According to Interactive Health Solutions, Inc. (IHS, interactivehs), 63% of adults have not seen a doctor within five years. In order to help battle ever-rising healthcare costs, IHS announced the introduction of Physician Link™ this week a revolutionary program connecting members to their physician, and wellness team, through an integrated communication process.
"A missing component in most wellness programs is getting the member's physician involved and aware of all the tools and services their patient's employer has already paid for in their wellness program," says Joe O'Brien, President and CEO at Interactive Health Solutions.
For the first time, through Physician Link, member's test results (including member specific testing) are proactively sent to their physician to aid in treatment, the continuum of care, and improved health outcomes. This integrated communication process leads directly to healthier lives and lower healthcare costs.
IHS utilizes their database of over 30,000,000 medical results to help proactively determine specific testing for members based on their medical history. For example, one of the fastest growing and preventable medical conditions is diabetes. The A1c test is considered the most important test a diabetic can take to properly monitor their diabetes, according to the American Diabetes Association. IHS is providing the A1c to specific members throughout the year and forwards the results to the member's physician. This engagement helps members stay connected with their doctors and reminds them throughout the year to stay in compliance with their medication and condition, which reduces medical costs and increases productivity.
The feedback from physicians, members and clients has been very positive. IHS surveyed doctors and found they reviewed the results and were more likely to follow up with patients. "They want to be a part of the wellness team," says Dr. Lidia Nelkovski of Interactive Health Solutions.
The goal of Physician Link is to ensure companies have the healthiest workforce possible, creating a more productive, higher quality workforce, while controlling cost of workers' compensation claims and the overall cost of health care. This is the ultimate win for the company and their employees.
вторник, 31 мая 2011 г.
понедельник, 30 мая 2011 г.
PharMEDium Participates In Anesthesia Patient Safety Foundation Summit: Medication Safety In The Operating Room; Time For A New Paradigm
PharMEDium Services, LLC, announced their participation in the Anesthesia Patient Safety Foundation (APSF) Summit held January 26th in Phoenix, AZ.
PharMEDium's commitment to patient safety aligned with the APSF goals of improving medication safety by offering a complete line of pre-filled, pre-labeled Anesthesia syringe medications intended for use in the Operating Room. "Pre-filled, pre-labeled syringes can support the hospital in being compliant with regulatory requirements for proper labeling. In addition, this service can support standardization of medications in this critical environment. Standardized barcodes are included on all syringe labels further enhancing the ability to integrate with new technologies designed to enhance patient safety " said David Jonas, PharMEDium's Chairman and Chief Executive Officer. "APSF's vision and leadership in bringing together this diverse group of opinion leaders shows an unwavering commitment to advancing patient safety in the Operating Room. A consensus involving the anesthesia, pharmacy, nursing and regulatory community is exceptional in the movement to improve patient safety in our healthcare system. This summit could not have been possible without the collaborative approach by APSF," he added.
About the Anesthesia Patient Safety Foundation
The Anesthesia Patient Safety Foundation was created in 1985 as an independent nonprofit corporation with the vision that "no patient shall be harmed by anesthesia." APSF's Mission is to improve continually the safety of patients during the anesthesia care by encouraging and conducting:
-- Safety research and education;
-- Patient safety programs and campaigns;
-- National and international exchange of information and ideas
About PharMEDium Services, LLC
PharMEDium is the leading national provider of pharmacy outsourced sterile I.V. compounding services and is comprised of a nationwide network of state licensed and federally registered compounding centers providing trusted solutions to more than 2,000 hospitals throughout the United States. The company complies with all applicable state laws and FDA regulations, including USP, and DEA requirements.
PharMEDium's commitment to patient safety aligned with the APSF goals of improving medication safety by offering a complete line of pre-filled, pre-labeled Anesthesia syringe medications intended for use in the Operating Room. "Pre-filled, pre-labeled syringes can support the hospital in being compliant with regulatory requirements for proper labeling. In addition, this service can support standardization of medications in this critical environment. Standardized barcodes are included on all syringe labels further enhancing the ability to integrate with new technologies designed to enhance patient safety " said David Jonas, PharMEDium's Chairman and Chief Executive Officer. "APSF's vision and leadership in bringing together this diverse group of opinion leaders shows an unwavering commitment to advancing patient safety in the Operating Room. A consensus involving the anesthesia, pharmacy, nursing and regulatory community is exceptional in the movement to improve patient safety in our healthcare system. This summit could not have been possible without the collaborative approach by APSF," he added.
About the Anesthesia Patient Safety Foundation
The Anesthesia Patient Safety Foundation was created in 1985 as an independent nonprofit corporation with the vision that "no patient shall be harmed by anesthesia." APSF's Mission is to improve continually the safety of patients during the anesthesia care by encouraging and conducting:
-- Safety research and education;
-- Patient safety programs and campaigns;
-- National and international exchange of information and ideas
About PharMEDium Services, LLC
PharMEDium is the leading national provider of pharmacy outsourced sterile I.V. compounding services and is comprised of a nationwide network of state licensed and federally registered compounding centers providing trusted solutions to more than 2,000 hospitals throughout the United States. The company complies with all applicable state laws and FDA regulations, including USP, and DEA requirements.
воскресенье, 29 мая 2011 г.
Medication Adherence Improves Blood Pressure Control In Chronic Kidney Disease
Researchers at the University of Cincinnati (UC) and the Cincinnati Veterans Affairs (VA) Medical Center have found that about one-third of chronic kidney disease patients who are prescribed therapies for high blood pressure do not often adhere to treatments.
This report was published in the Nov. 2 online edition of the American Journal of Nephrology.
The study, led by researchers at UC and the Cincinnati VA, showed that treatment of hypertension in patients with chronic kidney disease continues to be a challenge in their care and that by simply improving medication adherence, outcomes would improve greatly.
Chronic kidney disease is the slow loss of kidney function over time. The main function of the kidneys is to remove wastes and excess water from the body. Ongoing hypertension is often associated with kidney disease.
"Hypertension, or high blood pressure, is probably the most important modifiable risk factor in chronic kidney disease - a precursor to end-stage renal disease that is associated with increased risk of morbidity and mortality," says Charuhas Thakar, MD, associate professor in the division of nephrology and hypertension at UC and chief of the renal section at the Cincinnati VA. "In chronic conditions, such as hypertension, whether or not a patient takes the correct dosage and amount of their hypertension medication is critical in reaching treatment goals.
"Patterns of medication adherence for these agents and their impact on blood pressure in practice settings were not previously well studied. We wanted to find out if medication adherence could make a difference on outcomes in kidney disease patients."
Using two years worth of data from patients seeking ambulatory care at the VA, researchers examined 7,227 chronic kidney disease patients who received at least one blood pressure medication prescription. Outpatient blood pressure measurements were averaged as high (more than 130/80 mm of Hg) versus normal, based on the national guidelines for hypertension management in kidney disease.
Medication adherence was calculated using medication possession ratio, meaning the actual treatment days divided by the total possible treatment days.
"Good versus poor medication adherence groups were compared for differences in demographic, co-morbid and laboratory variables," says Kristen Schmitt, chief of pharmacy at the Cincinnati VA and the lead author of the study. "Results showed that while 67 percent of patients took their medication properly, a total of 33 percent of patients had poor medication adherence. More importantly, those with poor adherence were 23 percent more likely to have sub-optimal blood pressure control during the entire two-year study period."
"With this data, we hope to develop a multidisciplinary approach to help kidney disease patients adhere to their prescribed blood pressure medications. This will not only improve their clinical outcomes but will also help in reducing costs of care," she continues.
"Although the results represent a large sample of patients, they are derived from a single center," adds Thakar. "Further investigations are needed to accurately assess the impact of medication adherence on cardiovascular and renal outcomes in practice."
This study was funded by a Federal Services Research Grant from the American Society of Health System Pharmacists (ASHP) Foundation.
This report was published in the Nov. 2 online edition of the American Journal of Nephrology.
The study, led by researchers at UC and the Cincinnati VA, showed that treatment of hypertension in patients with chronic kidney disease continues to be a challenge in their care and that by simply improving medication adherence, outcomes would improve greatly.
Chronic kidney disease is the slow loss of kidney function over time. The main function of the kidneys is to remove wastes and excess water from the body. Ongoing hypertension is often associated with kidney disease.
"Hypertension, or high blood pressure, is probably the most important modifiable risk factor in chronic kidney disease - a precursor to end-stage renal disease that is associated with increased risk of morbidity and mortality," says Charuhas Thakar, MD, associate professor in the division of nephrology and hypertension at UC and chief of the renal section at the Cincinnati VA. "In chronic conditions, such as hypertension, whether or not a patient takes the correct dosage and amount of their hypertension medication is critical in reaching treatment goals.
"Patterns of medication adherence for these agents and their impact on blood pressure in practice settings were not previously well studied. We wanted to find out if medication adherence could make a difference on outcomes in kidney disease patients."
Using two years worth of data from patients seeking ambulatory care at the VA, researchers examined 7,227 chronic kidney disease patients who received at least one blood pressure medication prescription. Outpatient blood pressure measurements were averaged as high (more than 130/80 mm of Hg) versus normal, based on the national guidelines for hypertension management in kidney disease.
Medication adherence was calculated using medication possession ratio, meaning the actual treatment days divided by the total possible treatment days.
"Good versus poor medication adherence groups were compared for differences in demographic, co-morbid and laboratory variables," says Kristen Schmitt, chief of pharmacy at the Cincinnati VA and the lead author of the study. "Results showed that while 67 percent of patients took their medication properly, a total of 33 percent of patients had poor medication adherence. More importantly, those with poor adherence were 23 percent more likely to have sub-optimal blood pressure control during the entire two-year study period."
"With this data, we hope to develop a multidisciplinary approach to help kidney disease patients adhere to their prescribed blood pressure medications. This will not only improve their clinical outcomes but will also help in reducing costs of care," she continues.
"Although the results represent a large sample of patients, they are derived from a single center," adds Thakar. "Further investigations are needed to accurately assess the impact of medication adherence on cardiovascular and renal outcomes in practice."
This study was funded by a Federal Services Research Grant from the American Society of Health System Pharmacists (ASHP) Foundation.
суббота, 28 мая 2011 г.
HCPC Calls For Greater Healthcare Savings Through Improved Adherence To Prescription Drug Regimens
With today's announcement that the Pharmaceutical Research and Manufacturers of America (PhRMA) has offered to voluntarily grant some $80 billion in discounts to Medicare beneficiaries over the next decade in an effort to reduce overall healthcare costs, the Healthcare Compliance Packaging Council (HCPC) noted that far greater savings can be achieved if immediate steps are taken to help people take their prescription drugs properly.
Commonly referred to as pharmaceutical noncompliance, the end result of Americans not taking their prescription drugs properly is a well-documented phenomenon that drains more than $180 billion from our national economy every year due to unnecessary emergency room visits, hospital stays, trips to the doctor, lost productivity, and early death.
"Published research points to several key reasons why people don't take their prescription drugs properly," notes HCPC Executive Director Peter G. Mayberry. "And one reason that is almost always on the top of the list is 'forgetfulness.'" A recent study funded by the U.S. Department of Health and Human Services concludes, however, that better pharmaceutical packaging can significantly increase pharmaceutical compliance and improve healthcare outcomes.
The study - which was conducted by Ohio State University (OSU) and appears in the Jan/Feb 2008 edition of the Journal of the American Pharmacists Association - compared two groups of patients who were given the exact same drugs for high blood pressure in two different types of packaging: one group received their drugs in standard pharmacy vials, while the other group was given the exact same drug in a unit dose blister card with compliance-prompting features.
After a year of tracking both groups, OSU researchers found that the group who received their drugs in blister packs with compliance-prompting features refilled their prescriptions in a much for timely manner and also achieved markedly better reductions in their blood pressure readings.
The OSU study is just one example of research which points to the role that unit dose formats can play in improving pharmaceutical compliance Mayberry points out. "In the United States today, the only class of drugs currently dispensed by manufacturers in a unit dose format with compliance-prompting features is birth control pills, and the most recent data shows that compliance rates with these drugs exceeds 92 percent. This can be compared with compliance rates for organ-rejection drugs - which are not typically dispensed in special packaging - that have a compliance rate of about 82 percent."
If better packaging can improve compliance by a mere 10 percent, Mayberry notes, annual savings should equal about $18 billion. "Over ten years," he pointed out, "that is more than double what the PhRMA program seeks to achieve."
The HCPC is a not-for-profit trade association that was formed in 1990 to promote the many benefits of unit dose packaging. The United States is one of only a few countries in the world where pharmaceutical manufacturers are able to ship prescription drugs in bulk containers such that the drugs must be repackaged in the pharmacy before they can be given to consumers.
