Posts Tagged ‘Medicine’

A Key Measure of Preparedness Improves in AZ

March 18th, 2014

During a major crisis, such as an influenza pandemic, we might need to take extraordinary steps to ensure that healthcare workers have the medicines and supplies on hand to treat patients.  State, local, and federal agencies all participate in the Strategic National Stockpile program to help ensure that these critical resources are available during disaster situations.

The main purpose of our Strategic National Stockpile program is to distribute medicines, vaccine, and supplies during all types of public health emergencies.  This year, we improved that capability once again.  Scores for our state and local programs rose this year according to the CDC’s annual Technical Assistance Review.  Every year, the CDC looks at key “functional areas” across the state and in select local jurisdictions.  The Review score rose up to 97%, Maricopa County maintained its high mark of 99%, and Pinal County achieved a 100% in all 12 areas. 

These outstanding scores demonstrate our statewide commitment to the Strategic National Stockpile program, and highlight the extraordinary efforts of our public health preparedness teams.  Here’s how to learn more about the Strategic National Stockpile program.


Strategic National Stockpile Readiness

February 27th, 2013

The CDC’s “Strategic National Stockpile” is a large quantity of medicine and medical supplies that are available to states in case there’s a public health emergency (flu outbreak, asteroid, etc.) severe enough to cause local health supplies to run out.  Once federal and local authorities agree that the stockpile is needed, meds and supplies are delivered to any state in time for them to be effective. Each state is responsible for receiving and distributing the stockpile assets to local communities fast. 

Our Public Health Emergency Preparedness shop is responsible for the overall planning and execution in AZ.  The Plan (which isn’t posted on-line for security reasons) provides a step by step approach to accessing and distributing pharmaceuticals, vaccines and other medical equipment and products stored by the Feds.  Our Plan is evaluated yearly by the CDC.  The review covers every aspect of our plan… including how we communicate with the public, work with our healthcare and Agency partners as well as how we plan to work with vulnerable populations should SNS assets be needed. 

This year we got a score of 93% from the CDC…  and our partner counties (Pinal and Maricopa) received similar scores- demonstrating that the plans work together effectively to serve the public when they need to be activated.  We’ll be testing these plans during a full-scale exercise this week.  Congratulations to our preparedness rock-stars Teresa Ehnert, Marcus Castle, Stacey Cain and the whole emergency preparedness team! 

By the way…  we received and executed stockpile assets (antiviral medications and other healthcare supplies) during the 2009 H1N1 Influenza pandemic.  Our turnaround time from the minute we received the first shipment until everything was at its local destination was less than 36 hours- an impressive testament to our ability to plan and execute during a public health emergency. 


Lower the Pressure

September 14th, 2012

About 1/3 of American adults have high blood pressure and more than half of them don’t have it under control.   The majority of people with high blood pressure are being treated with medicine and have seen a doctor at least twice in the past year…  but their pressure still isn’t under control, according to a new Vital Signs report from the CDC this week. 

High blood pressure means blood pressure greater than or equal to 140/90 mm- Hg…  and its direct health care cost is almost $131B per year.  To learn more about blood pressure, visit   For more information on heart disease and stroke, visit  Controlling high blood pressure is also a key component of the Million Hearts initiative to prevent a million heart attacks and strokes by 2017.


Introducing Our New Licensing Director & Agency CMO

August 22nd, 2012

Please join me in welcoming Cara Christ, MD as our new Division of Licensing Services chief.  Cara has agreed to share her talents as the new Assistant Director for Licensing as well as serving as the Agency Chief Medical Officer.  Also, thanks a million to Colby Bower who’s been doing an excellent job serving as interim director for licensing since Alan passed away. 

Cara started her public health quest about a dozen years ago when she worked in our infectious disease epidemiology shop.  While there, she developed a passion for both medicine and epidemiology- so she left to study medicine with a goal of working as a CDC disease detective.  I can remember being disappointed when we lost her to medical school 10 years ago  but alas, she returned to us after graduating- and she’s been working in our Bureau of Epidemiology and Disease Control (EDC) for the last few years…  most recently serving as the EDC Bureau Chief (one of my old jobs). 

I think Cara will be perfect for this job- bringing value added from her solid leadership and management style to her eye for public health “leverage points”- and most of all her passion for improving outcomes and using public health principles to change lives and communities.  Our Licensing Division is perhaps our greatest leverage point for achieving these elements of our strategic map

Cara will also be providing Agency leadership in her new role as the ADHS Chief Medical Officer.  Dr. Nelson has been serving in the Agency CMO role for the last couple of years- doing an excellent job.  I’m certain that we can count on Cara to continue to carry that torch effectively for Arizona. 


