ElderWeb

The U.S. Food and Drug Administration (FDA) commissioned a study from a company called Cyveillance which states that of 11,000 "Canadian" Internet pharmacy sites they researched, most just redirect users to 1,099 sites that actually sell prescription drugs, and of the 1,009 sites that sell "Canadian" drugs, only 214 are actually based in Canada.

This raises many troubling questions and should justifiably frighten anyone buying drugs online, but little futher information was provided. I was not able to find any information about the study on the FDA web site at all, and only the press release is available on the Cyveillance site. The press release has been reproduced verbatim on numerous online and offline news outlets, but I only found one article, a story by Brian Krebs of the Washington Post, that seems to have dug further into the story (see it at http://www.washingtonpost.com/). Krebs tried to get additional information about the study, but was not able to find out which drug sites are actually located in Canada and was told by a FDA spokeperson that revealing that information would give Americans a "false sense of security" and that "as long as shipping medications into the United States remains illegal, the agency would continue to refuse to work with any entity supporting that activity."

I thought it would helpful to provide some tips to try to avoid problems when buying prescription drugs on the Internet:

1) Don't follow links in emails that offer Canadian drugs. One of the few bits of information in the press release was the fact that most of the bogus sites are only reachable via spam email links and cannot be found via legitimate search engine searches.

2) Many legitimate American sites will be be registered with the Verified Internet Pharmacy Practice service (VIPPS). Check their list at http://www.nabp.net/vipps/. Legitimate Canadian pharmacy sites can be found at the Canadian International Pharmacy Association (CIPA) at http://www.ciparx.ca/. If you don't see the site on one of these lists, you probably should avoid it.

3) CIPA also offers a list of tips on their web site to help ensure you are dealing with a legitimate Canadian pharmacy business, including suggestions to look for a Canadian Provincial pharmacy license number and a Canadian phone number (and to call that number to be sure it is legitimate). Consumers should also expect legitimate sites to require a prescription from a licensed physician.

The Canadian Institute for Health Information has released a new report called "Health Care in Canada 2000". This report looks at the performance of Canada's health care system, including the way that it adapts to the health care needs of seniors. The report analyzed the Canadian system, and compared it to systems in the United States, Australia, New Zealand, and the United Kingdom. In general, the report found that the confidence Canadians have in their health care system has dropped in the last 10 years. In 1991 about of Canadians 60% rated their system as good or better, but that had dropped to only about 25% by the year 2000.

Although only 12% of Canadians are age 65 or older, they account for 43% of all health care spending by provincial and territorial governments. Canadian seniors rated the quality of their medical care lower than did seniors in the United States, Australia, or New Zealand, although they were happier with their care than seniors in the United Kingdom.

About 185,000 Canadian seniors were living in nursing homes and other institutions in 1996/97. The average age of women in these facilities was 83 and the average age of men was far lower, 69. In addition, about 12% of Canadian seniors received publicly-funded home care services.

The report found that about 26% of Canadian seniors who had children often relied on their children as caregivers. One in four Canadians reported providing some sort of care to a family member in their home, and a study in Alberta found that 36% of respondents reported providing some sort of emotional, personal, or financial support to a family member in the last six months.

Both nurses and doctors in Canada are getting older themselves, leading to concerns about who will provide care to aging Canadians in the future. Nearly 40% of the physicians in Canada were age 50 or older in 1999, up from 35% in 1995. 90% of the nurses in Canada are over age 30, and more than 24% are age 50 or older.

Health Canada has released its annual report, which includes an overview of "extended services" (nursing home and home and community care) in each province or territory. These extended services are not covered by the federal program, so they differ from region to region.

In an article in the Journal of Clinical Nutrition, Randall J. Kaplan, from the University of Toronto in Canada, reports that memory of older people was significantly improved if they ate 50 grams of carbohydrates at breakfast, as compared to a high-glucose meal or no meal at all. The effects appeared to be the most pronounced on long-term memory and in those who had slight problems with glucose (blood sugar) regulation at the outset.

