AVINASH PATWARDHAN - Academia.edu (original) (raw)

Papers by AVINASH PATWARDHAN

This article focuses on the utilization of traditional medicine as an important catalyst to bridg... more This article focuses on the utilization of traditional medicine as an important catalyst to bridge the equity gap in global health care delivery. The authors touch upon validation of efficacy, regulation of safety, standardization of materials and harmonization of practices. The article draws substantially, though not only, from a study the authors had conducted for CIPIH-WHO in 2005.

Journal of Primary Care & Community Health, 2017

Evidence is accumulating that suggests that yoga has beneficial effects in mitigating the impact ... more Evidence is accumulating that suggests that yoga has beneficial effects in mitigating the impact of certain diseases. As a result, efforts are being made to medicalize yoga and use it within integrative medicine as a therapy. However, there are substantial shortcomings in the practice, policy, and research of yoga that undermine its optimal use. Yoga as a modality functions within a context. Therefore, it is important to occasionally step back and examine the entirety of the context from a high vantage to assess whether the tactical and programmatic endeavors are aligned with the strategic intended purpose. This commentary discusses a few policy issues relevant to some key stakeholders. It suggests that yoga therapists need to calibrate their model of yoga by reducing emphasis on postures and increasing it on meditation and breathing exercises while catering to clients with chronic conditions. It recommends that yoga research should be more critical in evaluating yoga’s fundamental ...

Journal of Evidence-Based Complementary & Alternative Medicine, 2017

We analyzed the National Health Institute Survey Alternative Medicine supplement yoga data for 20... more We analyzed the National Health Institute Survey Alternative Medicine supplement yoga data for 2002, 2007, and 2012 to answer the following questions: (1) Do the claims about increase in the use of yoga hold true at the level of specific health problems? (2) Do trends support a proposition that yoga is believed to be helpful in amelioration of disease conditions? (3) Do the prescribing patterns of health care providers correspond with the increasing popularity of yoga? Data were analyzed using SAS software, version 9.4. Response percentages were compared using chi-square test after adjusting for age. Between 2002 and 2012, use of yoga increased but adherence failed to increase, and use for specific health problems and for back pain declined; use of health care providers’ referral–driven yoga declined between 2007 and 2012. All results were statistically significant. Our results suggest that the use of medicalized yoga declined between 2002 and 2012.

Journal of Yoga and Physiotherapy, 2016

Archives of Family Medicine, 1996

Physician-industry relationships have come a long way since serious debates began after a 1990 Se... more Physician-industry relationships have come a long way since serious debates began after a 1990 Senate Committee on Labor and Human Resources report on the topic. On one side, the Sun Shine Act of 2007, now a part of the Patient Protection and Affordable Care Act that mandates disclosure of payments and gifts to the physicians, has injected more transparency into the relationships, and on the other side, numerous voluntary self-regulation guidelines have been instituted to protect patients. However, despite these commendable efforts, problem persists. Taking the specific case of physician-pharmaceutical sales representative (PSR) interactions, also called as detailing, where the PSRs lobby physicians to prescribe their brand drugs while bringing them gifts on the side, an August 2016 article concluded that gifts as small as $20 are associated with higher prescribing rates. A close examination reveals the intricacies of the relationships. Though PSRs ultimately want to push their drugs, more than gifts, they also bring the ready-made synthesized knowledge about the drugs, something the busy physicians, starving for time to read the literature themselves, find hard to let go. Conscientious physicians are not unaware of the marketing tactics. And yet, physicians too are humans. It is also the nature of their job that requires an innate cognitive dissonance to be functional in medical practice, a trait that sometimes works against them in case of PSR interactions. Besides, PSRs too follow the dictates of the shareholders of their companies. Therefore, if they try to influence physicians using social psychology, it is a job they are asked to do. The complexity of relationships creates conundrums that are hard to tackle. This commentary examines various dimensions of these relationships. In the end, a few suggestions are offered as a way forward. Keywords pharmaceutical sales representative, conflict of interest, gifts to physicians, physician-industry relationships, medical ethics, brand prescriptions, detailing, sun shine act, learned intermediary doctrine, independent physician heuristic Commentary 667597I NQXXX10.

Journal of Primary Care & Community Health, 2016

Research on yoga is witnessing an unprecedented proliferation currently, partly because of great ... more Research on yoga is witnessing an unprecedented proliferation currently, partly because of great interest in yoga’s health utility. However, yoga research does not seem to be sufficiently public health oriented, or its quality corresponding to its quantity. Yoga research is falling short to enable key stakeholders like end users, prescribers, and payers to meaningfully, confidently, and fruitfully answer the questions like: Is it generalizable? Is it standardizable? Which yoga style should be used/recommended/paid for? Or will it be worth the money? Therefore, it is important to examine the alignment to purpose or value of yoga research from a public health point of view so as to make it more practical. The issues such as lack of clear definition of yoga, wide variation in its dosage, cacophony of lineage-based styles, no data about comparative effectiveness between the yoga components, confounders and biases clouding the evidence regarding its benefits, too little data on long-term...

