Disease Management Update
Volume V, No. 7
June 12, 2008

Dear Healthcare Intelligence Network Client,

This Monday kicked off Men's Health Week, which runs until Sunday, June 15 — Father's Day. With these events in mind, this week's Disease Management Update takes a look at some health concerns for men, including prostate cancer and heart attack.

Your colleague in the business of healthcare,
Laura Greene
Editor, Disease Management Update

If this is a forwarded copy of Disease Management Update and you like what you see, you can register to receive your own copy of this complimentary service. Sign up at: http://www.hin.com/dmdesktop/diseasemanagement.html

Table of Contents

  1. Researchers Discover Traits of Aggressive Form of Prostate Cancer
  2. Disease Management Q&A: Chronic Pain Management
  3. HealthSounds Podcast: Improving the Quality of Life for Pain Patients
  4. Men With Vitamin D Deficiency May Have Increased Risk of Heart Attack
  5. Survey of the Month: Primary Care in 2008
  6. What's Working in Pain Management

1. Researchers Discover Traits of Aggressive Form of Prostate Cancer

Researchers have identified traits of an aggressive type of prostate cancer that occurs in about 10 percent of men who have the disease. The discovery could lead to a simple urine test that will help to diagnose this variation of prostate cancer.

The study analyzed data on 1,800 prostate cancers to find commonalities in their genetic aberrations. They learned that a gene called SPINK1 (serine peptidase inhibitor, Kazal type 1) was over-expressed, or found in excess amounts, in prostate cancers that do not have gene fusions. The finding suggests that SPINK1 is a biomarker — a molecule in bodily fluids, blood and tissue that can be a signal of a disease — for a subtype of prostate cancer.

The findings, reported in the June issue of the journal Cancer Cell, also suggest that men with SPINK1Ėrelated prostate cancers tend to have a quicker recurrence of the disease than those with other types of prostate cancer.

To learn more about this study, please visit:

2. Disease Management Q&A: Chronic Pain Management

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Danielle Butin, former manager of Health Information and Wellness at Oxford Health Plan.

Question: What kinds of programs and resources do you have available for patients dealing with chronic pain?

Response: (Danielle Butin) We have a chronic pain management program. There is so much information out there on pain management, from the use of analgesics to anesthesiology practices to pain reduction, but it is very hard for older adults to access and find courses that are specifically and solely geared towards self-management. Literally, how do you breathe? How do you reframe? I have yet to see studies that report on more than just reframing and improved health and perception and associated cost savings. We have developed a multi-week course in pain management taught by a complementary care practitioner with a background in the Alexander technique and other pain management techniques. She is a highly gifted lecturer who has written a book on living with chronic pain. Members attending this course learn how to get in and out of their beds and chairs, how to breathe and how to walk. They are given relaxation tapes and visual imagery tapes to listen to every night.

For more details on proactive care management, please visit:

We want to hear from you! Submit your question for Disease Management Q&A to info@hin.com.

3. HealthSounds Podcast: Improving the Quality of Life for Pain Patients

As a caregiver, one responsibility Cheryl Pacella has is improving the quality of life for her pain management patients. Pacella notes that mutual goals set by both the caregiver and the patient are important in delivering on this responsibility. Also in this podcast, Pacella, performance improvement advisor at Masspro, a performance management organization, discusses the measures she relies on to assess pain in her patients as well as the barriers she faces in providing adequate pain control.

To listen to this complimentary HIN podcast, please visit:

4. Men With Vitamin D Deficiency May Have Increased Risk of Heart Attack

Men who lack vitamin D have a greater risk of suffering from myocardial infarctions, according to a study from the Harvard School of Public Health (HSPH) and Brigham and Women's Hospital in Boston (BWH). For the study, 454 health professionals between the ages of 40 and 75 who had suffered a nonfatal heart attack or died of heart disease as well as 900 other men with no history of cardiovascular disease were followed for 10 years after providing blood samples to measure their vitamin D levels. Men classified as deficient in vitamin D were about 2 1/2 times more likely to have a heart attack than those with higher levels of the vitamin.

To view more of this study's findings, please visit:

5. Survey of the Month: Primary Care in 2008

Many factors are affecting the primary care system in the United States — a predicted shortfall of primary care physicians, new models of care, unchanged models of reimbursement, a focus on quality initiatives and increased demands for healthcare IT. Complete our survey on primary care by June 30 and receive a free summary of the compiled results.

To participate in this survey and receive its results, please visit: http://www.surveymonkey.com/s.aspx?sm=biSaeW_2f1fphC1jgPs3ojZw_3d_3d

6. What's Working in Pain Management

Chronic pain can affect an individualís life in more than one way. For instance, pain can wound a patientís wallet at a cost of $500 to $30,000 annually. Pain can also create roadblocks in day-to-day life: many chronic pain patients lose an average of 4.6 hours per week, which costs employers $61.2 billion annually. To relieve the physical and fiscal suffering associated with pain, many healthcare organizations have implemented pain management programs. To discover how these programs work and who is using them, the Healthcare Intelligence Network conducted a non-scientific online survey in April 2008. In response, 186 organizations, including hospitals, nursing homes and health plans, shared their experiences with pain management programs.

To download this complimentary white paper, please visit:
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