Researchers developing a vaccine against Alzheimer's disease have shown that it seems to stop mice with the condition from losing their memory, which boosts hopes that such vaccines could delay or prevent similar symptoms in humans. The vaccine also reduces the build-up of protein deposits in mouse brains - the other major indicator of Alzheimer's disease. The pharmaceutical company Elan, based in Dublin, Ireland, is poised to begin large-scale human clinical trials of a potential treatment based on the vaccine. But what works in mice does not always work in people and the vaccine will still have to prove its worth in a battery of further tests.

Peter St George-Hyslop of the University of Toronto in Canada and his colleagues and a second team led by Dave Morgan of the University of South Florida at Tampa showed that the vaccine reduces learning and memory loss as the mice age. Each group gave Alzheimer's mice learning and memory tests, in which the animals had to swim to a submerged platform. In one trial the platform was moved each day, testing short-term memory. The second trial investigated 'spatial-reference' memory by leaving the platform in one place and testing the mice once a month. Mice given the test vaccine developed fewer and smaller protein deposits in their brains and performed markedly better than unvaccinated animals in both types of memory test.

Whether the protein deposits actually cause dementia in people is unclear. Some researchers believe that preventing the deposits from forming should relieve the distressing mental symptoms, although others disagree. This research supports the hypothesis that the two are related, but other factors could still be involved.

A collection of research reports on this subject are included in the current issue of Nature Magazine.

The new issue of Chronic Diseases in Canada (CDIC) contains a study of the elements of mobility that predict the survival of elderly patients with dementia difficulty. The study found that difficulty in dressing and getting about were important prognostic factors. A history of falls was also found to predict poor survival, as well as poor motor strength and inability to perform the examination to assess gait function.

Health Minister Allan Rock and Dr.Yves Morin, member of the Governing Council of the Canadian Institutes of Health Research (CIHR), today announced health research grants of over $4.6 million, including funding of $856,000 for an important evaluative study on health care delivery for the elderly.

The Research Centre in Gerontology and Geriatrics of the Sherbrooke Geriatric University Institute will receive funding of over $856,000 from Health Canada's National Health Research and Development Program (NHRDP) for a study which will evaluate the implementation and impact of mechanisms and tools designed to improve the integration of care and services for the frail elderly.

Health Minister Allan Rock announced Health Canada's intention to develop a new regulatory approach for Canadians to access marihuana for medical purposes. This will address some of the issues relating to transparency of the process and a clear definition of medical necessity that stemmed from the decision by the Court of Appeal for Ontario in the case of R. v. Parker, rendered on July 31, 2000. The new regulatory approach will define the circumstances, and the manner in which the use of marihuana for medical purposes will be authorized.

The matter of an appeal on the narrow legal issues raised by the Parker decision is still under consideration. Whether or not leave to appeal the case is sought, the move to establish this new regulatory approach will go ahead. Issues raised by key stakeholders will be considered as the regulatory process is developed.

Until the new regulatory approach is in place, Canadians can continue to apply for an exemption for medical purposes under Section 56 of the Controlled Drugs and Substances Act with the support of their medical practitioner. An interim guidance document and application form are available online.

To date, marihuana is not approved as a drug in any country in the world. Health Canada is funding research activities which will lead to the scientific data necessary to evaluate the safety and effectiveness of marihuana for medical purposes in the future.

One of these projects, whose results are being eagerly awaited by stakeholders across Canada, is taking place here in Montreal. This is a pilot project that will test new ways of delivering integrated health services to vulnerable seniors and evaluate the benefits of this approach. The project involves 600 elderly people in the Bordeaux-Cartierville and C'des-Neiges districts of Montreal. The concept is to work with interdisciplinary teams to offer an integrated range of relevant health services to these individuals.

This project will demonstrate new ways of organizing health services to optimize the quality and level of care afforded the growing segment of the population which is aging. More to the point, this project is not premised on creating a single delivery model that will be broadly imposed. It is premised on creating a knowledge base that all provinces and territories can build on and expand in order to develop new and more effective systems tailored to their distinct realities.