When is it sleep apnea?

This issue covers topics including sleep apnea, prescribing generics, and hypertension.

Patients often report difficulty sleeping, and it's up to internists to determine which ones are suffering from lifestyle-related conditions like stress and which are affected by sleep apnea. Correct diagnosis and treatment of sleep apnea are particularly important in people who have jobs that involve operating large vehicles or heavy machinery, as a recent advisory from the National Transportation Safety Board has pointed out. In our story, Charlotte Huff outlines ways to pin down sleep apnea in primary care and summarizes the latest research, including a clinical practice guideline from ACP.

Prescribing generic drugs has traditionally been considered a way to save money for patients and for the health care system in general. However, recent reports have found several roadblocks. For example, certain drugs have seen precipitous spikes in their generic costs, and generics for some conditions, such as HIV, have in some cases been assigned to health plans' highest-cost tiers. In our story, Stacey Butterfield delves into the reasons behind these issues and offers ways for physicians to deal with higher-cost generics specifically and improve rates of generics prescribing in general.

Hypertension can be a tricky condition to manage because its effects are often silent and because treatment involves daily use of medication. Focusing on changing patients' behavior can be an important factor in successful blood pressure control. Our story looks at reasons for patients' nonadherence to hypertension treatment and how multifactorial interventions can help. In addition, our Success Story focuses on one such intervention that uses technology to involve hypertensive patients more closely in their care and connect them with support from a health care coach.

Finally, Internal Medicine Meeting 2015 will take place in Boston from April 30-May 2. Although ACP's premier scientific meeting is always a big event, this year is especially exciting because it marks the 100th anniversary of the College's founding. Our preview article details the special centennial events that are planned, including educational sessions focusing on ACP's history and update sessions that highlight past landmark articles from Annals of Internal Medicine. And if you're looking for even more centennial history, the next article in our year-long series will tell you what was happening with the College in the late 1930s and early 1940s.

Have you encountered issues with generic drugs? Let us know.


Jennifer Kearney-Strouse