Journal of Tourism & Hospitality, 2016

Journal of Psychology & Psychotherapy, 2016

health and yoga community to decide what might be the best approach to this challenge. Reasons to... more health and yoga community to decide what might be the best approach to this challenge. Reasons to Use Yoga alongside Psychotherapy Increase in the prevalence of mental health issues and stress in the society In 2014, 18.1% adults in the US had 'any mental illness (AMI) in the past year' compared to 17.7% in 2008 [11]. The percentage of adults who had 'serious psychological distress in the past 30 days' rose from 3% to 3.4% between 2005 and 2013 [12]. A 2014 survey by American Psychological Association (APA) found that the stress gap was widening between men & women, and women experienced higher stress than men and got more adversely affected than men on different dimensions of stress. The same report also showed that the stress level is much above the national average level for millennials and generation Xers [13]. A recent National Center for Health Statistics data brief reported that the suicide rate in the US increased by 24% between 1999 and 2014 with the pace accelerating after 2006, and that most people who committed suicide were suffering from mental health or substance use disorder [14]. Workforce shortage in the mental health field in the US A 2013 Substance Abuse and Mental Health Services Administration (SAMHSA) report to congress noted that "shortages of qualified workers, recruitment and retention of staff and an aging workforce have long been

Online Journal of Public Health Informatics, 2013

Objective To examine if the prescription sales data from a large retail pharmacy chain in the US ... more Objective To examine if the prescription sales data from a large retail pharmacy chain in the US were comparable to Google Flu trends and CDC's US ILI Network data as flu activity indicator.

Inquiry : a journal of medical care organization, provision and financing, 2014

This article is about readiness of the U.S. health care system to deal with crises. Using the Ebo... more This article is about readiness of the U.S. health care system to deal with crises. Using the Ebola crisis as a reference, first it examines the response to the current challenge. However, that is the smaller objective of the article. Lately, we are also being challenged to deal with other kinds of epidemics like obesity, mental health diseases, and violence. These crises are not dramatic like the Ebola crisis. However, these are no less insidious than Ebola. If we are not ready for them, then these crises have the potential to undermine the long-term health and prosperity of our society. In this context, and therefore mainly, this article is about two major long-standing systemic problems in the U.S. health care system that the unfolding of the Ebola crisis has bared. One is about how the inherent problem in the design of American federalist system regarding state autonomy on health matters is creating a dysfunctional health care system. The other is about the inertia of the resear...

PLoS ONE, 2012

The potential threat of bioterrorism along with the emergence of new or existing drug resistant s... more The potential threat of bioterrorism along with the emergence of new or existing drug resistant strains of influenza virus, added to expanded global travel, have increased vulnerability to epidemics or pandemics and their aftermath. The same factors have also precipitated urgency for having better, faster, sensitive, and reliable syndromic surveillance systems. Prescription sales data can provide surrogate information about the development of infectious diseases and therefore serve as a useful tool in syndromic surveillance. This study compared prescription sales data from a large drug retailing pharmacy chain in the United States with Google Flu trends surveillance system data as a flu activity indicator. It was found that the two were highly correlated. The correlation coefficient (Pearson 'r') for five years' aggregate data (2007-2011) was 0.92 (95% CI, 0.90-0.94). The correlation coefficients for each of the five years between 2007 and 2011 were 0.85, 0.92, 0.91, 0.88, and 0.87 respectively. Additionally, prescription sales data from the same large drug retailing pharmacy chain in the United States were also compared with US Outpatient Influenza-like Illness Surveillance Network (ILINet) data for 2007 by Centers for Disease Control and Prevention (CDC). The correlation coefficient (Pearson 'r') was 0.97 (95% CI, 0.95-0.98).

Journal of Primary Care & Community Health, 2012

This study measures waiting times and consultation times at convenient care clinics (CCCs), and c... more This study measures waiting times and consultation times at convenient care clinics (CCCs), and compares them with equivalent times in traditional, family practice, physician offices. The analysis was limited to conditions most commonly treated at CCCs. It was found that patients using CCCs had significantly shorter waiting times from check-in to seeing a clinician than the equivalent waiting times reported by patients at family practice physicians’ offices and that CCC patients had significantly longer consultation times with the clinician than those reported by family practice patients. Applying a correction factor to adjust for potential differences between real waiting times and perceived waiting times did not substantially alter the conclusions. Shorter waiting times may increase satisfaction and thereby encourage patients to seek care; and spending additional time with the clinician may help ensure that all of a patient’s concerns or questions are addressed. This study provide...