MOST Form Review
§ Cannot be required for admission. The form is voluntary. Per C.R.S. 15-18.7-108, a healthcare facility shall not require a person to have executed a MOST form as a condition of being admitted to, or receiving medical treatment from, the healthcare facility.
§ Not technically an advanced directive. It is a medical order set.
§ Fax and photocopies of the MOST form are valid
§ Can be partially completed and still be valid.
§ Verbal orders for the MOST form can be given.
Alzheimer’s drug controversy -aducanumab (Aduhelm)
The link above has a pretty good summary.
Patient information – It’s a New Day | Aducanumab Approved for Treatment | alz.org
– FDA recently approved aducanumab for treatment of AD
– Trials specifically enrolled patients with earlymemory changes and abnormal beta amyloid seen on brain scans.
– MRI will likely be required before starting the drug and intermittently during therapy.
– The drug attempts to reduce beta amyloid accumulation in the brain. It is thought that beta amyloid may be a significant component to the development of AD and other dementias. That theory has come under fire in recent years because other drugs reducing beta amyloid production have not shown enough efficacy for FDA approval. There are other proteins that appeared to, potentially, be more important than beta amyloid
– No specific indication was given but it MAY have some efficacy in early disease.
– It MAY prevent the speed of progression.
– Controversy exists because the data are not very impressive.
– FDA is requiring a phase 4 trial along with the approval and reserves the right to resend its approval depending on the data from this trial.
– Side effects (Aduhelm (aducanumab) dosing, indications, interactions, adverse effects, and more (medscape.com))
o ARIA-E (amyloid-imaging abnormalities- Edema) = Brain swelling or bleeding ~40%. Most were asymptomatic. Requires monitoring.
o Headache 21%
o Microhemorrhages 19%
o Superficial siderosis 15%
o Falls 15%
o Confusion/delirium/altered mental status/disorientation 8%
– More to come…..
COVID-19 Infections More Likely in Unvaccinated Healthcare Workers.
o VA Study
o fully vaccinated personnel were 19 times less likely than unvaccinated personnel to be diagnosed with COVID-19.
o In 14 weeks of follow-up, 6% of 1,408 the unvaccinated employees were diagnosed with COVID-19 versus 0.3% of 4,222 vaccinated employees.
o At least one large nursing home study shows similar data
§ With few exceptions, vaccinated residents and staff generally do not transmit virus as effectively and do not get very sick.
§ There will be breakthrough infections with ANY vaccine.