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Studies show severe toll of COVID-19 on sexual and reproductive health, rights around the world – World | ReliefWeb

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Studies show severe toll of COVID-19 on sexual and reproductive health, rights around the world - World | ReliefWeb

UNITED NATIONS, New York – Researchers, advocates and leaders convened last week ahead of the United Nations Commission on Population and Development to explore the continuing severe toll of the COVID-19 pandemic on gender equality and sexual and reproductive health around the world.

“COVID-19 has an unequal, compounding and devastating impact on the already most marginalized groups,” said Ambassador Pascale Grotenhuis of the Netherlands, which co-organized the event along with Canada, Mexico, South Africa, UNFPA and Rutgers University. “It’s awful and disturbing to see the progress that we achieved by working jointly and by putting our actions and resources together over decades is threatened to be reversed.”

Findings from experts in the UN, academia, civil society, government ministries and other partners showed widespread losses in access to sexual and reproductive health information and services and increased concerns over gender-based violence.

Findings paint stark picture

Since the outset of the pandemic, UNFPA has been projecting that the crisis could seriously curtail access to life-saving sexual and reproductive health services, including family planning. Additionally, lockdowns and economic disruptions were expected to greatly increase the incidence of gender-based violence and harmful practices like child marriage and female genital mutilation.

“We are at this stage where countries now have hard evidence” of such disruptions, said Dr. Julitta Onabanjo, the UNFPA Regional Director in East and Southern Africa, who presented results from a UN study led by UNFPA and UN Women showing serious income losses across the region. Growing economic insecurity and related vulnerabilities are undermining efforts to secure gender equality, the study finds.

Aliza Singh, a programme coordinator for Beyond Beijing Committee Nepal, announced findings from a Rutgers-led survey of nearly 2,700 young people across Ghana, Indonesia, Kenya, Nepal, Uganda and Zimbabwe. “More than a third of young people felt more vulnerable to harassment, sexual physical emotional or financial abuse than before COVID-19. One third of young people were not able to access family planning services they needed,” she explained.

“The closure of schools hindered access to comprehensive sexuality education,” added Brian Ssekajja, a peer educator at Reproductive Health Uganda. “Young people got HIV, STIs, contracted diseases.”

With firm data now increasingly available, Dr. Onabanjo said, it is time to “begin to shift into policies and programmes and what needs to be done.”

Women and girls take the brunt

Women and girls face a disproportionate burden, the panellists explained.

“Today with the pandemic, we have seen a peak in maternal mortality,” noted Dr. Karla Berdichevsky, General Director of the National Centre for Gender Equality and Reproductive Health in Mexico. “We are observing that these maternal mortalities are being caused by a lack of access to services.”

Girls also spoke about worsening access to menstrual hygiene information and supplies because of economic stresses, mobility restrictions and school closures. In some cases, “parents decided to withhold provision of certain commodities to their girls like sanitary pads so as to get other essential items like food,” Mr. Ssekajja reported, echoing findings Ms. Singh reported from Nepal.

School closures have also led to less access to information about sexual and reproductive health. As a result, “we reported a number of teenage pregnancies and unwanted pregnancies, child marriages,” Mr. Ssekajja said. The school closures and economic insecurity also “exposed a lot of girls to sexual activity and sexual violence from opportunists.”

“The statistics before COVID were already bleak,” Ambassador Grotenhuis reminded participants. “It’s shocking that only half of women are able to take essential decisions about their own body,” she said, referring to data from the recently launched State of World Population report. “We were already in an era of incredible pushback against gender equality, sexual and reproductive health and rights and bodily autonomy… The COVID pandemic showed us that we really have to act now.”

“COVID is indeed a crisis with a woman’s face,” UNFPA Executive Director Dr. Natalia Kanem reiterated at the Commission’s opening. “We see an upsurge in gender-based violence, in child marriage, in adolescent pregnancy, and as barriers are thrown up to the normal, protective sexual and reproductive health services.”

She urged Member States and partners to prioritize the rights of women and girls. “We must show the world that this time, nourishing the aspirations of women, girls — and indeed, everyone — will not escape our grasp.”