Bulk distribution of drug product adds unnecessary burdens to the pharmacy industry, allows drugs to be exposed to the atmosphere during repackaging and household use, promotes dispensing errors, and facilitates the introduction of counterfeit and/or expired drug products into legitimate dispensing chains. Greater use of unit dose packaging with compliance-prompting features by pharmaceutical manufacturers in the U.S. would reduce overall healthcare costs by improving healthcare outcomes, while also improving the pharmaceutical supply chain, and providing U.S. consumers with greater piece of mind.
It is for all these reasons that the HCPC has launched an outreach effort to the Obama administration and the United States Congress urging public policy that will bring U.S. pharmaceutical packaging standards more closely in line with the standards pharmaceutical manufacturers must meet when they sell the exact same drugs in Europe, Asia, and Latin America.
Commonly referred to as pharmaceutical noncompliance, the end result of Americans not taking their prescription drugs properly is a well-documented phenomenon that drains more than $180 billion from our national economy every year due to unnecessary emergency room visits, hospital stays, trips to the doctor, lost productivity, and early death.
"Published research points to several key reasons why people don't take their prescription drugs properly," notes HCPC Executive Director Peter G. Mayberry. "And one reason that is almost always on the top of the list is 'forgetfulness.'" A recent study funded by the U.S. Department of Health and Human Services concludes, however, that better pharmaceutical packaging can significantly increase pharmaceutical compliance and improve healthcare outcomes.
The study - which was conducted by Ohio State University (OSU) and appears in the Jan/Feb 2008 edition of the Journal of the American Pharmacists Association - compared two groups of patients who were given the exact same drugs for high blood pressure in two different types of packaging: one group received their drugs in standard pharmacy vials, while the other group was given the exact same drug in a unit dose blister card with compliance-prompting features.
After a year of tracking both groups, OSU researchers found that the group who received their drugs in blister packs with compliance-prompting features refilled their prescriptions in a much for timely manner and also achieved markedly better reductions in their blood pressure readings.
The OSU study is just one example of research which points to the role that unit dose formats can play in improving pharmaceutical compliance Mayberry points out. "In the United States today, the only class of drugs currently dispensed by manufacturers in a unit dose format with compliance-prompting features is birth control pills, and the most recent data shows that compliance rates with these drugs exceeds 92 percent. This can be compared with compliance rates for organ-rejection drugs - which are not typically dispensed in special packaging - that have a compliance rate of about 82 percent."
If better packaging can improve compliance by a mere 10 percent, Mayberry notes, annual savings should equal about $18 billion. "Over ten years," he pointed out, "that is more than double what the PhRMA program seeks to achieve."
The HCPC is a not-for-profit trade association that was formed in 1990 to promote the many benefits of unit dose packaging. The United States is one of only a few countries in the world where pharmaceutical manufacturers are able to ship prescription drugs in bulk containers such that the drugs must be repackaged in the pharmacy before they can be given to consumers.
Bulk distribution of drug product adds unnecessary burdens to the pharmacy industry, allows drugs to be exposed to the atmosphere during repackaging and household use, promotes dispensing errors, and facilitates the introduction of counterfeit and/or expired drug products into legitimate dispensing chains. Greater use of unit dose packaging with compliance-prompting features by pharmaceutical manufacturers in the U.S. would reduce overall healthcare costs by improving healthcare outcomes, while also improving the pharmaceutical supply chain, and providing U.S. consumers with greater piece of mind.
It is for all these reasons that the HCPC has launched an outreach effort to the Obama administration and the United States Congress urging public policy that will bring U.S. pharmaceutical packaging standards more closely in line with the standards pharmaceutical manufacturers must meet when they sell the exact same drugs in Europe, Asia, and Latin America.
пятница, 27 мая 2011 г.
Few Pharmacies Can Translate Prescription Labels Into Spanish
Surprisingly few pharmacies in the U.S. are able to translate prescription medication instructions into Spanish, making it difficult for patients who speak only Spanish to understand how to take their medications properly, according to a new study from the Northwestern University Feinberg School of Medicine.
The first multi-state study investigating the ability of pharmacies to translate prescription labels found more than half of the pharmacies were unable to translate any labels or could do only a limited number of translations. The study looked at pharmacies in states with a large existing Latino population (Texas and Colorado) and in states with a rapid growth in Latino population (Georgia and North Carolina). These states -- because of their large Latino populations -- are likely to have the greatest demand and capability for translation. Other states may be further behind, researchers said.
"The lack of translation for prescription medication instructions is a major problem," said lead author Stacy Cooper Bailey, clinical research associate and director of the Health Literacy and Learning Program at Northwestern's Feinberg School. "If you don't know how to take your medications correctly, it is going to be difficult for you to manage your medical condition. Taking medications incorrectly could cause serious problems or even death."
The study will appear in the June issue of the journal Medical Care.
Bailey said the study results indicate the overall problem is far more prevalent than what had been suggested in prior single-site studies conducted in New York and Milwaukee.
Bailey and colleagues surveyed 764 pharmacies, including national chains, in four states. The study found 34.9 percent (267) could not offer any translation services; 21.7 percent (166) offered only limited translation services and 43.3 percent (331) said they could provide translated instructions. Of the total, 28 percent were independent pharmacies and 72 percent were part of national, regional or state chains.
The data also showed that 44 percent of pharmacies located in counties where the Latino population exceeds a quarter of the population were unable to provide comprehensive Spanish medication instructions.
"The numbers are much worse than I anticipated," Bailey said.
"A lot of effort has gone into improving language services in hospitals, but pharmacies have been overlooked," Bailey said. "That is unfortunate because a lot of people take medications. It's one of the most common health tasks that you have to perform. Knowing how to take your medications correctly is essential."
Bailey said some pharmacists report being afraid to use translations because they don't know what the Spanish translations mean. "They worry they are giving an incorrect instruction and they will be liable for it," Bailey said. "Pharmacies also may not be aware of software programs that offer translations," she added.
Availability of translations is likely to be even worse for people who speak a language other than Spanish, Bailey said. "We have to be able to provide medication instructions in multiple languages, even beyond Spanish. More laws need to be passed to guide and enforce language services in pharmacies. We also need to come up with innovative ways of helping pharmacies provide these services. There are ways to overcome this obstacle."
Marla Paul Marla Paul
Northwestern University
The first multi-state study investigating the ability of pharmacies to translate prescription labels found more than half of the pharmacies were unable to translate any labels or could do only a limited number of translations. The study looked at pharmacies in states with a large existing Latino population (Texas and Colorado) and in states with a rapid growth in Latino population (Georgia and North Carolina). These states -- because of their large Latino populations -- are likely to have the greatest demand and capability for translation. Other states may be further behind, researchers said.
"The lack of translation for prescription medication instructions is a major problem," said lead author Stacy Cooper Bailey, clinical research associate and director of the Health Literacy and Learning Program at Northwestern's Feinberg School. "If you don't know how to take your medications correctly, it is going to be difficult for you to manage your medical condition. Taking medications incorrectly could cause serious problems or even death."
The study will appear in the June issue of the journal Medical Care.
Bailey said the study results indicate the overall problem is far more prevalent than what had been suggested in prior single-site studies conducted in New York and Milwaukee.
Bailey and colleagues surveyed 764 pharmacies, including national chains, in four states. The study found 34.9 percent (267) could not offer any translation services; 21.7 percent (166) offered only limited translation services and 43.3 percent (331) said they could provide translated instructions. Of the total, 28 percent were independent pharmacies and 72 percent were part of national, regional or state chains.
The data also showed that 44 percent of pharmacies located in counties where the Latino population exceeds a quarter of the population were unable to provide comprehensive Spanish medication instructions.
"The numbers are much worse than I anticipated," Bailey said.
"A lot of effort has gone into improving language services in hospitals, but pharmacies have been overlooked," Bailey said. "That is unfortunate because a lot of people take medications. It's one of the most common health tasks that you have to perform. Knowing how to take your medications correctly is essential."
Bailey said some pharmacists report being afraid to use translations because they don't know what the Spanish translations mean. "They worry they are giving an incorrect instruction and they will be liable for it," Bailey said. "Pharmacies also may not be aware of software programs that offer translations," she added.
Availability of translations is likely to be even worse for people who speak a language other than Spanish, Bailey said. "We have to be able to provide medication instructions in multiple languages, even beyond Spanish. More laws need to be passed to guide and enforce language services in pharmacies. We also need to come up with innovative ways of helping pharmacies provide these services. There are ways to overcome this obstacle."
Marla Paul Marla Paul
Northwestern University
четверг, 26 мая 2011 г.
InforMedix Rings Up Med-ePhone - Mobile, Wireless Patient Medication Adherence Solution
InforMedix Holdings, Inc. (OTCBB: IFMX,
informedix), developer of the Med-eMonitor™, an
interactive smart pillbox system for medication adherence and health
management, is planning to introduce a new device, the Med-ePhone™.
InforMedix expects that the Med-ePhone system will provide a simple,
inexpensive method for reminding users to take their medications
regularly, and that the device will record and monitor patient medication
adherence and health status over mobile phones and landlines. The
Med-ePhone system is being designed to send patient- reported data to be
analyzed by proprietary software algorithms already operational in
InforMedix's Med-eXpert™ System which will then alert loved ones and/or
care managers when a patient's medications are missed or health declines.
Once Med-ePhone users are linked into the system, they will receive up to
three daily reminders. These reminders will be kept short and simple to
encourage high levels of user satisfaction, and will include prompts to
provide answers to simple health status queries. Six of InforMedix's
issued patents disclose the use of voice technologies to improve patient
medication adherence.
In addition to tracking patient adherence to their medication use and
health status, InforMedix expects that the Med-ePhone system will provide
healthcare professionals with automated real-time alerts when patients
miss their medications or their health declines.
"We designed Med-ePhone to be an entry-level product to complement our
Med-eMonitor," said Mike Gavin, Vice President of Research and
Development at InforMedix. "We anticipate that the Med-ePhone will be an
excellent solution for patients and their families for managing simpler
medication regimens while preserving the core features of the
Med-eMonitor System's prompting, monitoring, and reporting services."
Remie Smith, Vice President of Software Development at InforMedix
remarked, "What excites us about the Med-ePhone is that we will remotely
program it, monitor the patients, and report the urgent alerts through
our same Med-eXpert System, which has proven to be a highly reliable and
robust database and reporting engine."
"We expect that the Med-ePhone will be another important device in our
patient empowerment toolbox," said Bruce A. Kehr, MD, CEO of InforMedix.
"InforMedix's goal is to help people lead safe, productive, and
independent lives while bringing peace-of-mind to patients and their
loved ones. With Med-ePhone, we plan to continue to make medication use
safe and easy with an entry-level, mass-market product for patients on
simpler medication regimens. The Med-ePhone is being designed to
complement the Med-eMonitor's functionality, which provides a
comprehensive management system for the more complex patients, including
individualized alerts, instructions, and medication education and
monitoring for up to twenty-five different medications per patient. After
the planned launch, with two products at two price points, we believe
that InforMedix will be able to provide solutions for virtually every
conceivable medication adherence challenge."
Med-ePhone is currently under development and being tested. Upon
successful completion of testing, InforMedix expects to introduce it to
the consumer market through pharmacies in early 2008.
About InforMedix, Inc.
InforMedix, Inc., based in Rockville, Maryland, has developed the Med-
eMonitor™ and Med-ePhone™ System as The Medication Adherence Solution for
consumer product and disease management markets, to deliver peace-
of-mind, improved independent living, and better health outcomes to
patients and their loved ones. The Med-eMonitor System ("Medication, Safe
and Easy"™) integrates a portable patient-interactive "smart pillbox",
hardware, software, and call center monitoring. This is designed to
enable chronically ill patients and their loved ones, professionals in
disease management programs, and medical researchers to efficiently
monitor and manage patients' medication and care plan adherence, clinical
response, and drug safety.
informedix
Safe Harbor Statement
This press release may contain forward looking statements that involve
risks and uncertainties, including statements regarding our business
strategy and development plans, plans for entering into new businesses,
the anticipated introduction of new products, anticipated sources and
uses of funds and other statements regarding our plans, objectives,
expectations and intentions that are not historical facts. Because these
forward-looking statements involve risks and uncertainties, actual
results could differ materially from those discussed in this press
release. These risks and uncertainties are described in greater detail in
the reports that we file with the Securities and Exchange Commission. Our
actual results, performance or achievements may vary materially from
those expressed or implied in any forward-looking statements. All
forward-looking statements reflect our beliefs and expectations as of the
date of this press release and should not be relied upon as representing
our views as of any subsequent date. While we may elect to update these
forward- looking statements publicly at some point in the future, we
specifically disclaim any obligation to do so, whether as a result of new
information, future events or otherwise.
InforMedix, Inc.
informedix), developer of the Med-eMonitor™, an
interactive smart pillbox system for medication adherence and health
management, is planning to introduce a new device, the Med-ePhone™.
