Ascension Doctors Perform Innovative 'Hot Chemotherapy'
In April, Ascension Saint Thomas announced Jason Barnett, MD, and Michael Stany, MD, became the first gynecological oncologists in the state to perform a type of chemotherapy treatment known as Hyperthermic Intraperitoneal Chemotherapy (HIPEC) or "hot chemotherapy" when they used it in surgery earlier this year.
Michael Stany, MD
Research suggests heating a standard dose of chemotherapy and applying directly to the abdomen during surgery increases penetration of the cancerous tissues. Though HIPEC has more frequently been used by surgical oncologists to manage cancers of the abdomen, Barnett and Stany made state history by employing this technique at Ascension Saint Thomas Hospital Midtown in the treatment of an ovarian cancer patient.
In this particular case, the patient first completed traditional chemotherapy treatments before heated chemo was applied at the time of "debulking," or surgical removal of the cancerous tumors. The surgery took approximately six hours with additional rounds of traditional chemotherapy planned. The patient, a Middle Tennessee resident, has returned home and is recovering well.
"Any time a treatment is new, there is a learning curve. Dr. Stany and I are excited about this innovative use of HIPEC, and we feel optimistic about its potential for life-saving application in ovarian cancer patients," said Barnett.
UnitedHealthcare Awards More Than $276,000 in Maternal Health Grants
UnitedHealthcare Community Plan of Tennessee has awarded more than $276,000 in maternal health grants to six community organizations aimed at improving maternal health outcomes, reducing disparities and expanding access to care. The grants, ranging from $5,000 to $75,000, support programs focused on disparities, prepartum and postpartum education and addressing social determinants of health.
"Pregnant women in the U.S. are increasingly experiencing adverse maternal and birth outcomes, particularly Black women," said Keith Payet, CEO, UnitedHealthcare Community Plan of Tennessee. "UnitedHealthcare believes that we must identify and support high-risk mothers early and throughout their care journey including after birth, through partnerships with national and local community-based organizations."
Four of the grants are for organizations covering West Tennessee. Two of the largest grants, however, are for Nashville organizations. Mother to Mother has been awarded $65,964 to purchase car seats, cribs and strollers. Nashville Diaper Connection was awarded $45,000 to purchase diapers and to support program promotional materials.
"Nashville Diaper Connection's mission is to ensure that every baby in Nashville has enough diapers to remain clean, dry and healthy. We leverage Nashville Diaper Connection's partner network and our diaper donations to improve crucial maternal, infant and toddler health outcomes," said Doug Adair, CEO and founder of Nashville Diaper Connection. "This maternal health grant allows us to better serve high-risk mothers and babies while working toward our goal of 'No Child Wet Behind.'"
These grants are part of several initiatives that UnitedHealthcare, along with its parent company UnitedHealth Group, is launching to address maternal health outcomes throughout the United States, including over $5 million in recent philanthropic grants to support maternal health and $2.85 million in support to March of Dimes for a public-private partnership with the Department of Health and Human Services that aims to reduce the Black-White disparity gap and improve maternal health outcomes.
Increased Risk of Serious Opioid Events in New Moms
A new study from Vanderbilt University Medical Center researchers finds that new mothers who receive opioids after uncomplicated vaginal births face an increased risk of serious opioid-related events regardless of the opioid dosage, a finding that could significantly impact care delivery.
Andrew Wiese, PhD, MPH, assistant professor of Health Policy in the Division of Pharmacoepidemiology, authored the paper published online April 15 in Women's Health Issues, with Sarah Osmundson, MD, MPH, associate professor of Obstetrics and Gynecology, and other researchers in the departments of Biostatistics and Health Policy.
The study examined roughly 147,000 women enrolled in TennCare between 2007 and 2014 who gave birth and had received one or fewer opioid prescriptions prior to delivery. The median age of the women was 23 years. Most women (68 percent) were white, and most were from Central and East Tennessee.
The study found that receiving an outpatient opioid prescription within four days after vaginal childbirth was associated with an increased risk of developing a serious opioid-related event, including becoming a persistent opioid user, developing an opioid use disorder, or experiencing an opioid-related overdose or death. Even women prescribed less than 100 MME -- roughly equivalent to 20 hydrocodone or 13 oxycodone pills (5 mg strength) -- faced a 52 percent increase in the risk of a serious opioid-related event compared with those who did not fill a prescription.
"We generally assume that higher dosages of opioids are associated with a greater risk of negative outcomes," Wiese said. "But we wanted to answer the question of whether low-dose prescriptions were completely safe, and it turns out even low dose prescriptions harbor some increased risk of bad outcomes."
Although the absolute risk of these outcomes in the first year after birth is relatively rare, given the large number of births that occur annually, many women may be at risk for adverse outcomes with opioid exposure. This research also demonstrates that many of these negative events occur after the traditional 42-day postpartum period.
Wiese also said their primary finding could affect how clinicians, particularly those in obstetrics and gynecology, consider prescribing opioids for women after vaginal births in the future, but establishing best practices is still unclear.
TDH WIC Program Releases Smartphone App
In April, the Tennessee Department of Health announced the release of the WICShopper application for smartphones. As a part of the Women, Infants and Children (WIC) program, the new WICShopper app is another tool to help participants establish and re-enforce healthy eating habits.
The app allows participants to scan the UPC barcode of store products determining whether that product is allowable as a WIC food item and on the participants WIC benefits. The app also includes other key features including location of Health Department clinics, WIC authorized store locations, healthy recipes, cooking and shopping tips.
''The WICShopper App makes it one step easier to access healthy food and nutrition education resources available through WIC,'' said Tennessee Health Commissioner Lisa Piercey, MD, MBA, FAAP. 'The WICShopper App puts resources at the fingertip and is another example of how the Tennessee Department of Health is implementing innovative solutions to improve services for Tennesseans.''
Since the statewide rollout of the TNWIC Electronic Benefits Transfer (EBT) card in April 2019, the Tennessee WIC program continued to enhance the process for WIC participants to receive benefits and purchase food products for their families with the WICShopper app representing the most recent example of this commitment. Participants can download the free app from the Apple App Store or the Google Play Store. Additionally, participants can visit the TDH website at www.tn.gov/wicshopper for instructions on how to download the app.