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A Global Call to Action – Reducing the Clinical and Public Health Burden of Familial Hypercholesterolemia

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Healthcare systems around the world have failed to rescue individuals born with Familial Hypercholesterolemia (FH), even though we have had life-saving therapies for the last 34 years. Without the societal commitment to screen, diagnose, and manage FH, the opportunity to prevent heart disease and stroke for an entire generation has been lost.
In planning for our 2018 FH Global Summit, the FH Foundation brought together the original authors of the groundbreaking World Health Organization (WHO) Report on Familial Hypercholesterolemia to honor them, take stock of the progress, and reinvigorate our global efforts to address FH as a public health priority. In the two years that followed, the FH Foundation and the World Heart Federation partnered to convene more than 40 patient advocacy organizations and thought leaders from around the world. Together, we reissued an emphatic call to close the gaps in identification and care of this common cause of preventable premature death and disease – the FH Global Call to Action.
We’re renewing our call to action today, and everyday, until there are substantial efforts by public health officials, health systems, and the medical community to assure that families carrying the FH gene have the chance to understand their condition and have access to care. To drive these changes, the FH Foundation continues to do important research to illuminate the gaps in care and the human and societal costs of avoidable premature cardiovascular disease.
In the past 20 years, progress in addressing and treating FH has been grossly insufficient, considering the magnitude of the suffering it inflicts. But the opportunity to make an impact now is greater than ever with the continued introduction of additional therapies and the dramatic increase in affordable genetic testing.
How to Fight FH – A Global Call to Action
Familial Hypercholesterolemia (FH) is under-diagnosed and under-treated.
To address the root causes contributing to poor diagnosis and inadequate care of FH, the Global Call to Action highlights 9 priorities.
A Global Call to Action for FH - Recommendations
  • Awareness in educational institutions, the medical community, the healthcare delivery system, and the general public
  • Advocacy by partnerships of patients, physicians, and other healthcare professionals
  • Screening, testing, and diagnosis performed according to country-specific conditions and guidelines
  • Treatment for FH, made more available, affordable, and patient-centered
  • Separate guidelines for severe and homozygous FH, which merit special consideration
  • Family-based care with opportunities for greater patient involvement and agency, including shared decision-making
  • Registries for research to qualify current practices and identify gaps between guidelines and healthcare delivery
  • Research – scientific, genetic, epidemiologic, clinical, and beyond – to improve FH care
  • Cost and value for families and society, including productivity and quality of life, better quantified and understood
Join the global FH community and change the fate of FH families:
Today, FH can be a story of hope for families with a history of heart disease and stroke. Simple identification and appropriate medical management can give every person the chance for a longer, healthier life.
Katherine A. WilemonKatherine A. Wilemon

The post A Global Call to Action – Reducing the Clinical and Public Health Burden of Familial Hypercholesterolemia appeared first on The FH Foundation.

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World Health Organization Enters Damage Control Mode – Prepare For Change

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While the mainstream media has, by and large, dismissed the theory that SARS-CoV-2 was created and leaked from a high-security biocontainment lab in Wuhan, China, a number of high-ranking U.S. officials are sticking to it, and there’s probably good reason for this.

On the whole, if the virus was actually a natural occurrence, a series of improbable coincidences would have had to transpire. Meanwhile, a series of highly probable “coincidences” point to the Wuhan Institute of Virology (WIV) being the most likely source, and to dismiss them as a whole simply doesn’t make sense.

Media Struggle to Prop Up Unproven Zoonotic Theory

I first mentioned that the outbreak had the hallmarks of a laboratory escape in an article we posted well over a year ago, February 4, 2020. On the upside, some members of the media are now finally starting to inch toward more honest reporting on this — probably because U.S. officials keep leaning that way.

That doesn’t mean some aren’t still trying to defend the official narrative. Take The New York Times, for example. The original headline of its March 26, 2021, article about Dr. Robert Redfield, former director of the Centers for Disease Control and Prevention, read: “Ex-CDC Director Favors Debunked Covid-19 Origin Theory.”1

Three days later, that headline was toned down to: “The CDC’s Ex-Director Offers No Evidence in Favoring Speculation That the Coronavirus Originated in a Lab,”2 with a correction notice noting that the earlier headline “referred incorrectly to a theory on the origins of the coronavirus. The theory is unproven, not debunked.”