InforMedix expects that the Med-ePhone system will provide a simple,
inexpensive method for reminding users to take their medications
regularly, and that the device will record and monitor patient medication
adherence and health status over mobile phones and landlines. The
Med-ePhone system is being designed to send patient- reported data to be
analyzed by proprietary software algorithms already operational in
InforMedix's Med-eXpert™ System which will then alert loved ones and/or
care managers when a patient's medications are missed or health declines.
Once Med-ePhone users are linked into the system, they will receive up to
three daily reminders. These reminders will be kept short and simple to
encourage high levels of user satisfaction, and will include prompts to
provide answers to simple health status queries. Six of InforMedix's
issued patents disclose the use of voice technologies to improve patient
medication adherence.
In addition to tracking patient adherence to their medication use and
health status, InforMedix expects that the Med-ePhone system will provide
healthcare professionals with automated real-time alerts when patients
miss their medications or their health declines.
"We designed Med-ePhone to be an entry-level product to complement our
Med-eMonitor," said Mike Gavin, Vice President of Research and
Development at InforMedix. "We anticipate that the Med-ePhone will be an
excellent solution for patients and their families for managing simpler
medication regimens while preserving the core features of the
Med-eMonitor System's prompting, monitoring, and reporting services."
Remie Smith, Vice President of Software Development at InforMedix
remarked, "What excites us about the Med-ePhone is that we will remotely
program it, monitor the patients, and report the urgent alerts through
our same Med-eXpert System, which has proven to be a highly reliable and
robust database and reporting engine."
"We expect that the Med-ePhone will be another important device in our
patient empowerment toolbox," said Bruce A. Kehr, MD, CEO of InforMedix.
"InforMedix's goal is to help people lead safe, productive, and
independent lives while bringing peace-of-mind to patients and their
loved ones. With Med-ePhone, we plan to continue to make medication use
safe and easy with an entry-level, mass-market product for patients on
simpler medication regimens. The Med-ePhone is being designed to
complement the Med-eMonitor's functionality, which provides a
comprehensive management system for the more complex patients, including
individualized alerts, instructions, and medication education and
monitoring for up to twenty-five different medications per patient. After
the planned launch, with two products at two price points, we believe
that InforMedix will be able to provide solutions for virtually every
conceivable medication adherence challenge."
Med-ePhone is currently under development and being tested. Upon
successful completion of testing, InforMedix expects to introduce it to
the consumer market through pharmacies in early 2008.
About InforMedix, Inc.
InforMedix, Inc., based in Rockville, Maryland, has developed the Med-
eMonitor™ and Med-ePhone™ System as The Medication Adherence Solution for
consumer product and disease management markets, to deliver peace-
of-mind, improved independent living, and better health outcomes to
patients and their loved ones. The Med-eMonitor System ("Medication, Safe
and Easy"™) integrates a portable patient-interactive "smart pillbox",
hardware, software, and call center monitoring. This is designed to
enable chronically ill patients and their loved ones, professionals in
disease management programs, and medical researchers to efficiently
monitor and manage patients' medication and care plan adherence, clinical
response, and drug safety.
informedix
Safe Harbor Statement
This press release may contain forward looking statements that involve
risks and uncertainties, including statements regarding our business
strategy and development plans, plans for entering into new businesses,
the anticipated introduction of new products, anticipated sources and
uses of funds and other statements regarding our plans, objectives,
expectations and intentions that are not historical facts. Because these
forward-looking statements involve risks and uncertainties, actual
results could differ materially from those discussed in this press
release. These risks and uncertainties are described in greater detail in
the reports that we file with the Securities and Exchange Commission. Our
actual results, performance or achievements may vary materially from
those expressed or implied in any forward-looking statements. All
forward-looking statements reflect our beliefs and expectations as of the
date of this press release and should not be relied upon as representing
our views as of any subsequent date. While we may elect to update these
forward- looking statements publicly at some point in the future, we
specifically disclaim any obligation to do so, whether as a result of new
information, future events or otherwise.
InforMedix, Inc.
среда, 25 мая 2011 г.
HealthHonors' Innovative Technology Platform Adopted By AstraZeneca - Program Will Help Patients Take Their Medicines As Prescribed
HealthHonors® today announced that AstraZeneca Pharmaceuticals LP has implemented HealthHonors' proprietary technology platform to help patients remember to take their medicine as prescribed.
The HealthHonors platform, known as Dynamic Intermittent Reinforcement (DIR™), is a patient incentive program that uses intermittent reinforcement schedules to motivate patients to take their medications as prescribed. In a random?¬ized study using this proprietary system, patients who took part in the program were 33 percent more adherent to their medications as compared to patients who were not a part of the program; and prescription refill latency, defined as the length of time that elapses between a scheduled refill and when the patient picks up the medicine, decreased by 34 percent.
Studies have shown that more than half of the 3.5 billion annual dispensed prescriptions in the United States are not taken as prescribed. This can lead to disease progression, increased hospitalization and additional costs to the U.S. health system. When patients fail to take their prescribed medicine, it leads to more than $100 billion per year in additional system costs and 125,000 deaths, and accounts for 10 percent of all hospitalizations in the United States, according to a study by Drs. Terrence Blaschke and Lars Osterberg that appeared in a 2005 edition of the New England Journal of Medicine.
John Sheehan, president and CEO of HealthHonors, said AstraZeneca's use of HealthHonors' platform underscores AstraZeneca's commitment to patients. "We are very pleased that AstraZeneca has invested in Dynamic Intermittent Reinforcement technology," said Sheehan. "With mounting numbers of patients not taking their medicines as prescribed, our DIR technology can truly make a difference for patients."
"AstraZeneca is committed to finding innovative ways to help people lead healthier lives and we believe the Dynamic Intermittent Reinforcement technology can help deliver on this goal," said Mark Mallon, VP Marketing & Sales Operations, of AstraZeneca.
This latest development comes on the heels of HealthHonors announcing that its patent-pending technology will be used by health care payors, manufacturers, employers and service providers to increase patient adherence to prescribed drug therapy and wellness initiatives.
At the same time, HealthHonors announced that it is the recipient of a National Institutes of Health and National Institute on Aging grant to further measure the impact of the HealthHonors technology platform on patients over 55 who are on prescribed statin therapy. The study will be conducted with the Yale University School of Medicine through its primary care clinic in New Haven, Conn.
About HealthHonors
HealthHonors®, a Boston-area company, motivates consumers to adhere to healthy behavior through its proprietary technology, Dynamic Intermittent Reinforcement (DIR™). The DIR™ platform identifies and matches individual behavioral patterns with the most effective incentive schedule, resulting in improved adherence, lower cost per person and increased ROI. Customers include large health insurers, pharmacies, health service providers and pharmaceutical manufacturers. To learn more about HealthHonors and obtain published papers by its founders, Dr. Murat Kalayoglu and Dr. Michael Singer, visit healthhonors.
HealthHonors
The HealthHonors platform, known as Dynamic Intermittent Reinforcement (DIR™), is a patient incentive program that uses intermittent reinforcement schedules to motivate patients to take their medications as prescribed. In a random?¬ized study using this proprietary system, patients who took part in the program were 33 percent more adherent to their medications as compared to patients who were not a part of the program; and prescription refill latency, defined as the length of time that elapses between a scheduled refill and when the patient picks up the medicine, decreased by 34 percent.
Studies have shown that more than half of the 3.5 billion annual dispensed prescriptions in the United States are not taken as prescribed. This can lead to disease progression, increased hospitalization and additional costs to the U.S. health system. When patients fail to take their prescribed medicine, it leads to more than $100 billion per year in additional system costs and 125,000 deaths, and accounts for 10 percent of all hospitalizations in the United States, according to a study by Drs. Terrence Blaschke and Lars Osterberg that appeared in a 2005 edition of the New England Journal of Medicine.
John Sheehan, president and CEO of HealthHonors, said AstraZeneca's use of HealthHonors' platform underscores AstraZeneca's commitment to patients. "We are very pleased that AstraZeneca has invested in Dynamic Intermittent Reinforcement technology," said Sheehan. "With mounting numbers of patients not taking their medicines as prescribed, our DIR technology can truly make a difference for patients."
"AstraZeneca is committed to finding innovative ways to help people lead healthier lives and we believe the Dynamic Intermittent Reinforcement technology can help deliver on this goal," said Mark Mallon, VP Marketing & Sales Operations, of AstraZeneca.
This latest development comes on the heels of HealthHonors announcing that its patent-pending technology will be used by health care payors, manufacturers, employers and service providers to increase patient adherence to prescribed drug therapy and wellness initiatives.
At the same time, HealthHonors announced that it is the recipient of a National Institutes of Health and National Institute on Aging grant to further measure the impact of the HealthHonors technology platform on patients over 55 who are on prescribed statin therapy. The study will be conducted with the Yale University School of Medicine through its primary care clinic in New Haven, Conn.
About HealthHonors
HealthHonors®, a Boston-area company, motivates consumers to adhere to healthy behavior through its proprietary technology, Dynamic Intermittent Reinforcement (DIR™). The DIR™ platform identifies and matches individual behavioral patterns with the most effective incentive schedule, resulting in improved adherence, lower cost per person and increased ROI. Customers include large health insurers, pharmacies, health service providers and pharmaceutical manufacturers. To learn more about HealthHonors and obtain published papers by its founders, Dr. Murat Kalayoglu and Dr. Michael Singer, visit healthhonors.
HealthHonors
вторник, 24 мая 2011 г.
PRISYM ID's Medica Greatly Simplifies FDA And MHRA Compliance
PRISYM ID Limited announced the launch of a new product that allows life science companies to review, validate and record their product labels quickly and efficiently while allowing greater collaboration across the process. PRISYM Medica is a web-based solution designed for life science companies that need to design, validate and approve labelling on a variety of products, from medical devices to pharmaceuticals and into clinical trials. The announcement was made from the Validation Week Europe conference in Dublin where PRISYM ID is sponsoring.
"With 200,000 deaths a year in the US alone caused by preventable medical mistakes(1), such as inaccurate or unclear labelling, accuracy, accountability, and thus compliance, are vital for life sciences," said Dave Taylor, Product Manager of PRISYM ID. "With every step of a product's development needing approval from many different people, often in different locations, simply designing, validating and approving labelling on products can be a very time-consuming, inefficient process. Even when this process can be automated, the relevant software will typically need to be installed at each location, turning what could be a simple process into an essentially massive change management process."
PRISYM Medica is a web-based product that offers life science companies a single solution to meet their packaging and labelling requirements. PRISYM Medica has been designed to increase collaboration and lessen the expense and inefficiency of validation, by allowing all relevant parties access to the design, review and validation process online. There is no need to install the relevant software at each location and the web-based nature of the solution also means that it is simpler to involve people simultaneously at each step of the label production process, making collaboration much easier.
PRISYM Medica is a simple to use label design and management application which allows you to develop, review, validate and distribute labels aiding with compliance for the Food and Drug Administration (FDA) and the Medicines and Healthcare products Regulatory Agency (MHRA) regulations, among others. It enables unique serialised codes to be automatically applied in the format necessary to meet local legislative requirements. Where appropriate, live batch information, destination information and intelligent serial numbers needed for compliance with international regulations can be passed for printing automatically.
PRISYM Medica benefits include:
-- Secure, automated and accurate labelling for globally distributed life science products
-- Web-based using Microsoft Internet Explorer, allowing quick deployment and easy use
-- Automated printing and reporting of identity codes to comply with national and international standards
-- A proactive review and approval work engine, increasing the accuracy of layout and data used on labels and reducing the likelihood of product recalls
-- Support in meeting with FDA, MHRA and other compliance regulations
-- Template-based label development, minimising the changes needed for each separate design
-- Design labels for global use due to Unicode compliance
-- Produce over 35 types of barcodes GS1 DataBar, ITF14, EAN, DataMatrix, Code 39, Code 93 and QR codes
"When your product is as important as pharmaceuticals and medical devices, zero defect labelling is vital," said Dave Taylor, Product Manager of PRISYM ID. "A lack of accuracy and clarity in labelling contributes to 1 in 10 NHS patients suffering from mistakes in their treatment(2), while without accountability in labelling, piracy and counterfeiting, which cost the life sciences industry $38 billion a year, become harder to spot. With PRISYM Medica, we are aiming to make this accuracy and accountability as smooth, simple and straightforward as possible for life sciences companies. By allowing greater collaboration and easier access, accuracy is improved. Also the validation becomes a much faster, lower cost process, which allows vital products to be rolled out much sooner."
In addition, PRISYM ID has an experienced team to support you with your labelling training requirements and specialist labelling supplies.
About PRISYM ID
PRISYM ID design and deliver high quality, industry compliant RFID, labelling and barcode solutions for companies in a wide range of sectors including life sciences, chemical, manufacturing and automotive. With over 20 years experience and product development, the company boasts a comprehensive range of software and consumables from intuitive label design and print to automated track and trace systems. Our elite client list includes Johnson & Johnson, Pfizer, Allergan and Glaxo Smith Kline.
Headquartered in the United Kingdom, PRISYMID has offices in the USA and Europe as well as a strategic network of partners to meet our customers' needs on a global scale.
