching for our members.
As the newest addition to the suite of ODS Care Programs, the Spine & Joint
Care Program offers members condition-specific outreach, including e-mail and
telephone-based "health coaching" from a multidisciplinary team of
clinicians who focus on the following spine and joint topics: - Informed decision support
One-on-one health coaches work actively with ODS
members to help them understand spine and joint anatomy and create a plan
of modified, joint-sparing activities and techniques to perform at
home and work. The program emphasizes the member working with his or her
healthcare provider on interventions, including stretching and
strengthening exercises, relaxation techniques, diet and weight management,
smoking cessation and medication management.
Applying both patient activation measures and motivational interviewing
techniques, one-on-one coaching helps members make realistic and meaningful
decisions that reflect their personal needs and values. We identify members
needing higher levels of support based on the member's knowledge, skills and
confidence in managing his or her health condition. These members may be
offered care coordination and case management services.
Coaches communicate with the member's healthcare provider when necessary
to discuss treatment plans and goals. As with other ODS Care Programs, coaches
screen patients for depression, making referral recommendations to the
healthcare provider when appropriate.
For more information
Contact your marketing representative if you have any questions about the ODS
Spine & Joint Care Program. |
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Preventing a Mouth Malady
USC School of Dentistry study is among the first to acknowledge correlation
between common osteoporosis medications and jawbone death by Beth Dunham
According to a recent study by researchers at the University of Southern
California (USC) School of Dentistry, even short-term use of common oral
osteoporosis drugs may leave the jaw vulnerable to devastating necrosis, or
death of the jawbone.
The study, which appeared in the Jan. 1, 2009, issue of The Journal of the
American Dental Association, is the first large institutional study in the
United States to investigate the relationship between oral bisphosphonate use
and jawbone death, says principal investigator Parish Sedghizadeh, assistant
professor of clinical dentistry at the USC School of Dentistry.
After controlling for referral bias and other health factors, nine of 208
School of Dentistry patients who take or have taken Fosamax for any length of
time were diagnosed with osteonecrosis of the jaw (ONJ). Fosamax is the most
widely prescribed oral bisphosphonate for people with osteoporosis.
Bisphosphonates are typically used to reduce the risk of bone fracture and to
increase bone mass in people with osteoporosis. Other negative side effects
have been reported in the past, including unusual fractures of the thigh bone,
inflammatory eye disease and increased risk of atrial fibrillation-a type of
abnormal heart rhythm.
The study's results are in contrast to drug makers' prior assertions that
bisphosphonate-related ONJ risk is noticeable only with intravenous use of the
drugs, not oral usage, Sedghizadeh says.
"We've been told that the risk with oral bisphosphonates is negligible,
but 4 percent is not negligible," he says. "This is more frequent
than everybody would like to think it is."
ONJ is characterized by pain, soft-tissue swelling, infection, loose teeth and
exposed bone. Most doctors who have prescribed bisphosphonates have not told
patients about any oral health risks associated with the use of the drugs,
despite even short-term usage, which poses a risk due to the drug's tenacious
10-year half-life in bone tissue.
Lydia Macwilliams of Los Angeles said no one told her about the risk posed by
her three years of Fosamax usage until she became a patient of Sedghizadeh's at
the School of Dentistry.
"I was surprised," she says. "My doctor who prescribed the
Fosamax didn't tell me about any possible problems with my teeth."
Macwilliams was especially at risk for complications because she was to have
three teeth extracted. The danger for infection is especially pronounced with
procedures that directly expose the jawbone, such as tooth extractions and
other oral surgery. This is because the infection is a result of a biofilm
bacterial process. The bacteria infecting the mouth and jaw tissues reside
within a slimy matrix that protects the bacteria from many conventional
antibiotic treatments, and bisphosphonate use may make the infection more
aggressive in adhering to the jaw, Sedghizadeh says.
After her extractions, two of the three extraction sites had difficulty healing
due to infection, Macwilliams says. Luckily, with treatment as well as the
rigorous oral hygiene regimen that USC dentists developed especially for
patients with a history of bisphosphonate usage, the remaining sites slowly but
fully healed.
"It took about a year to heal," she said, "but it's doing just
fine now."
Sedghizadeh hopes to have other researchers confirm his findings and thus
encourage more doctors and dentists to talk with patients about the oral health
risks associated with the widely used drugs. The results confirm the suspicions
of many in the oral health field, he says.
"Here at the School of Dentistry, we're getting two or three new patients
a week that have bisphosphonate-related ONJ," he says, "and I know
we're not the only ones seeing it."
Sedghizadeh says they now screen every patient for bisphosphonate use and treat
accordingly. "We put patients on anti-microbial, anti-fungal rinse one
week pre-operatively or post-operatively," he says. "If they have
been on bisphosphonates six months or a year or longer, then we have a
prevention protocol which has been very, very effective."
Reprinted with permission from USC HealthNow |
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Disclaimer
Not all plans have access to
all resources or tools referenced in this newsletter. Please refer to your
member handbook, or call your ODS marketing representative for plan-specific
information.
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ODS Adopts Milliman Care Guidelines
As part of our ongoing commitment to promote quality care,
patient safety and the most appropriate use of healthcare resources, effective
Thursday, April 22, ODS has adopted the evidence-based Milliman Care
Guidelines®. Specifically, we will use the Care Guidelines products for: Inpatient and outpatient surgeries Initial and ongoing goal length of stay for admissions to: - Inpatient facilities, including
medical and behavioral health
- Skilled nursing facilities
- Acute inpatient rehabilitation
- Long-term acute care facilities
- Chiropractic, acupuncture and
massage services
- Durable medical equipment
The Milliman Care Guidelines are developed using
the industry's most rigorous evidence-based methodology. All content is
reviewed annually and updated as necessary by doctors and nurses who cite more
than 15,000 unique references, including peer review journals, in the current
seven-product Care Guidelines series. Milliman Care Guidelines epidemiologists
then examine databases that cover a significant portion of the United States
population to validate that these published research results are achievable in
real-life situations. If you have any questions about the Milliman Care Guidelines, please contact
your marketing representative. |
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