Well, the truth is, all other theories are equally unproven — and are riddled with far more holes. The theory that the virus arose through natural mutation, for example, looks like Swiss cheese in comparison to the lab-leak theory.

In a February 16, 2021, article3 in Independent Science News, molecular biologist and virologist Jonathan Latham, Ph.D., and Allison Wilson, Ph.D., a molecular biologist, reviewed the evidence for a laboratory origin and the reasons why a zoonotic origin “will never be found.” I also summarized their review in “How We Know SARS-CoV-2 Leaked From a Chinese Lab.”

The half-baked idea brought forth by the World Health Organization’s investigative team, that the virus somehow naturally evolved in some unknown part of the world and then piggy-backed into Wuhan on top of frozen food, is held together by even fewer facts.

Among the more compelling “coincidences” that hint at lab-origin are the facts that the WIV has admitted storing and working with bat coronaviruses collected significant distances away from the lab, and that it’s the only biosafety lab in China that studies human coronaviruses. These viruses include RaTG13,4 the closest known ancestor to SARS-CoV-2, obtained from miners who fell ill with severe respiratory illness after working in a Mojiang mine in 2012.

WHO COVID Report ‘Totally Flawed’

In a March 30, 2021, opinion piece in The Washington Post,5 Josh Rogin accurately points out that the WHO’s report6 on the origin of SARS-CoV-2 is so flawed, “a real investigation has yet to take place.” We simply cannot count that report as the result of a true investigative effort.

“Determining the origin of the SARS-CoV-2 virus should have nothing to do with politics,” he writes.7 “It is a forensic question, one that requires thorough investigation of all possible theories, and one that should encompass both the scenario that the virus jumped from animals to humans in nature as well as one related to human error in a Wuhan lab.

But a fatally flawed investigation by the World Health Organization and Chinese officials and experts only muddies the waters, and it places the WHO further at odds with the U.S. government and the Biden administration.”

As noted by Rogin and many others, the investigation was far from independent and transparent, as China was allowed to select its members, who then relied on their Chinese counterparts when it came to data collection. It’s no surprise then that this team decided the natural origin theory is the most credible, while the lab-accident theory is summarily dismissed as unworthy of further consideration and study.

In a March 25, 2021, CNN interview,8 Secretary of State Antony Blinken stated, “We’ve got real concerns about the methodology and the process that went into that report, including the fact that the government in Beijing apparently helped to write it.” Rogin adds:9

“Specifically, declassified U.S. intelligence, confirmed by Blinken’s own State Department,10 alleges that the WIV was conducting undisclosed research on bat coronaviruses, had secret research projects with the Chinese military, and failed to disclose that several lab workers got sick with COVID-like symptoms in autumn 2019.”

Someone’s Not Telling the Truth

According to the WHO report, the labs “were well-managed, with a staff health monitoring program with no reporting of COVID-19 compatible respiratory illness during the weeks/months prior to December 2019.” “In other words, the WHO is saying the U.S. intelligence is wrong,” Rogin writes.11

Not a word is mentioned in the report about U.S. government claims that the WIV engaged in the very research required to create a novel coronavirus with the specific affinity to infect human cells.

Recently, Shi Zhengli, who heads bat coronavirus research at the WIV spoke at a Rutgers University seminar, calling the WIV’s research “open“ and ”transparent.” Former deputy national security adviser Matthew Pottinger disagrees. In an interview with Lesley Stahl on 60 Minutes, he said:12

“There was a direct order from Beijing to destroy all viral samples — and they didn’t volunteer to share the genetic sequences. There is a body of research that’s been taking place, conducted by the Chinese military in collaboration with the WIV, which has not been acknowledged by the Chinese government.

We’ve seen the data. I’ve personally seen the data. We don’t know [why the military were in that lab]. It is a major lead that needs to be pursued by the press, certainly by the WHO.”