(1) Hearst media corporation investigation
(2) NHS figures
"With 200,000 deaths a year in the US alone caused by preventable medical mistakes(1), such as inaccurate or unclear labelling, accuracy, accountability, and thus compliance, are vital for life sciences," said Dave Taylor, Product Manager of PRISYM ID. "With every step of a product's development needing approval from many different people, often in different locations, simply designing, validating and approving labelling on products can be a very time-consuming, inefficient process. Even when this process can be automated, the relevant software will typically need to be installed at each location, turning what could be a simple process into an essentially massive change management process."
PRISYM Medica is a web-based product that offers life science companies a single solution to meet their packaging and labelling requirements. PRISYM Medica has been designed to increase collaboration and lessen the expense and inefficiency of validation, by allowing all relevant parties access to the design, review and validation process online. There is no need to install the relevant software at each location and the web-based nature of the solution also means that it is simpler to involve people simultaneously at each step of the label production process, making collaboration much easier.
PRISYM Medica is a simple to use label design and management application which allows you to develop, review, validate and distribute labels aiding with compliance for the Food and Drug Administration (FDA) and the Medicines and Healthcare products Regulatory Agency (MHRA) regulations, among others. It enables unique serialised codes to be automatically applied in the format necessary to meet local legislative requirements. Where appropriate, live batch information, destination information and intelligent serial numbers needed for compliance with international regulations can be passed for printing automatically.
PRISYM Medica benefits include:
-- Secure, automated and accurate labelling for globally distributed life science products
-- Web-based using Microsoft Internet Explorer, allowing quick deployment and easy use
-- Automated printing and reporting of identity codes to comply with national and international standards
-- A proactive review and approval work engine, increasing the accuracy of layout and data used on labels and reducing the likelihood of product recalls
-- Support in meeting with FDA, MHRA and other compliance regulations
-- Template-based label development, minimising the changes needed for each separate design
-- Design labels for global use due to Unicode compliance
-- Produce over 35 types of barcodes GS1 DataBar, ITF14, EAN, DataMatrix, Code 39, Code 93 and QR codes
"When your product is as important as pharmaceuticals and medical devices, zero defect labelling is vital," said Dave Taylor, Product Manager of PRISYM ID. "A lack of accuracy and clarity in labelling contributes to 1 in 10 NHS patients suffering from mistakes in their treatment(2), while without accountability in labelling, piracy and counterfeiting, which cost the life sciences industry $38 billion a year, become harder to spot. With PRISYM Medica, we are aiming to make this accuracy and accountability as smooth, simple and straightforward as possible for life sciences companies. By allowing greater collaboration and easier access, accuracy is improved. Also the validation becomes a much faster, lower cost process, which allows vital products to be rolled out much sooner."
In addition, PRISYM ID has an experienced team to support you with your labelling training requirements and specialist labelling supplies.
About PRISYM ID
PRISYM ID design and deliver high quality, industry compliant RFID, labelling and barcode solutions for companies in a wide range of sectors including life sciences, chemical, manufacturing and automotive. With over 20 years experience and product development, the company boasts a comprehensive range of software and consumables from intuitive label design and print to automated track and trace systems. Our elite client list includes Johnson & Johnson, Pfizer, Allergan and Glaxo Smith Kline.
Headquartered in the United Kingdom, PRISYMID has offices in the USA and Europe as well as a strategic network of partners to meet our customers' needs on a global scale.
(1) Hearst media corporation investigation
(2) NHS figures
понедельник, 23 мая 2011 г.
News From The February Issue Of Chest
BENEFITS OF ICS FOR COPD MAY BE OVERSTATED
Inhaled corticosteroids (ICS) are widely used for the treatment of chronic obstructive pulmonary disease (COPD). However, new research suggests that ICS may only provide a modest benefit in reducing exacerbations in patients with COPD. Researchers from India conducted a metaanalysis of 11 studies (8,164 patients) that reported the efficacy of ICS versus placebo in prevention of COPD exacerbations. The use of ICS was associated with a modest reduction in the occurrence of exacerbations, with a subgroup analysis revealing only a benefit in patients with a FEV1 less than 50 percent. Upon further analysis using metaregression, the researchers found no demonstrable linear relationship between the efficacy of ICS and prevention of COPD exacerbation that was related to the level of stable lung function. Researchers conclude that the role of ICS in preventing COPD exacerbations warrants reexamination. This article is published in the February issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2010; 137(2):318-325.
MAJORITY OF TB PATIENTS DO NOT COMPLETE THERAPY
New research shows that less than half of patients starting treatment for latent TB infection (LTBI) actually complete therapy. Researchers from several major medical institutions, including Boston University School of Public Health, found that at 32 clinics in the United States and Canada, 123 of 720 patients tested and offered treatment for LTBI declined. Furthermore, of 1,994 patients who started treatment for LTBI in 68 US and Canadian clinics, 1,045 failed to complete therapy. Employees at health-care facilities were most likely to decline treatment altogether, while those in congregate settings, such as nursing homes and jail, were least likely to complete therapy. The article is published in the February issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2010; 137(2):401-409.
PATIENTS WITH COPD HAVE INCREASED RISK FOR DEPRESSION
A new study provides further evidence that patients with chronic obstructive pulmonary disease (COPD) are at an increased risk for developing depression. Researchers from Switzerland compared the prevalence of depression among 35,722 patients with COPD with 35,722 patients who were COPD-free. Results showed that the prevalence of diagnosed depression prior to the first COPD diagnosis was higher in the COPD population (23.1 percent) than among patients without COPD (16.8 percent). In addition, the incidence rate of a new-onset diagnosis of depression after the first COPD diagnosis was 16.2/1,000 person-years in the COPD group, compared with 9.4/1,000 person-years in the group without COPD. Patients with severe COPD had the highest risk of developing depression. This study is published in the February issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2010; 137(2):341-347.
Inhaled corticosteroids (ICS) are widely used for the treatment of chronic obstructive pulmonary disease (COPD). However, new research suggests that ICS may only provide a modest benefit in reducing exacerbations in patients with COPD. Researchers from India conducted a metaanalysis of 11 studies (8,164 patients) that reported the efficacy of ICS versus placebo in prevention of COPD exacerbations. The use of ICS was associated with a modest reduction in the occurrence of exacerbations, with a subgroup analysis revealing only a benefit in patients with a FEV1 less than 50 percent. Upon further analysis using metaregression, the researchers found no demonstrable linear relationship between the efficacy of ICS and prevention of COPD exacerbation that was related to the level of stable lung function. Researchers conclude that the role of ICS in preventing COPD exacerbations warrants reexamination. This article is published in the February issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2010; 137(2):318-325.
MAJORITY OF TB PATIENTS DO NOT COMPLETE THERAPY
New research shows that less than half of patients starting treatment for latent TB infection (LTBI) actually complete therapy. Researchers from several major medical institutions, including Boston University School of Public Health, found that at 32 clinics in the United States and Canada, 123 of 720 patients tested and offered treatment for LTBI declined. Furthermore, of 1,994 patients who started treatment for LTBI in 68 US and Canadian clinics, 1,045 failed to complete therapy. Employees at health-care facilities were most likely to decline treatment altogether, while those in congregate settings, such as nursing homes and jail, were least likely to complete therapy. The article is published in the February issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2010; 137(2):401-409.
PATIENTS WITH COPD HAVE INCREASED RISK FOR DEPRESSION
A new study provides further evidence that patients with chronic obstructive pulmonary disease (COPD) are at an increased risk for developing depression. Researchers from Switzerland compared the prevalence of depression among 35,722 patients with COPD with 35,722 patients who were COPD-free. Results showed that the prevalence of diagnosed depression prior to the first COPD diagnosis was higher in the COPD population (23.1 percent) than among patients without COPD (16.8 percent). In addition, the incidence rate of a new-onset diagnosis of depression after the first COPD diagnosis was 16.2/1,000 person-years in the COPD group, compared with 9.4/1,000 person-years in the group without COPD. Patients with severe COPD had the highest risk of developing depression. This study is published in the February issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2010; 137(2):341-347.
воскресенье, 22 мая 2011 г.
Why Are There Variations In Costs Of Diabetes Non-Adherence?
There are important variations in the reported costs of diabetes non adherence which are due to methodological differences among studies. Therefore, decision makers need to identify those sources of variation, and based their decision only on high quality studies.
The objective was to review and analyze carefully all published studies related to costs of diabetic patients who do not adhere to medications and identify sources of differences among studies.
We identified 219 studies with important differences in the estimated costs. For example, if patients do not take the medicine as prescribed for 5 years will increase the average total costs from $4,000 to more than $15,000, depending on the study. The differences in those estimations are due to characteristics of patients included, data sources for costs, time of follow-up and methods used for analysis.
Costs of not taking medications as prescribed have an impact on the US economy increasing the costs up to $100 billion per year. In addition, poor adherence to antidiabetic medications might explain why 43% of patients with diabetes mellitus do not reach adequate glycemic control.
This is a true teamwork effort, Dr. Salas said, that has been supported by the ISPOR Special Interest Initiative that provided a forum for information exchange among interested members. This topic is especially important because diabetes is a chronic disease where it is important to maintain adequate drug levels in the body to obtain an effect, which might be translated in reduction of morbi-mortality.
The article appeared in of Value in Health, the official journal of the International Society for Pharmacoeconomics and outcomes Research.
Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research and help health care leaders to make decisions that are solidly evidence-based. The journal is published bi-monthly and has a regular readership of over 4,000 clinicians, decision-makers, and researchers worldwide.
ISPOR is a nonprofit, international organization that strives to translate pharmacoeconomics and outcomes research into practice to ensure that society allocates scarce health care resources wisely, fairly, and efficiently.
Source
ISPOR
The objective was to review and analyze carefully all published studies related to costs of diabetic patients who do not adhere to medications and identify sources of differences among studies.
We identified 219 studies with important differences in the estimated costs. For example, if patients do not take the medicine as prescribed for 5 years will increase the average total costs from $4,000 to more than $15,000, depending on the study. The differences in those estimations are due to characteristics of patients included, data sources for costs, time of follow-up and methods used for analysis.
Costs of not taking medications as prescribed have an impact on the US economy increasing the costs up to $100 billion per year. In addition, poor adherence to antidiabetic medications might explain why 43% of patients with diabetes mellitus do not reach adequate glycemic control.
This is a true teamwork effort, Dr. Salas said, that has been supported by the ISPOR Special Interest Initiative that provided a forum for information exchange among interested members. This topic is especially important because diabetes is a chronic disease where it is important to maintain adequate drug levels in the body to obtain an effect, which might be translated in reduction of morbi-mortality.
The article appeared in of Value in Health, the official journal of the International Society for Pharmacoeconomics and outcomes Research.
Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research and help health care leaders to make decisions that are solidly evidence-based. The journal is published bi-monthly and has a regular readership of over 4,000 clinicians, decision-makers, and researchers worldwide.
ISPOR is a nonprofit, international organization that strives to translate pharmacoeconomics and outcomes research into practice to ensure that society allocates scarce health care resources wisely, fairly, and efficiently.
Source
ISPOR
суббота, 21 мая 2011 г.
Pennsylvania Hospital Readmissions Increase, Report Says
Readmission rates at Pennsylvania hospitals for 20 conditions and procedures increased from 18.7% in 2004 to 19.1% in 2006, according to a report released Thursday by the Pennsylvania Health Care Cost Containment Council, the Pittsburgh Tribune-Review reports. According to the council, the 57,993 readmissions that occurred during that period resulted in nearly $2.3 billion in charges and 352,000 hospital days.
About a quarter of the readmissions, or 15,057, were caused by infections or complications. "Reducing readmissions, especially those related to infections and other complications, is one possible way to restrain health care costs while improving patient care," Council Executive Director Marc Volavka said.
However, according to Harold Miller, a strategic initiatives consultant at the Pittsburgh Regional Healthcare Initiative, readmissions also can result from "things that happen outside the hospital. The patient may need to take a certain kind of medication, and they go home and they don't follow through." He noted that better coordination between hospitals and patients regarding care after hospital discharge could help reduce readmissions (Fabregas, Pittsburgh Tribune-Review, 9/27).
The report is available online
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
About a quarter of the readmissions, or 15,057, were caused by infections or complications. "Reducing readmissions, especially those related to infections and other complications, is one possible way to restrain health care costs while improving patient care," Council Executive Director Marc Volavka said.
However, according to Harold Miller, a strategic initiatives consultant at the Pittsburgh Regional Healthcare Initiative, readmissions also can result from "things that happen outside the hospital. The patient may need to take a certain kind of medication, and they go home and they don't follow through." He noted that better coordination between hospitals and patients regarding care after hospital discharge could help reduce readmissions (Fabregas, Pittsburgh Tribune-Review, 9/27).
The report is available online
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
пятница, 20 мая 2011 г.