The Scientific Literature Gradient

July 18th, 2012

Medicine and public health have relied on peer-reviewed published scientific literature to help guide progress in patient treatment and public health interventions for decades- even centuries. For example, when we did the fact-finding to inform our decision about whether to add the petitioned conditions to the list of disorders that qualify for AZ medical marijuana cards- we (and the UA) turned to the scientific literature. Within the scientific literature- there are different categories of research designs that each have their strengths and weaknesses. 

Studies to assess the effectiveness of an intervention (like whether Cannabis is an effective treatment for depression) can have an Experimental or Observational design. For example, a randomized and controlled experimental study selects participants at random and places them in the intervention or control group and then follows up on the subjects over time to assess any differences in outcomes. Experimental studies generally provide the highest quality and most reliable results. 

An Observational study isn’t really experimental- rather, it’s a study that looks at natural variation regarding an intervention (or exposure) and looks at differences in outcomes among people or populations. Controlled observational studies can look at before and after conditions. For example, a cohort observational study can look at populations prospectively, retrospectively, or as part of a time series. Observational studies can also be of case-control or cross-sectional design. Observational studies can also simply look at a series of cases and look at interventions and outcomes without a control group. 

In general, the highest quality studies use the experimental approach and include a randomized design. Studies in the category can be very high quality if there is little bias and confounders are identified and controlled for… and if the study is large. Observational studies are generally of lower quality- although they can be quite useful if they limit bias, are consistent, direct, and control for confounding factors. The lowest quality study is what’s called a case series with no controls. Often, case series studies are simply observations made by clinicians- but without control groups… and they usually don’t control for confounders or bias.

 Anyway- you get the idea… scientific studies are absolutely critical to helping the public health system design interventions, make policy decisions, and measure results. Published scientific literature allows us to use science to inform our policy decisions and interventions in an objective way- increasing the likelihood that the public health system makes a positive impact in people’s lives.  Understanding what makes a published scientific study strong and compelling is critical to sorting through the published scientific literature for the types of strong studies that make for solid foundations for policy and intervention decisions. 

My post tomorrow will summarize ways to evaluate the quality and reliability of various kinds of studies.

National Poison Prevention Week

April 5th, 2012

This week marks the 50th anniversary of National Poison Prevention Week. For the first time ever- poisoning surpassed car crashes as the number one cause of injury deaths in AZ and more than 2,000 kids had to go to emergency rooms last year from unintentional poisoning.  Kids under 5 had the highest rates of non-fatal emergency department visits from poisoning.  For more information on poisoning in Arizona, check out our recently posted Poisonings Among Arizona Residents, 2010 PowerPoint

Nationally, more than 60,000 young children end up in emergency rooms because they got into medicines while their parent or caregiver was not looking.   The new  Up and Away and Out of Sight  educational program was created to remind families of the importance of safe medicine storage. 

Phoenix Magazine also wrote a story that explains prescription drug abuse from the perspective of someone battling chronic pain.. it’s called Bad Medicine and is in the Top Docs issue… so hopefully a lot of people will read it, take stock of their “inventory” and dump it before there are more accident poisonings.


Clean Your Medicine Cabinet This Weekend!

April 29th, 2011

Prescription drugs can be safe and effective at treating illnesses and conditions, but they can also be tempting for experimental teens, and misuse and abuse of narcotic prescriptions is a growing and now urgent problem.  Powerful prescription drugs are often available and easily accessible in many, if not most, homes and many parents don’t recognize that these (sometimes dangerous) unused meds can be tempting for teens.  They’re often easily accessible in home medicine cabinets, and hundreds Arizonans face the devastating effects of prescription drug abuse every day.

In 2009, more than 1,100 Arizonans died from drug poisoning, which is more than the number of Arizonans that die in car accidents every year.  Opioids (such as codeine, morphine, oxycodone, and other synthetic narcotics) were responsible for most drug overdoses. Our drug-related death statistics for 1985-2009 are available online.  Parents of teens should really pay attention to what they have around the house, and this weekend is your perfect opportunity to clean up.

This Saturday the Drug Enforcement Agency (DEA)  and its state & local partners are sponsoring the National Prescription Drug Take-Back Day at dozens of sites all across Arizona.  The idea is to encourage folks to turn in their unused prescription drugs for proper disposal.  The service is free and anonymous, no questions asked. At last year’s event Arizonans turned in more than 3 tons prescription drugs at nearly 75 sites. On Saturday, April 30 from 10 a.m. to 2 p.m. DEA and its partners will open collection sites.  There are dozens of drop-off sites that will be open Saturday, you can find the location nearest you by visiting the DEA Site Locator.