As noted by Pottinger, Shi published studies showing how bat coronaviruses were manipulated to render them more infectious to humans, and the U.S. government has in the past received reports of safety concerns due to lax standards at the WIV.

“They were doing research specifically on coronaviruses that attach to the ACE2 receptors in human lungs just like the COVID-19 virus,” Pottinger told Stahl.13 “It’s circumstantial evidence. But it’s a pretty potent bullet point when you consider that the place where this pandemic emerged was a few kilometers away from the WIV.”

US State Department Suspects Lab Leak

In a March 21, 2021, interview with Sky News Australia,14 David Asher, former lead investigator for the U.S. State Department’s task force that looked into the origins of COVID-19, also stated that the data they collected “made us feel the Wuhan Institute was highly probably the source of the COVID pandemic.”

According to Asher, three workers at the WIV who worked with the RatG13 coronavirus — the closest relative to SARS-CoV-2 identified to date — appear to have actually been the first cluster of cases of COVID-19. They fell ill with symptoms consistent with COVID-19 as early as October 2019. At least one of the workers required hospitalization.

He also pointed out there is evidence in the genetic sequence of SARS-CoV-2 suggesting it’s been synthetically altered. It has the backbone of a bat coronavirus, combined with a pangolin receptor and “some sort of humanized mice transceptor.” “These things don’t naturally make sense,” Asher said, adding that experts around the world agree that the odds of this configuration occurring naturally is “very low.”

Another troubling indicator that something was amiss at the WIV was the Chinese government’s taking down of a WIV database in September 2019. According to the Chinese, this was done because of “thousands of hacking attempts.”

However, Asher pointed out many other databases were taken offline around the same time as well.15 The Chinese even tried to remove data posted in a European database containing viral sequencing from patients exhibiting COVID-19-related symptoms. Interestingly, those sequences included adenovirus, which is a vaccine vector. This, Asher said, could indicate that SARS-CoV-2 is part of a vaccine developed in response to a biological weapon.

In an earlier article16 by The Sun, Asher is quoted saying the WIV “was operating a secret, classified program,” and that “In my view … it was a biological weapons program.” He stops short of accusing China of intentional release, however, which also would not make sense from a bioweapon point of view. Instead, he said he believes it was a weapon vector that, during development, “somehow leaked.”17

A March 27, 2020, assessment report by the U.S. Defense Intelligence Agency also concluded SARS-CoV-2 was likely an accidental release from an infectious diseases laboratory, but stops short of calling it a biological weapon.18 Asher also told Sky News19 he’s never seen a more systematic cover-up, and The Sun20 quotes him as saying that “Motive, cover-up, conspiracy, all the hallmarks of guilt are associated with this.”

Former FDA Commissioner Weighs in on Lab Origin

March 28, 2021, former FDA commissioner Dr. Scott Gottlieb, now a board member of Pfizer (producer of one of the COVID vaccines), weighed in on the origin of the pandemic in a Face the Nation interview, saying:21

“It looks like the WHO report was an attempt to try to support the Chinese narrative … You know, the lab leak theory doesn’t seem like a plausible theory unless you aggregate the biggest collection of coronaviruses and put them in a lab, a minimum-security lab in the middle of a densely-populated center and experiment on animals, which is exactly what the Wuhan Institute of Virology did.

They were using these viruses in a BSL-2 lab and, we now know, infecting animals. So that creates the opportunity for a lab leak. It might not be the most likely scenario on how this virus got out, but it has to remain a scenario. And I think at the end of the day, we’re never going to fully discharge that possibility. What we’re going to have here is a battle of competing narratives.”

WHO Enters Damage Control Mode

In response to growing critique, WHO director general, Tedros Adhanom Ghebreyesus and 13 other world leaders have joined the U.S. government in expressing “frustration with the level of access China granted an international mission to Wuhan.” As reported by The Washington Post, March 30, 2021:22

“Ghebreyesus said in a briefing to member states … that he expected ‘future collaborative studies to include more timely and comprehensive data sharing’ — the most pointed comments to date from an agency that has been solicitous toward China through most of the pandemic.