Glaucoma Research Highlights From AAO-SOE Joint Meeting Nov. 9
Glaucoma-related highlights of the scientific program of the 2008 Joint Meeting of the American Academy of Ophthalmology (Academy) and European Society of Ophthalmology (SOE) include a study that correlates optic nerve damage in glaucoma patients with carotid artery narrowing and potentially elevated risk for stroke, and a survey that looks at how the practice of fasting, common to the world's seven major religions, may affect patient compliance with treatment for glaucoma and other eye diseases.
Damage to Optic Nerve in Glaucoma Patients May Indicate Significant Carotid Artery Narrowing
Glaucoma is often associated with elevated pressure inside the eye (intraocular pressure, or IOP) which can damage the optic nerve, leading to vision loss and even blindness. Medication and/or surgery allow patients to control their IOP, thus preventing the development of vision loss. Mostafa Elgohary, MD, of Essex County and Broomfield Hospitals in the UK and his colleagues were concerned when several patients who had been under their care for several years continued to lose their vision in one or both eyes even though their IOP had been kept within normal limits either through medicine or surgery.
The authors reviewed 16 retrospective case reports to determine if there was a possible association of internal carotid artery narrowing, or stenosis, with the development of glaucoma or glaucoma-like damage to the optic nerve. The internal carotid arteries are the main arteries in the neck that carry the blood to the brain and the eye. On further investigation, the authors found that six of those patients had significant carotid artery narrowing (greater than 60 percent of the artery lumen) and some even had total blockage of the artery on the same side as the eye with the glaucoma, or on both sides. One patient showed improvement in the visual field after undergoing surgery to remove the blockage. The authors then extended their investigation by prospectively collecting data for 58 patients who were referred with similar optic nerve or visual field changes and carotid artery stenosis as part of the hospital audit system and found that 17 percent of these patients had significant carotid artery narrowing.
The study results are significant because they add to the evidence for the role of reduced blood flow to the optic nerve as a possible cause or predisposing factor for glaucoma or glaucoma-like optic nerve damage. Moreover, the results indicate a possible association with significant carotid artery narrowing which is a potentially serious condition as it carries the risk of stroke. "The study is of a small scale and will obviously need further research to confirm the findings," the authors say. "However, in the meantime it may be prudent to consider referring patients with progressive or asymmetric glaucoma despite normal eye pressure---especially in the presence of cardiovascular risk factors such as hypertension, hypercholesterolemia or ischemia heart disease---for carotid artery Doppler scan to pick up those who could be at high risk for stroke and may benefit from carotid artery treatment."
Could Religious Beliefs Affect Compliance with Ocular Treatment?
For people of strong faith, religious beliefs and related cultural taboos can have a powerful impact on how they care for their health, including the medical treatments they choose to accept. Increasingly, ophthalmologists (Eye M.D.s) in the US and other countries, care for patients of diverse backgrounds. This is accelerating the need for reliable information on the interaction of religious beliefs and compliance with prescribed treatments. The effectiveness of glaucoma treatment, in particular, often depends on patients' ability and willingness to self-administer eye drop medications on a regular schedule over months or years. Glaucoma patients often notice no symptoms in the early stages of the disease, which poses challenges for physicians in motivating patients to stick to treatment regimens. If patients neglect treatment until their vision noticeably declines, the damage is often irreversible.
Many of the world's religions practice obligatory or voluntary fasting---abstaining from food and often also fluid---during periods that can last from a few days to more than a month, on an annual basis. Researchers led by Nishant Kumar, MBBS, of the University Hospital, Liverpool, UK, studied patient compliance in relation to fasting by analyzing 350 surveys completed by members of the worlds' major faiths: Islam, Hinduism, Jainism, Christianity, Judaism, Bahai, and Buddhism (50 surveys per religion) - the first study of its kind, the researchers believe. Population reports show that approximately 20 percent of the world's people are Muslim and about 15 percent are Hindu; fasting is important to both religions. It is mandatory during the daylight hours of the month of Ramadan for Muslims; for Hindus fasting is generally voluntary.
Dr. Kumar's team previously surveyed Muslim patients on their use of prescribed eye drops during Ramadan and concluded that treatment compliance was significantly reduced in patients who kept the fast. If patients reduced or stopped their glaucoma treatment for an extended period, such as the month of Ramadan or other continuous fasting periods, their vision could be adversely affected.
In the new survey, the majority of patients self-identified as Hindus, Muslims and Jains stated that the use of eye drops during their fasting hours would break their fast, and therefore they would not use drops while fasting. However, these patient groups said they would be more likely to use drops while fasting for painful eye conditions or if vision was affected. The majority of Christian, Buddhist, Bahai and Jewish survey respondents did not believe that using drops would break their fasts, and stated that they would use eye drops during their fasting periods.
Dr. Kumar concludes: "A broad awareness among ophthalmologists regarding the religious beliefs of the patient groups they treat will allow them to formulate management plans in keeping with these beliefs without compromising care." He adds that medical specialties such as hematology, neurology, endocrinology, in the treatment of diabetes, have led the way in developing such management strategies.
About the Academy-SOE Joint Meeting
The 2008 Joint Meeting of the American Academy of Ophthalmology and European Society of Ophthalmology is the largest and most comprehensive ophthalmic educational meeting in the world. It is in session November 8 to 11 at the Georgia World Congress Center, Atlanta. Offerings include 277 continuing medical education courses, 179 "Breakfast with the Experts" roundtables, 95 skills transfer courses, and more than 100 hours of scientific presentations, at no charge.
About the American Academy of Ophthalmology
AAO is the world's largest association of eye physicians and surgeons - Eye M.D.s - with more than 27,000 members worldwide. Eye health care is provided by the three "O's" - opticians, optometrists and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery. To find an Eye M.D. in your area, visit the Academy's Web site at aao/
Damage to Optic Nerve in Glaucoma Patients May Indicate Significant Carotid Artery Narrowing
Glaucoma is often associated with elevated pressure inside the eye (intraocular pressure, or IOP) which can damage the optic nerve, leading to vision loss and even blindness. Medication and/or surgery allow patients to control their IOP, thus preventing the development of vision loss. Mostafa Elgohary, MD, of Essex County and Broomfield Hospitals in the UK and his colleagues were concerned when several patients who had been under their care for several years continued to lose their vision in one or both eyes even though their IOP had been kept within normal limits either through medicine or surgery.
The authors reviewed 16 retrospective case reports to determine if there was a possible association of internal carotid artery narrowing, or stenosis, with the development of glaucoma or glaucoma-like damage to the optic nerve. The internal carotid arteries are the main arteries in the neck that carry the blood to the brain and the eye. On further investigation, the authors found that six of those patients had significant carotid artery narrowing (greater than 60 percent of the artery lumen) and some even had total blockage of the artery on the same side as the eye with the glaucoma, or on both sides. One patient showed improvement in the visual field after undergoing surgery to remove the blockage. The authors then extended their investigation by prospectively collecting data for 58 patients who were referred with similar optic nerve or visual field changes and carotid artery stenosis as part of the hospital audit system and found that 17 percent of these patients had significant carotid artery narrowing.
The study results are significant because they add to the evidence for the role of reduced blood flow to the optic nerve as a possible cause or predisposing factor for glaucoma or glaucoma-like optic nerve damage. Moreover, the results indicate a possible association with significant carotid artery narrowing which is a potentially serious condition as it carries the risk of stroke. "The study is of a small scale and will obviously need further research to confirm the findings," the authors say. "However, in the meantime it may be prudent to consider referring patients with progressive or asymmetric glaucoma despite normal eye pressure---especially in the presence of cardiovascular risk factors such as hypertension, hypercholesterolemia or ischemia heart disease---for carotid artery Doppler scan to pick up those who could be at high risk for stroke and may benefit from carotid artery treatment."
Could Religious Beliefs Affect Compliance with Ocular Treatment?
For people of strong faith, religious beliefs and related cultural taboos can have a powerful impact on how they care for their health, including the medical treatments they choose to accept. Increasingly, ophthalmologists (Eye M.D.s) in the US and other countries, care for patients of diverse backgrounds. This is accelerating the need for reliable information on the interaction of religious beliefs and compliance with prescribed treatments. The effectiveness of glaucoma treatment, in particular, often depends on patients' ability and willingness to self-administer eye drop medications on a regular schedule over months or years. Glaucoma patients often notice no symptoms in the early stages of the disease, which poses challenges for physicians in motivating patients to stick to treatment regimens. If patients neglect treatment until their vision noticeably declines, the damage is often irreversible.
Many of the world's religions practice obligatory or voluntary fasting---abstaining from food and often also fluid---during periods that can last from a few days to more than a month, on an annual basis. Researchers led by Nishant Kumar, MBBS, of the University Hospital, Liverpool, UK, studied patient compliance in relation to fasting by analyzing 350 surveys completed by members of the worlds' major faiths: Islam, Hinduism, Jainism, Christianity, Judaism, Bahai, and Buddhism (50 surveys per religion) - the first study of its kind, the researchers believe. Population reports show that approximately 20 percent of the world's people are Muslim and about 15 percent are Hindu; fasting is important to both religions. It is mandatory during the daylight hours of the month of Ramadan for Muslims; for Hindus fasting is generally voluntary.
Dr. Kumar's team previously surveyed Muslim patients on their use of prescribed eye drops during Ramadan and concluded that treatment compliance was significantly reduced in patients who kept the fast. If patients reduced or stopped their glaucoma treatment for an extended period, such as the month of Ramadan or other continuous fasting periods, their vision could be adversely affected.
In the new survey, the majority of patients self-identified as Hindus, Muslims and Jains stated that the use of eye drops during their fasting hours would break their fast, and therefore they would not use drops while fasting. However, these patient groups said they would be more likely to use drops while fasting for painful eye conditions or if vision was affected. The majority of Christian, Buddhist, Bahai and Jewish survey respondents did not believe that using drops would break their fasts, and stated that they would use eye drops during their fasting periods.
Dr. Kumar concludes: "A broad awareness among ophthalmologists regarding the religious beliefs of the patient groups they treat will allow them to formulate management plans in keeping with these beliefs without compromising care." He adds that medical specialties such as hematology, neurology, endocrinology, in the treatment of diabetes, have led the way in developing such management strategies.
About the Academy-SOE Joint Meeting
The 2008 Joint Meeting of the American Academy of Ophthalmology and European Society of Ophthalmology is the largest and most comprehensive ophthalmic educational meeting in the world. It is in session November 8 to 11 at the Georgia World Congress Center, Atlanta. Offerings include 277 continuing medical education courses, 179 "Breakfast with the Experts" roundtables, 95 skills transfer courses, and more than 100 hours of scientific presentations, at no charge.
About the American Academy of Ophthalmology
AAO is the world's largest association of eye physicians and surgeons - Eye M.D.s - with more than 27,000 members worldwide. Eye health care is provided by the three "O's" - opticians, optometrists and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery. To find an Eye M.D. in your area, visit the Academy's Web site at aao/
четверг, 19 мая 2011 г.
In Australia Doctor-Pharmacist Partnership Reduces Hospitalization For Heart Failure
Thinking "outside the medicine cabinet" is paying off in Australia, where a doctor-pharmacist partnership is reducing hospitalizations for heart failure - one of the most expensive conditions to treat - researchers report in Circulation: Heart Failure.
In the American Heart Association journal, researchers describe a collaborative model for ensuring heart failure patients take their medicines properly. The rate of hospitalization was cut by 45 percent in the first year of being part of a collaborative medicines review service.
"This is the first study to show these benefits in real-world practice rather than in a trial setting," said Elizabeth E. Roughead, Ph.D., lead author of the study and a pharmacist and associate professor in the School of Pharmacy and Medical Sciences at the University of South Australia in Adelaide. "If you have heart failure, getting a home visit with your pharmacist and then having a follow-up visit with your doctor about your medicines can keep you out of the hospital."
Researchers followed 273 heart failure patients over age 65 who underwent collaborative medicine review and compared them to 5,444 controls who didn't have their medicines reviewed. The participants were Australian veterans, who have extremely detailed medical records. All participants took one of three types of beta blocker drugs. Before these drugs are used, Australian physicians must sign paperwork confirming a heart failure diagnosis.
Those in the test group were slightly sicker than controls, and had more co-morbidities (eight other conditions vs. seven for the controls). Compared to controls, the group undergoing medicine review also had more prescriptions, more changes in medication prior to their home review, prescriptions from a higher number of caregivers and more hospitalizations.
After adjusting for a range of possible confounders, the researchers found that only 5.5 percent of the patients in the collaborative review group were hospitalized within a year, compared to 12 percent of the control group.
The collaborative approach features house calls with a twist: Pharmacists go to patients' homes and ask them to bring out all their prescription and non-prescription medications. The pharmacists are trained to notice signs of possible medication misuse, including under-dosing, overdosing and hoarding unneeded medicines from old prescriptions - a habit that increases the chance of accidentally taking the wrong medicine.
