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December 28, 2006     Cape Gazette
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December 28, 2006

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28 - CAPE GAZETTE - Wednesday, December 27 - Thursday, December 28, 2006 Bayhealth Home Care named one c,f' the 2006 HomeCare Elite Bayhealth Home Care has been named one of the 2006 HomeCare Elite, the inaugural compilation of the most successful home-care providers in the United States. Bayhealth Home Care was one of only three Delaware home-health- care agencies to receive the dis- tinction. The 2006 HomeCare Elite " names the top 25 percent of agen- cies whose performance measures in quality, improvement and finan- cial performance are best. This is the first in a series of HomeCare Elite reports, lists, articles and fea- tures that will examine different views of the data, including regional analysis and the underly- ing components of agency suc- cess. The list was developed by OCS, a post-acute healthcare information company. "Bayhealth Home Care is very excited to be recognized national- ly by this organization. This recognition fulfills the Bayhealth Medical Center Inc. vision to dis- tinguish ourselves as the health- care provider of choice by deliver- ing the highest quality care with an exceptional patient experience," said Bayhealth Home Care Director Elizabeth Mende, RN, MSHSA. Bayhealth Home Care services help patients in all three Delaware counties recover from illness or injury in their own homes. The staff includes nurses, therapists and aides who provide nursing services; physical, occu- pational and speech therapy; and other services such as nutrition counseling, diabetes education and wound/ostomy service. Better evidence needed for popular treatments Physicians frequently look down on home reme- dies and other alternative therapies because there is rarely scientific evidence to support them. In an age of evidence-based medicine, there is no room for folklore. When our readers tell us that Vicks VapoRub helps heal nail fungus, Listerine cures dandruff or putting keys down the back of the neck can stop a nosebleed, many medical experts sneer. The only trouble with this condescending attitude is that the evidence supporting many conventional treatments is often surprisingly inadequate. A recent report in the Journal of the American Medical Association (Nov. 22/29, 2006) revealed spinal surgery on herniated disks was not clearly better than standard therapy for scialiea. Patients with arthritis were told that a new gener- ation of anti-inflammatory drugs, the COX-2 inhibitors, would be much safer than older medica- tions such as ibuprofen or naproxen. Tens of millions of patients were prescribed drugs like Vioxx, Bextra and Celebrex because they were supposed to be better. Now we know the evidence of safety was illuso- ry and many people suffered heart attacks or strokes as side effects. The most recent shocker involves drug-coated stents. These devices are tiny mesh tubes that prop open clogged coronary arteries. Bare metal stents had been used for years, but the arteries frequently clogged up again. Coating the metal with a medication designed to retard cell growth seemed like a breakthrough. Initial studies suggested that the pricey drug-elut- ing stents would be safer over the long term. A new study from the Cleveland Clinic (American Journal of Medicine, December 2006) now suggests that these new and improved stents are actually four or five times more likely to result in a blood clot that can lead to a heart attack. Millions of people now worry that they may be at increased risk of fatal heart attacks because of an intervention that was supposed to save them from this very fate. Physicians want to do the right thing. Making good decisions does require scientific evidence. PEOPLE'S PHARMACY Joe and Teresa Graedon Too often, the evidence is not as gtrong as manufac- turers claim. For years, makers of hormone replacement ther- apy (HRT) told doctors that estrogen and progestin would prevent a variety of serious health problems. Women were encouraged to take hormones to pro- tect their hearts, their bones and their brains. We now know, however, that HRT can increase the risk of heart attacks, strokes and breast cancer. The new generation of antipsychotic medications was supposed to be substantially better than older drugs for schizophrenia. But a new study shows that the pricey new pills offer no clear advantage over older medicines (American Journal of Psychiatry, December 2006). Is it any wonder that patients are becoming skepti- cal about so-called drug breakthroughs? Doctors and patients alike should have better information on which to base treatment decisions. People often turn to Consumer Reports for head-to- head evaluations of toasters, TVs or automobiles. The same type of objective analysis should be available for medication interventions. Editor's note: Joe Graedon is a pharmacologist, and Teresa Graedon is a medical anthropologist. 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