He said there is a particular need for a ‘full analysis’ of the role of animal markets in Wuhan and that the report did not conduct an ‘extensive enough’ assessment of the possibility the virus was introduced to humans through a laboratory incident …

The United States, Britain, South Korea, Israel, Japan and others issued a joint statement23 … expressing concern. ‘Together, we support a transparent and independent analysis and evaluation, free from interference and undue influence,’ it reads …

Tedros said24 … that mission team members raised concerns to him about access to raw data needed for the report … ‘The team reports that the first detected case had symptom onset on the 8th of December 2019. But to understand the earliest cases, scientists would benefit from full access to data, including biological samples from at least September 2019,’ he said.”

WHO Investigation Team Accused of Spreading Disinformation

In a March 2020 interview with Independent Science News,25 molecular biologist Richard Ebright, Ph.D., laboratory director at the Waksman Institute of Microbiology and member of the Institutional Biosafety Committee of Rutgers University and the Working Group on Pathogen Security of the state of New Jersey, called out the members of the WHO-instigated investigative team as “participants in disinformation.”

Ebright was one of 26 scientists who signed an open letter26 demanding a full and unrestricted forensic investigation into the origins of the pandemic, published in the Wall Street Journal and French Le Monde, March 4, 2021. When asked to describe the shortcomings of the WHO-China team’s investigation, he responded:

“A credible investigation would have had Terms of Reference that: 1) Acknowledged the possibility of laboratory origin, 2) Ensured access of investigators to records, samples, personnel, and facilities at the Wuhan laboratories that handle bat SARS-related coronaviruses,

3) Enabled collection of evidence, not mere meet-and-greet photo-ops, 4) Authorized an investigation of months, not mere days, and 5) A credible investigation also would have had conflict-of-interest-free investigators, not persons who were subjects of the research and/or closely associated with subjects of the investigation …

It is crucial that any team reviewing the issues include not only research scientists, but also biosafety, biosecurity, and science policy specialists.”

Ebright, who has repeatedly called the WHO mission “a charade,” stated that “its members were willing — and, in at least one case, enthusiastic — participants in disinformation.” Importantly, the terms of reference for the investigation were prenegotiated, and did not include even the possibility of a laboratory origin. He’s also highly critical of the inclusion of Peter Daszak, whose conflicts of interest alone are enough to invalidate the investigation.

“Daszak was the contractor who funded the laboratory at WIV that potentially was the source of the virus (with subcontracts from $200 million from the US Department of State and $7 million from the US National Institutes of Health), and he was a collaborator and co-author on research projects at the laboratory,” Ebright noted.

What Do We Know?

While another signer of the open letter, Dr. Steven Quay, claims to have calculated27 the lab-origin hypothesis as having a 99.8% probability of being correct, Ebright is unwilling to assign relative probabilities to either theory. Rather, he insists a truly thorough forensic investigation and analysis is what is required, as there is biological evidence going in both directions. He explains:

“The genome sequence of the outbreak virus indicates that its progenitor was either the horseshoe-bat coronavirus RaTG13, or a closely related bat coronavirus.

RaTG13 was collected by Wuhan Institute of Virology in 2013 from a horseshoe-bat colony in a mine in Yunnan province, where miners had died from a SARS-like pneumonia in 2012, was partly sequenced by WIV in 2013-2016, was fully sequenced by WIV in 2018-2019, and was published by WIV in 2020.

Bat coronaviruses are present in nature in multiple parts of China. Therefore, the first human infection could have occurred as a natural accident, with a virus passing from a bat to a human, possibly through another animal. There is clear precedent for this. The first entry of the SARS virus into the human population occurred as a natural accident in a rural part of Guangdong province in 2002.

But bat coronaviruses are also collected and studied by laboratories in multiple parts of China, including the Wuhan Institute of Virology. Therefore, the first human infection also could have occurred as a laboratory accident, with a virus accidentally infecting a field collection staffer, a field survey staffer, or a laboratory staffer, followed by transmission from the staffer to the public.

There also is clear precedent for this. The second, third, fourth and fifth entries of the SARS virus into human populations occurred as a laboratory accident in Singapore in 2003, a laboratory accident in Taipei in 2003, and two separate laboratory accidents in Beijing in 2004.