The pharmacists also look for over-the-counter medications and vitamins that could interact with the patients' prescription drugs. The average age of patients in both groups was 81.6 years, Roughead said.
Under the system used in Australia since 2001, a patient's general practitioner provides a referral to a pharmacist with the special collaborative training. The pharmacist conducts an interview, preferably in the patient's home, and reports findings from the review to the general practitioner. The report notes any known or potential problems the patient may have managing their medicines. The doctor then follows up with the patient if necessary. That follow-up could include showing the patient how, why and when to take their medicines or discussing proper ways to store the drugs as well as describing possible interactions between prescriptions, non-prescription medicines or vitamins found in the home by the pharmacist.
"Poor use of medicines can increase costs enormously," Roughead said. "This study indicates that investing in improvements in medication management can result in more cost-effective health care."
Co-authors include John D. Barratt, B. Pharm., B. App. Sc.; Emmae Ramsay, B.Sc.; Nicole Pratt, B.Sc.; Philip Ryan, M.B.B.S.; Robert Peck, B. Pharm.; Graeme Killer, M.B.B.S. and Andrew L. Gilbert, Ph.D. Author disclosures are on the manuscript.
The Australian Government Department of Veterans' Affairs funded the research.
In the American Heart Association journal, researchers describe a collaborative model for ensuring heart failure patients take their medicines properly. The rate of hospitalization was cut by 45 percent in the first year of being part of a collaborative medicines review service.
"This is the first study to show these benefits in real-world practice rather than in a trial setting," said Elizabeth E. Roughead, Ph.D., lead author of the study and a pharmacist and associate professor in the School of Pharmacy and Medical Sciences at the University of South Australia in Adelaide. "If you have heart failure, getting a home visit with your pharmacist and then having a follow-up visit with your doctor about your medicines can keep you out of the hospital."
Researchers followed 273 heart failure patients over age 65 who underwent collaborative medicine review and compared them to 5,444 controls who didn't have their medicines reviewed. The participants were Australian veterans, who have extremely detailed medical records. All participants took one of three types of beta blocker drugs. Before these drugs are used, Australian physicians must sign paperwork confirming a heart failure diagnosis.
Those in the test group were slightly sicker than controls, and had more co-morbidities (eight other conditions vs. seven for the controls). Compared to controls, the group undergoing medicine review also had more prescriptions, more changes in medication prior to their home review, prescriptions from a higher number of caregivers and more hospitalizations.
After adjusting for a range of possible confounders, the researchers found that only 5.5 percent of the patients in the collaborative review group were hospitalized within a year, compared to 12 percent of the control group.
The collaborative approach features house calls with a twist: Pharmacists go to patients' homes and ask them to bring out all their prescription and non-prescription medications. The pharmacists are trained to notice signs of possible medication misuse, including under-dosing, overdosing and hoarding unneeded medicines from old prescriptions - a habit that increases the chance of accidentally taking the wrong medicine.
The pharmacists also look for over-the-counter medications and vitamins that could interact with the patients' prescription drugs. The average age of patients in both groups was 81.6 years, Roughead said.
Under the system used in Australia since 2001, a patient's general practitioner provides a referral to a pharmacist with the special collaborative training. The pharmacist conducts an interview, preferably in the patient's home, and reports findings from the review to the general practitioner. The report notes any known or potential problems the patient may have managing their medicines. The doctor then follows up with the patient if necessary. That follow-up could include showing the patient how, why and when to take their medicines or discussing proper ways to store the drugs as well as describing possible interactions between prescriptions, non-prescription medicines or vitamins found in the home by the pharmacist.
"Poor use of medicines can increase costs enormously," Roughead said. "This study indicates that investing in improvements in medication management can result in more cost-effective health care."
Co-authors include John D. Barratt, B. Pharm., B. App. Sc.; Emmae Ramsay, B.Sc.; Nicole Pratt, B.Sc.; Philip Ryan, M.B.B.S.; Robert Peck, B. Pharm.; Graeme Killer, M.B.B.S. and Andrew L. Gilbert, Ph.D. Author disclosures are on the manuscript.
The Australian Government Department of Veterans' Affairs funded the research.
среда, 18 мая 2011 г.
How To Increase Patient Understanding In Health-Care Facilities
Studies show that nearly half of all Americans have difficulty understanding health information. Confusing medical directions, such as dosage and timing of prescription medicine, can lead to serious consequences including health setbacks, inappropriate hospital admissions and, sometimes, death. Now, researchers at the University of Missouri School of Health Professions are examining what health care facilities can do to increase patient understanding and positive outcomes.
Diane Smith, an assistant professor in MU's Department of Occupational Therapy and a collaborator with the University of Missouri's Center for Health Policy, and four occupational therapy graduate students conducted a pilot study focusing on the "health literacy environment" of two health care facilities. "Health literacy" is defined as a patient's ability to understand the health information provided to them by health professionals. The study focused on ease of navigation, including use of signage, facility maps and verbal & written communication.
"Our study is directed toward the provider making health information easier to understand for the client," said Smith, who is the interim chair of the occupational therapy department. "If patients can understand information better, they are going to be more compliant with medical direction. If they are more compliant, they are more likely to get better outcomes."
The study examined a rehabilitation facility and an independent senior-living facility. Although both facilities exhibited many strong points, both had areas in need of improvement. At the independent living facility, paperwork was written at a college-sophomore reading level. Previous studies have recommended that medical information be written at a fifth to eighth-grade reading level. Another common health literacy issue is clear oral communication between health care professionals and patients. At the rehabilitation facility, health care professionals rarely asked patients if they were "being clear." Problems with oral communication also extend to a lack of availability of multilingual employees who can translate for providers. Following the evaluation, the researchers gave suggestions to each facility.
Smith recommends several steps that the health care industry can take to increase patient understanding:
Health care professionals should use plain language, instead of professional jargon, as well as make sure a patient understands their directions.
Printed materials should be available in large, easy-to-read fonts and written at a fifth to eighth grade level.
Clear maps and consistent navigational signs should be posted throughout the interior, as well as on the exterior of the building.
Wheelchair accessibility also should be a consideration beyond mobility. For example, maps should be posted at wheelchair-level.
Smith is working to educate current and future health care professionals on the importance of patient understanding by speaking at professional conferences and advocating curriculum changes. This year, Smith has spoken and is scheduled to speak at professional conferences for rehabilitation professionals including occupational and speech therapists. MU's School of Health Professions also has added a health care literacy requirement to some of its degree programs.
"Health literacy is even more important as people are being discharged sooner from hospitals and are charged with their own care," Smith said. "I don't think miscommunication with patients is anything that anyone does on purpose. To facilitate better understanding, health literacy is something that should be more on the forefront of curriculum."
Smith is planning a future study focusing on more health care facilities in Missouri. The study was published in the journal Occupational Therapy in Health Care.
Diane Smith, an assistant professor in MU's Department of Occupational Therapy and a collaborator with the University of Missouri's Center for Health Policy, and four occupational therapy graduate students conducted a pilot study focusing on the "health literacy environment" of two health care facilities. "Health literacy" is defined as a patient's ability to understand the health information provided to them by health professionals. The study focused on ease of navigation, including use of signage, facility maps and verbal & written communication.
"Our study is directed toward the provider making health information easier to understand for the client," said Smith, who is the interim chair of the occupational therapy department. "If patients can understand information better, they are going to be more compliant with medical direction. If they are more compliant, they are more likely to get better outcomes."
The study examined a rehabilitation facility and an independent senior-living facility. Although both facilities exhibited many strong points, both had areas in need of improvement. At the independent living facility, paperwork was written at a college-sophomore reading level. Previous studies have recommended that medical information be written at a fifth to eighth-grade reading level. Another common health literacy issue is clear oral communication between health care professionals and patients. At the rehabilitation facility, health care professionals rarely asked patients if they were "being clear." Problems with oral communication also extend to a lack of availability of multilingual employees who can translate for providers. Following the evaluation, the researchers gave suggestions to each facility.
Smith recommends several steps that the health care industry can take to increase patient understanding:
Health care professionals should use plain language, instead of professional jargon, as well as make sure a patient understands their directions.
Printed materials should be available in large, easy-to-read fonts and written at a fifth to eighth grade level.
Clear maps and consistent navigational signs should be posted throughout the interior, as well as on the exterior of the building.
Wheelchair accessibility also should be a consideration beyond mobility. For example, maps should be posted at wheelchair-level.
Smith is working to educate current and future health care professionals on the importance of patient understanding by speaking at professional conferences and advocating curriculum changes. This year, Smith has spoken and is scheduled to speak at professional conferences for rehabilitation professionals including occupational and speech therapists. MU's School of Health Professions also has added a health care literacy requirement to some of its degree programs.
"Health literacy is even more important as people are being discharged sooner from hospitals and are charged with their own care," Smith said. "I don't think miscommunication with patients is anything that anyone does on purpose. To facilitate better understanding, health literacy is something that should be more on the forefront of curriculum."
Smith is planning a future study focusing on more health care facilities in Missouri. The study was published in the journal Occupational Therapy in Health Care.
вторник, 17 мая 2011 г.
Kaiser Daily HIV/AIDS Report Highlights Recently Released Journal Articles On HIV/AIDS
The following highlights recently released journal articles on HIV/AIDS.
"The Role of Health Care in the Spread of HIV/AIDS in Africa: Evidence From Kenya," International Journal of STD and AIDS: Stuart Brody of the University of Paisley in Scotland and Eva Deuchert of the University of Freiburg in Germany analyzed data from the 2003 Kenya Demographic and Health Survey of 1,620 pregnant women who did not report being HIV-positive prior to receiving neonatal tetanus-toxoid shots, the Washington Times reports. The researchers found that the pregnant women who received a tetanus shots were almost twice as likely to subsequently test HIV-positive, compared with those who did not receive a tetanus shot. According to Brody, the findings of the study and previous studies provide "mounting evidence" that health organizations are "misguided" in focusing HIV-prevention efforts on a strategy that promotes safer sex. George Schmid, a senior researcher for the World Health Organization's HIV/AIDS Department, questioned the study's design and findings. According to Schmid, less than 5% of infections worldwide are transmitted by unsafe injections (Bawa, Washington Times, 11/1). The study authors recommend that health care resources be reallocated to address health care-related HIV transmission (Brody/Deuchert, International Journal of STD and AIDS, November 2006).
"Pregnant Women With HIV Infection Can Expect Healthy Survival: Three-Year Follow-Up," Journal of Acquired Immune Deficiency Syndromes: Fabiola Martin of St. Mary's NHS Trust in London and colleagues followed up with 311 HIV-positive pregnant women who had given birth to assess their long-term health, Reuters Health reports (Reuters Health, 10/30). The researchers divided the women into three groups depending on their immune status. One group was treated with zidovudine monotherapy, the second group received highly active antiretroviral therapy during and after pregnancy, and a third group received short-term HAART during pregnancy only (Martin et al., JAIDS, 10/1). The average follow-up time was 33 months, according to Reuters Health. The study found that 98% of all the women survived through the last follow-up visit without progressing to AIDS. The study also found that three of the 85 women who received zidovudine monotherapy had disease progression; two of the 154 women who were treated with HAART during and after pregnancy had disease progression; and one of the 71 women who were treated with short-term HAART during pregnancy had disease progression. Researchers concluded that with access to HAART, teh progression to AIDS for women giving birth is uncommon, and it is possible to achieve a frequency of mother-to-child HIV transmission that is less than 1% (Reuters Health, 10/30).
"Initial Highly Active Antiretroviral Therapy With a Protease Inhibitor Versus a Non-Nucleoside Reverse Transcriptase Inhibitor: Discrepancies Between Direct and Indirect Meta-Analyses," Lancet: Roger Chou of Oregon Health and Science University and colleagues reviewed 12 trials over 24 weeks comparing non-nucleoside reverse transcriptase inhibitor-based highly active antiretroviral treatment, which can sometimes be administered once daily, with protease inhibitor-based HAART, which must be taken more frequently, in HIV-positive people who had little or no previous antiretroviral exposure (Chou et al., Lancet, 10/28). The study found that NNRTI-based treatment regimens were more effective at decreasing viral load than PI-based regimens and that they were as effective as PI-based regimens in fighting disease progression. In addition, the study found that similar numbers of HIV-positive people in both treatment groups stopped taking HAART because of adverse effects associated with the medication. According to researchers, the findings favor NNRTIs as a more convenient HIV/AIDS treatment method that could boost patient adherence to the drug regimen (CQ HealthBeat, 10/27).