At this point in time, there is no secure basis to assign relative probabilities to the natural-accident hypothesis and the laboratory-accident hypothesis. Nevertheless, there are three lines of circumstantial evidence that are worth noting.

1. First, the outbreak occurred in Wuhan, a city of 11 million persons that does not contain horseshoe-bat colonies; that is tens of kilometers from, and that is outside the flight range of, the nearest known horseshoe-bat colonies. Furthermore, the outbreak occurred at a time of year when horseshoe bats are in hibernation and do not leave colonies.

2. Second, the outbreak occurred in Wuhan, on the doorstep of the laboratory that conducts the world’s largest research project on horseshoe bat viruses, that has the world’s largest collection of horseshoe-bat viruses, and that possessed and worked with the world’s closest sequenced relative of the outbreak virus …

3. Third, the bat-SARS-related-coronavirus projects at the Wuhan Institute of Virology used personal protective equipment (usually just gloves; sometimes not even gloves) and biosafety standards (usually just biosafety level 2) that would pose very high risk of infection of field-collection, field-survey, or laboratory staff upon contact with a virus having the transmission properties of SARS-CoV-2.”

Who’s Qualified to Opine on Viral Origin?

When asked “What would you say to the scientists who declined to comment on the open letter because it does not come from virologists?” Ebright responded:28

“The claim is unsound. There were virologists among the signers of the Open Letter. There even were coronavirologists among the signers of the Open Letter. More important, COVID-19 affects every person on the planet. Not just virologists …

Microbiologists and molecular biologists are as qualified as virologists to assess the relevant science and science policies. Virology is a subset, not a superset, of microbiology and molecular biology. The sequencing, sequence analysis, cell culture, animal-infection studies and other laboratory procedures used by virologists are not materially different from the procedures used by other microbiologists and molecular biologists.”

Is Gain-of-Function Research Ever Justifiable?

Clearly, getting to the bottom of the origin of SARS-CoV-2 is crucial if we are to prevent a similar pandemic from erupting in the future. If gain-of-function research was in fact involved, we need to know, so that steps can either be taken to prevent another leak (which is not likely possible) or to dismantle and ban such research altogether for the common good.

As long as we are creating the risk, the benefit will be secondary. Any scientific or medical gains made from this kind of research pales in comparison to the incredible risks involved if weaponized pathogens are released, and it doesn’t matter if it’s by accident or on purpose. This sentiment has been echoed by others in a variety of scientific publications.29,30,31,32

Considering the potential for a massively lethal pandemic, I believe it’s safe to say that BSL 3 and 4 laboratories pose a very real and serious existential threat to humanity.

Historical facts tell us accidental exposures and releases have already happened, and we only have our lucky stars to thank that none have turned into pandemics taking the lives of tens of millions, as was predicted at the beginning of the COVID-19 pandemic.

Seeing how scientists have already figured out a way to mutate SARS-CoV-2 such that it evades human antibodies, as detailed in “Lab Just Made a More Dangerous COVID Virus,” having a frank, open discussion about the scientific merits of this kind of work is more pertinent than ever before.

If SARS-CoV-2 really was the result of zoonotic spillover, the easiest and most effective way to quash “conspiracy theories” about a lab origin would be to present compelling evidence for a plausible theory. So far, that hasn’t happened, and as noted by Latham and Wilson, the most likely reason for that is because the virus does not have a natural zoonotic origin, and you cannot find that which does not exist.

Ideally, we need to reevaluate the usefulness of the WHO. Strong evidence indicates it is heavily influenced, if not outright controlled by Bill Gates. On the whole, it seems it would be far wiser to decentralize pandemic planning from the global and federal levels to the state and local levels. Both medicine and government work best when individualized and locally applied.

Sadly, even though this is clearly the best strategy for successfully addressing any truly serious infectious threat, the likelihood of this happening is very close to zero.

This is largely due to decades of careful planning by the technocrats that have carefully placed their surrogates in virtually every arena of global government, finances and media, which allows them to easily dictate their propaganda campaigns and censor or deplatform virtually anyone who disagrees and seeks to provide a balanced counter-narrative.