"Short-Term Risk of AIDS or Death in People Infected With HIV-1 Before Antiretroviral Therapy in South Africa: A Longitudinal Study," Lancet: Motasim Badri of the Desmond Tutu HIV Centre at the University of Cape Town in Cape Town, South Africa, and colleagues examined 1,399 HIV-positive people residing in Cape Town who had no access to antiretroviral drugs or who were receiving zidovudine only and cohorts of HIV-positive Europeans and Australians at similar clinical stages of the disease to determine when antiretroviral therapy should begin in resource-limited settings (Badri et al., Lancet, 10/7). The study noted that current World Health Organization guidelines, which recommend that HIV-positive people in lower-income countries begin antiretroviral treatment when their CD4+ T cell counts fall below 200, are based on studies carried out in high-income countries (SAPA/Business Day, 10/30). The study found that the Cape Town residents with CD4+ T cell counts of less than 200 or greater than 350 had a similar six-month risk of progression to AIDS to those in the European and Australian cohorts. However, for participants in Cape Town with CD4+ T cell counts between 200 and 350, the risk of progressing to AIDS was 1.9 times greater, compared with the European and Australian cohorts. "The high death rate before development of AIDS and a high risk of AIDS in those with CD4 cell counts of 200 to 350 cells ... indicate that delay in initiation of [antiretroviral therapy] is associated with increased morbidity and mortality," the researchers write, concluding, "These findings might help to amend criteria for start of ART in resource-limited settings" (Badri et al., Lancet, 10/7).
"HIV Stigma, and Rates of Infection: A Rumour Without Evidence," PLoS Medicine: "On any ranked list of stigmatized conditions, HIV would have to lie towards the top," but the "actual evidence base" to prove a direct link between HIV-related stigma and the pandemic "is almost nonexistent," Daniel Reidpath of Brunel University's Centre for Public Health Research and Kit Yee Chan of Deakin University's School of Health and Social Development write in a PLoS Medicine essay. Blaming stigma for fueling the HIV/AIDS pandemic "gives too much weight to individual behavioral change as the answer to HIV prevention," Reidpath and Yee Chan write, adding that it also "neglects the more difficult issues" associated with how "HIV spreads in populations, the social vulnerabilities it exploits and the ways in which individuals within subpopulations interact with each other and with members of other subpopulations." The authors add that there are some "core scientific issues" that need to be resolved if the question of the link between HIV stigma and the HIV/AIDS pandemic is to be determined. "Whether HIV stigma is one of the greatest barriers to the global control of the epidemic remains a hypothesis," the authors write, concluding, "The scientific investigation of it demands significant effort, and should be a matter of priority" (Reidpath/Yee Chan, PLoS Medicine, October 2006).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
понедельник, 16 мая 2011 г.
Telemedicine System Using Interactive Digital Television
Telecommunications engineer at the Public University of Navarre, Alejandro Fanjul Fern??ndez, has designed a pioneering system of telemedicine for interactive digital television. This system enables the monitoring and treatment of and support for both patients and elderly people, from the comfort and convenience of their homes, by means of the television. This is the first tele-assistence system in Spain for interactive digital television and a number of companies and government bodies have expressed interest in marketing the application.
Alejandro Fanjul Fern??ndez has worked on this project for his graduate thesis, under the auspices of Mikel Sag???©s Garc?a and within the remit of the MHProject research group of the Department of Electrical and Electronic Engineering at the Public University of Navarre. He focused his activity on research into and implementation of innovative technology within the Multimedia Home Platform (MHP) for interactive digital television.
This designed tele-assistance system, known as ATS-Interactiva, focuses its services on the monitoring and treatment of and support for patients by means of television. To this end, every so often, a series of check-ups and medication reminders are carried out, which at the same time enable a channel of communication to be opened up between the health care professional and the patient.
Monitoring of patients and interactive dosifier
Through a complex system of data treatment and interactivity with the patient, the ATS-Interactiva system enables doctors to have a complete system of monitoring of patients at hand at all times, enabling them to assess patients' progress through the observation of their vital signs: weight, pulse, blood pressure, glucose level and so on.
This application may be of great benefit in the monitoring of patients who are convalescing in a post-operative recovery stage but who can carry out their basic functions in an independent manner. It is also of great interest to some seniors who require a minimum of control and monitoring of their state of health on a daily basis. The patients can be monitored without them having to be transferred to a health clinic or hospital - the monitoring being undertaken simply from their sitting-room sofa using the TV remote control.
Moreover, for the over 60s who watch more than 4?? hours of TV daily, the system has an application known as an "interactive dosifier" that provides a personalised reminder for the administration of medicines. In this way, when the patient is due to take medication, the system emits a sound signal and a nurse appears on the TV screen to remind the patient of what has to be taken and a complete description or written recommendation from the doctor on how it should be taken.
The system also enables communication between the patient and the doctor through interactive messages or by electronic mail, again using the TV set. Today the possibility of communicating with the doctor has become vital in the treatment of any kind of ailment. This creates genuine patient-health care professional trust when dealing with a possible health problem.
The application of tele-assistance, moreover, does not interfere with television viewing, as the screen can be minimised or left in the background of the TV screen in such a way that, while the system is operating, TV programmes continue to be seen, the system information appearing in the foreground only when the patient has to be reminded or she or he requests information.
Personalised system
The ATS-Interactiva identifies the patient by means of an intelligent card, in such a way that he or she may locate to a different town and the monitoring can continue, as long as the intelligent card is carried on their person and connected to a receptor where the ATS-Interactiva application is available. In principle the emission of the system over a specific TV channel is being considered
As regards future developments of this system, Alejandro Fanjul has revealed that the possibility of adapting it to function using mobile phones with DVB-H technology is being studied. In order to facilitate the introduction of data into the system, they are working on the use of sensors that directly transfer data to the system, with minimal intervention by the user.
Contact: Oihane Lakar
Elhuyar Fundazioa
Alejandro Fanjul Fern??ndez has worked on this project for his graduate thesis, under the auspices of Mikel Sag???©s Garc?a and within the remit of the MHProject research group of the Department of Electrical and Electronic Engineering at the Public University of Navarre. He focused his activity on research into and implementation of innovative technology within the Multimedia Home Platform (MHP) for interactive digital television.
This designed tele-assistance system, known as ATS-Interactiva, focuses its services on the monitoring and treatment of and support for patients by means of television. To this end, every so often, a series of check-ups and medication reminders are carried out, which at the same time enable a channel of communication to be opened up between the health care professional and the patient.
Monitoring of patients and interactive dosifier
Through a complex system of data treatment and interactivity with the patient, the ATS-Interactiva system enables doctors to have a complete system of monitoring of patients at hand at all times, enabling them to assess patients' progress through the observation of their vital signs: weight, pulse, blood pressure, glucose level and so on.
This application may be of great benefit in the monitoring of patients who are convalescing in a post-operative recovery stage but who can carry out their basic functions in an independent manner. It is also of great interest to some seniors who require a minimum of control and monitoring of their state of health on a daily basis. The patients can be monitored without them having to be transferred to a health clinic or hospital - the monitoring being undertaken simply from their sitting-room sofa using the TV remote control.
Moreover, for the over 60s who watch more than 4?? hours of TV daily, the system has an application known as an "interactive dosifier" that provides a personalised reminder for the administration of medicines. In this way, when the patient is due to take medication, the system emits a sound signal and a nurse appears on the TV screen to remind the patient of what has to be taken and a complete description or written recommendation from the doctor on how it should be taken.
The system also enables communication between the patient and the doctor through interactive messages or by electronic mail, again using the TV set. Today the possibility of communicating with the doctor has become vital in the treatment of any kind of ailment. This creates genuine patient-health care professional trust when dealing with a possible health problem.
The application of tele-assistance, moreover, does not interfere with television viewing, as the screen can be minimised or left in the background of the TV screen in such a way that, while the system is operating, TV programmes continue to be seen, the system information appearing in the foreground only when the patient has to be reminded or she or he requests information.
Personalised system
The ATS-Interactiva identifies the patient by means of an intelligent card, in such a way that he or she may locate to a different town and the monitoring can continue, as long as the intelligent card is carried on their person and connected to a receptor where the ATS-Interactiva application is available. In principle the emission of the system over a specific TV channel is being considered
As regards future developments of this system, Alejandro Fanjul has revealed that the possibility of adapting it to function using mobile phones with DVB-H technology is being studied. In order to facilitate the introduction of data into the system, they are working on the use of sensors that directly transfer data to the system, with minimal intervention by the user.
Contact: Oihane Lakar
Elhuyar Fundazioa
воскресенье, 15 мая 2011 г.
Get Well Soon - Without Antibiotics, UK
We must all play a part in conserving antibiotics to help tackle
infections
The Government will today launch a national campaign to remind
doctors of the problem of antibiotic resistance and make clear to
patients that antibiotics will not get rid of the common cold.
Almost a decade after the original national public education campaign
to discourage over-use of antibiotics, the Government has warned that
resistance is still on the increase and action is necessary to
preserve the efficacy of the drugs that we have.
Chief Medical Officer, Liam Donaldson said:
"Antibiotic resistance is becoming more common and in recent years
fewer new antibiotics have been discovered. Antibiotics treat
bacterial infections but all colds and most coughs and sore throats
are caused by viruses so cannot be cured with antibiotics.
"The more we take antibiotics when they are not necessary, the more
bacteria will become resistant to them. We must all play a part in
conserving antibiotics as a valuable clinical resource. Patients can
take other remedies to help relieve the symptoms of a cough or cold.
Their pharmacist is well placed to give them advice."
Patients sometimes request antibiotics from doctors 'just in case'.
But bacteria adapt and find ways to survive the effects of an
antibiotic, becoming 'antibiotic resistant'. The more we use an
antibiotic, the more likely it is that bacteria will become resistant
to it. This can lead to antibiotics becoming less effective at
fighting infections
If a patient is prescribed antibiotics they should not stop taking
them as soon as the symptoms fade. Antibiotics should be taken as
prescribed and the course should be finished, unless a doctor or
pharmacist advises otherwise. Antibiotic resistance is more likely to
develop if antibiotics are not taken regularly or taken in too low a
dose.
Adverts will appear in national newspapers and magazines. Posters and
leaflets will also be placed in GPs surgeries and pharmacies.
Notes:
1. Copies of the posters and leaflets can be found at
nhs.uk/antibiotics
2. Patients are advised to see a doctor if
- a cough lasts more than three weeks,
- shortness of breath or chest pains develop,
- if they already have a chest complaint.
Patients should also see a doctor if you are worried about symptoms.
3. The last national public education campaign was launched by the
Chief Medical Officer in October 1999. This was based on the cartoon
character "Andybiotic".
4. In 2006/7 the NHS spent 175.8million on antibiotics prescribed in
the community. This does not include antibiotics prescribed in
hospitals.
5. On 8th January 2008, DH launched the strategy 'Clean, safe care'
to provide guidance on infection control and cleanliness in the NHS.
Supported by extra funding of ??270 million per year by 2010/11, The
funding will allow local organisations to invest up to ??45m on
additional specialist staff which could include antimicrobial
pharmacists.
dh.uk
infections
The Government will today launch a national campaign to remind
doctors of the problem of antibiotic resistance and make clear to
patients that antibiotics will not get rid of the common cold.
Almost a decade after the original national public education campaign
to discourage over-use of antibiotics, the Government has warned that
resistance is still on the increase and action is necessary to
preserve the efficacy of the drugs that we have.
Chief Medical Officer, Liam Donaldson said:
"Antibiotic resistance is becoming more common and in recent years
fewer new antibiotics have been discovered. Antibiotics treat
bacterial infections but all colds and most coughs and sore throats
are caused by viruses so cannot be cured with antibiotics.
"The more we take antibiotics when they are not necessary, the more
bacteria will become resistant to them. We must all play a part in
conserving antibiotics as a valuable clinical resource. Patients can
take other remedies to help relieve the symptoms of a cough or cold.
Their pharmacist is well placed to give them advice."
Patients sometimes request antibiotics from doctors 'just in case'.
But bacteria adapt and find ways to survive the effects of an
antibiotic, becoming 'antibiotic resistant'. The more we use an
antibiotic, the more likely it is that bacteria will become resistant
to it. This can lead to antibiotics becoming less effective at
fighting infections
If a patient is prescribed antibiotics they should not stop taking
them as soon as the symptoms fade. Antibiotics should be taken as
prescribed and the course should be finished, unless a doctor or
pharmacist advises otherwise. Antibiotic resistance is more likely to
develop if antibiotics are not taken regularly or taken in too low a
dose.
Adverts will appear in national newspapers and magazines. Posters and
leaflets will also be placed in GPs surgeries and pharmacies.
Notes:
1. Copies of the posters and leaflets can be found at
nhs.uk/antibiotics
2. Patients are advised to see a doctor if
- a cough lasts more than three weeks,
- shortness of breath or chest pains develop,
- if they already have a chest complaint.
Patients should also see a doctor if you are worried about symptoms.
3. The last national public education campaign was launched by the
Chief Medical Officer in October 1999. This was based on the cartoon
character "Andybiotic".
4. In 2006/7 the NHS spent 175.8million on antibiotics prescribed in
the community. This does not include antibiotics prescribed in
hospitals.
5. On 8th January 2008, DH launched the strategy 'Clean, safe care'
to provide guidance on infection control and cleanliness in the NHS.