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Health tool significantly reduces medication over-prescription, improving patient safety

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Health tool significantly reduces medication over-prescription, improving patient safety

When a doctor stops or changes a prescription in a patient’s electronic health record, this information may not reach the pharmacy, leading to the problem of dispensing discontinued medications.

A new study from a team of researchers at the University of Wisconsin–Madison has found that the e-prescribing tool CancelRx more than doubled the proportion of successfully discontinued medications, from 34 percent to 93 percent, at UW Health, a major health system in Wisconsin.

Michelle Chui

CancelRx, built and standardized by the National Council for Prescription Drug Programs, is the only tool of its kind. Without CancelRx, there is no automatic mechanism to notify pharmacies of canceled prescriptions, leaving the door open for patients to be over-prescribed or to pick up discontinued medications, both of which pose a health risk.

The findings could encourage more health systems to utilize CancelRx to improve patient safety, and it lays the groundwork for future research.

The researchers, led by UW–Madison School of Pharmacy Professor Michelle Chui, reviewed data comparing the 12 months preceding UW Health’s implementation of CancelRx in October 2017 to the 12 months following implementation.

“This research project presented an opportunity to implement a healthcare technology at an academic health center and use the data to demonstrate that, on a really large scale, CancelRx was successful at deactivating medications in the pharmacy that had been discontinued by the provider,” says Chui.

Their findings — the first peer-reviewed study into a health system-wide implementation of CancelRx — were published in the Journal of the American Medical Informatics Association on April 9.

“CancelRx has been around since 2017, and even so, there are many health systems that have not turned it on,” says Chui. “CancelRx is intended to improve medication safety in outpatient settings. Our findings on the successful implementation of CancelRx could potentially push health systems to move forward on this.”

The greatest change in the proportion of successfully discontinued medications was in primary care settings, a 71 percent increase, as compared with specialty care, which increased 54 percent. Before CancelRx implementation, it took an average of 12 hours for clinic staff to manually contact pharmacies about a canceled medication — sometimes several days, depending on clinician workflow. With the tool, the communication is immediate.

Taylor Watterson

“This has the potential to increase patient safety by improving communication and ensuring things don’t fall through the cracks,” says study coauthor Taylor Watterson, a graduate student in the School of Pharmacy’s Health Services Research in Pharmacy program.

“It has safety implications for controlled substances, including opioid pain medication, stimulants, and benzodiazepines,” she says. “A patient could have multiple prescriptions on file in multiple places, and it can be hard to track, so technology like CancelRx has a practical safety application in those situations, too.”

In addition to Chui’s research group at the School of Pharmacy, the study authors include collaborators from across the UW–Madison campus — including the School of Medicine and Public Health, College of Engineering, and the School of Nursing — as well as the Wisconsin Department of Health Services and the Johns Hopkins University School of Medicine.

“This is a great collaboration between the School of Pharmacy, UW Health, and the UW School of Medicine and Public Health,” says Chui. The research was funded by the Agency for Healthcare Research and Quality, The Gordon and Betty Moore Foundation, the National Council for Prescription Drug Programs Foundation, and the UW–Madison Office of the Vice Chancellor for Research in Graduate Education.

Going forward, researchers can explore how the tool affects the workflow of both clinicians and pharmacists and how CancelRx would work at community pharmacies outside of a health system, such as Walgreens, CVS, or an independent pharmacy.

CancelRx notifies pharmacists that a medication was stopped, but not why it was stopped, so Watterson sees an opportunity for researchers to explore that question, too.

“If a medication is stopped for an anaphylactic reaction, that’s more serious than just wanting to stop it because another medication worked better,” she says. “If pharmacists know why, then they have access to the patient care process, which improves coordination of care.”

As one of the most accessible providers, pharmacists can impact patient health by ensuring medication safety.

“We saw the lifecycle of the prescription, all the way from the physician’s office to the pharmacy,” says Chui. “Ultimately, we want to equip pharmacists with the right information, so they can take care of their patients. This is just one demonstration of how that can be done.”

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