Supported by extra funding of ??270 million per year by 2010/11, The
funding will allow local organisations to invest up to ??45m on
additional specialist staff which could include antimicrobial
pharmacists.
dh.uk
суббота, 14 мая 2011 г.
Questionnaire Helps Doctors Predict Which Patients Will Stick To Physical Therapy
Patients' responses to a simple questionnaire can reliably predict whether they will adhere to physical therapy after spine surgery, Johns Hopkins researchers suggest in a new study. The findings could help physicians identify patients who might benefit from additional preoperative preparation to ensure they attend therapy sessions and follow through with prescribed exercise, a factor that can greatly affect their long-term recovery.
"It has long been known that physical therapy after spine surgery greatly improves outcomes, but to date, there has been no easy-to-administer, standardized method for assessing a patient's willingness to adhere to therapy," says Richard L. Skolasky, Sc.D., of the Department of Orthopaedic Surgery at Johns Hopkins University School of Medicine.
In the study, published online in the Oct. 1 Spine, Skolasky and his colleagues demonstrated that spine surgery patients who scored high on the Patient Activation Measure (PAM) questionnaire were 38 percent more likely to attend physical therapy and were rated as significantly more engaged in rehabilitation by their physical therapists compared to patients with low PAM scores.
The PAM, developed in 2004, is a participant-completed, 13-item questionnaire that assesses a patient's ability to play an active role in his or her health care. To date, it has been studied for use with chronic diseases such as HIV, type 2 diabetes and hypertension. This is the first time it has been applied to surgery and physical therapy.
This questionnaire asks patients to rate their agreement to a variety of statements, ranging from strongly agree to strongly disagree. Examples of statements include: When all is said and done, I am the person who is responsible for managing my health condition; Taking an active role in my own health care is the most important factor in determining my health and ability to function; and, I am confident I can follow through on medical treatments I need to do at home.
"Essentially, the test places patients on a continuum of activation ranging from those who don't see an active role on their part as necessary to those who are highly motivated to take an active role in their own health care," says Skolasky.
The researchers recruited 65 Johns Hopkins patients to participate in the study, funded by the Agency for Healthcare Research and Quality. All underwent their first surgical treatment for a degenerative spine disease between August 2005 and May 2006. Eighty-nine percent were non-Hispanic white and 58 percent were female. The mean age was 58 years old.
Before the surgery, each patient completed a PAM questionnaire. Then, for the next six weeks after surgery, patients recorded how often they attended prescribed physical therapy sessions. After the last therapy session, therapists scored the patients' engagement in physical therapy by rating their attitude, need for prompts, understanding the importance of therapy, and activity during sessions.
Results showed that attendance rose in direct correlation to PAM scores. Patients who had the lowest PAM scores attended 55.6 percent of their therapy sessions. In contrast, those with the highest PAM scores attended physical therapy 94.1 percent of the time. Similarly, engagement scale scores also went up as PAM scores increased.
"These results were very encouraging, and since the PAM is easy to administer, it may provide a practical component to a patient's preoperative treatment," says Skolasky.
Skolasky said that before they can bring the PAM into the examination room, they will need to develop a protocol for improving PAM scores. He and his colleagues are planning a randomized clinical trial in which trained interviewers will meet with patients who score low on the PAM and employ various techniques to improve involvement in their own care. Surgical outcomes for these patients would be compared to outcomes of those who receive standard pre-surgery care.
One area Skolasky plans to focus on is improving communication between patients and doctors. He says patients are sometimes resistant to bring up questions or to discuss problems or symptoms with doctors and instead are more comfortable responding to questions doctors give them. Increasing a patient's knowledge about his or her condition and the steps he or she can take to alleviate symptoms or improve recovery may greatly increase PAM scores, Skolasky notes.
Other researchers from Johns Hopkins who worked on this study include Lee H. Riley, III, M.D., of the Department of Orthopaedic Surgery; Stephen T. Wegener, Ph.D., of the Department of Physical Medicine and Rehabilitation and Ellen J. Mackenzie, Ph.D., of the Department of Health Policy and Management at the Bloomberg School of Public Health.
For more information, go to:
hopkinsortho/html/richard_l__skolasky.html
hopkinsortho/
"It has long been known that physical therapy after spine surgery greatly improves outcomes, but to date, there has been no easy-to-administer, standardized method for assessing a patient's willingness to adhere to therapy," says Richard L. Skolasky, Sc.D., of the Department of Orthopaedic Surgery at Johns Hopkins University School of Medicine.
In the study, published online in the Oct. 1 Spine, Skolasky and his colleagues demonstrated that spine surgery patients who scored high on the Patient Activation Measure (PAM) questionnaire were 38 percent more likely to attend physical therapy and were rated as significantly more engaged in rehabilitation by their physical therapists compared to patients with low PAM scores.
The PAM, developed in 2004, is a participant-completed, 13-item questionnaire that assesses a patient's ability to play an active role in his or her health care. To date, it has been studied for use with chronic diseases such as HIV, type 2 diabetes and hypertension. This is the first time it has been applied to surgery and physical therapy.
This questionnaire asks patients to rate their agreement to a variety of statements, ranging from strongly agree to strongly disagree. Examples of statements include: When all is said and done, I am the person who is responsible for managing my health condition; Taking an active role in my own health care is the most important factor in determining my health and ability to function; and, I am confident I can follow through on medical treatments I need to do at home.
"Essentially, the test places patients on a continuum of activation ranging from those who don't see an active role on their part as necessary to those who are highly motivated to take an active role in their own health care," says Skolasky.
The researchers recruited 65 Johns Hopkins patients to participate in the study, funded by the Agency for Healthcare Research and Quality. All underwent their first surgical treatment for a degenerative spine disease between August 2005 and May 2006. Eighty-nine percent were non-Hispanic white and 58 percent were female. The mean age was 58 years old.
Before the surgery, each patient completed a PAM questionnaire. Then, for the next six weeks after surgery, patients recorded how often they attended prescribed physical therapy sessions. After the last therapy session, therapists scored the patients' engagement in physical therapy by rating their attitude, need for prompts, understanding the importance of therapy, and activity during sessions.
Results showed that attendance rose in direct correlation to PAM scores. Patients who had the lowest PAM scores attended 55.6 percent of their therapy sessions. In contrast, those with the highest PAM scores attended physical therapy 94.1 percent of the time. Similarly, engagement scale scores also went up as PAM scores increased.
"These results were very encouraging, and since the PAM is easy to administer, it may provide a practical component to a patient's preoperative treatment," says Skolasky.
Skolasky said that before they can bring the PAM into the examination room, they will need to develop a protocol for improving PAM scores. He and his colleagues are planning a randomized clinical trial in which trained interviewers will meet with patients who score low on the PAM and employ various techniques to improve involvement in their own care. Surgical outcomes for these patients would be compared to outcomes of those who receive standard pre-surgery care.
One area Skolasky plans to focus on is improving communication between patients and doctors. He says patients are sometimes resistant to bring up questions or to discuss problems or symptoms with doctors and instead are more comfortable responding to questions doctors give them. Increasing a patient's knowledge about his or her condition and the steps he or she can take to alleviate symptoms or improve recovery may greatly increase PAM scores, Skolasky notes.
Other researchers from Johns Hopkins who worked on this study include Lee H. Riley, III, M.D., of the Department of Orthopaedic Surgery; Stephen T. Wegener, Ph.D., of the Department of Physical Medicine and Rehabilitation and Ellen J. Mackenzie, Ph.D., of the Department of Health Policy and Management at the Bloomberg School of Public Health.
For more information, go to:
hopkinsortho/html/richard_l__skolasky.html
hopkinsortho/
пятница, 13 мая 2011 г.
CVS Caremark Study Finds Value Based Insurance Designs Can Increase Adherence In Diabetes Patients
A study by CVS Caremark (NYSE: CVS), published this week in the American Journal of Pharmacy Benefits, finds that insurance benefit designs that reduce the cost of medications for plan participants result in patients being more likely to start and stay on their medication therapy.
The study compared more than 20,000 plan participants in value-based insurance design (VBID) plans to more than 190,000 participants of similar age and gender breakdowns in standard three-tier plans. The study concluded initiation and adherence rates for both insulin and oral diabetes medicines among participants in value-based plans were significantly higher.
"There have been discussions around the impact of price and affordability on patients' ability and willingness to start and stay on their medications and this research adds to that body of knowledge. We took a look at one disease state diabetes and showed how cost impacts a patient's prescription initiation and adherence rates," said Troyen A. Brennan, M.D., M.P.H., Executive Vice President and Chief Medical Officer, CVS Caremark. "This research is important as we seek to educate the public and patients that adherence can be the most cost effective intervention in health care."
In the VBID plans studied, generic co-pays were reduced from $15 to zero, preferred brands dropped to between $10 and $15 from $30, and non-preferred brands remained at $35 co-pay, compared with standard plans which had no changes in co-pays during the study period. Participants in VBID plans had higher prescription initiation rates (2.3% versus 1.6% on the total study population) and lower discontinuation rates (16% versus 24.3%).
This study is part of a broader research effort by CVS Caremark to learn more about why patients do not take prescriptions that are prescribed, or drop the medications in the middle of therapy. The research includes continuing internal analysis of CVS Caremark clients and an external partnership with Harvard and Brigham & Women's Hospital. Separately, a recent study by the New England Healthcare Institute found that not taking medications as prescribed leads to poorer health, more frequent hospitalization, a higher risk of death and as much as $290 billion annually in increased medical costs.
The research findings will be used to develop programs that aim to improve patient education about the importance of adherence, and communications for timely interventions with patients that include face-to-face first fill counseling; IVR and Web refill reminders, renewals and pick-up prompts; and outreach calls to potentially non-adherent patients from their local CVS pharmacist.
"As the health care debate continues, one thing is clear: We all have to find ways to make health care more affordable," Brennan said. "Our passion and expertise is to help our clients receive the best pharmacy care available, and that can be achieved by focusing on adherence to impact the health of our customers and help take costs out of the health care system," Brennan said.
About CVS Caremark
CVS Caremark is the largest pharmacy health care provider in the United States. Through our integrated offerings across the entire spectrum of pharmacy care, we are uniquely positioned to provide greater access, to engage plan participants in behaviors that improve their health and to lower overall health care costs for plan sponsors and participants. CVS Caremark is a market leader in mail order pharmacy, retail pharmacy, specialty pharmacy, and retail clinics. We are also a leading provider of Medicare Part D Prescription Drug Plans. As one of the country's largest pharmacy benefit managers (PBMs), we provide access to a network of approximately 60,000 pharmacies, including approximately 7,000 CVS/pharmacy stores that provide unparalleled service and capabilities. Our clinical expertise includes one of the industry's most comprehensive disease management programs.
The study compared more than 20,000 plan participants in value-based insurance design (VBID) plans to more than 190,000 participants of similar age and gender breakdowns in standard three-tier plans. The study concluded initiation and adherence rates for both insulin and oral diabetes medicines among participants in value-based plans were significantly higher.
"There have been discussions around the impact of price and affordability on patients' ability and willingness to start and stay on their medications and this research adds to that body of knowledge. We took a look at one disease state diabetes and showed how cost impacts a patient's prescription initiation and adherence rates," said Troyen A. Brennan, M.D., M.P.H., Executive Vice President and Chief Medical Officer, CVS Caremark. "This research is important as we seek to educate the public and patients that adherence can be the most cost effective intervention in health care."
In the VBID plans studied, generic co-pays were reduced from $15 to zero, preferred brands dropped to between $10 and $15 from $30, and non-preferred brands remained at $35 co-pay, compared with standard plans which had no changes in co-pays during the study period. Participants in VBID plans had higher prescription initiation rates (2.3% versus 1.6% on the total study population) and lower discontinuation rates (16% versus 24.3%).
This study is part of a broader research effort by CVS Caremark to learn more about why patients do not take prescriptions that are prescribed, or drop the medications in the middle of therapy. The research includes continuing internal analysis of CVS Caremark clients and an external partnership with Harvard and Brigham & Women's Hospital. Separately, a recent study by the New England Healthcare Institute found that not taking medications as prescribed leads to poorer health, more frequent hospitalization, a higher risk of death and as much as $290 billion annually in increased medical costs.
The research findings will be used to develop programs that aim to improve patient education about the importance of adherence, and communications for timely interventions with patients that include face-to-face first fill counseling; IVR and Web refill reminders, renewals and pick-up prompts; and outreach calls to potentially non-adherent patients from their local CVS pharmacist.
"As the health care debate continues, one thing is clear: We all have to find ways to make health care more affordable," Brennan said. "Our passion and expertise is to help our clients receive the best pharmacy care available, and that can be achieved by focusing on adherence to impact the health of our customers and help take costs out of the health care system," Brennan said.
About CVS Caremark
CVS Caremark is the largest pharmacy health care provider in the United States. Through our integrated offerings across the entire spectrum of pharmacy care, we are uniquely positioned to provide greater access, to engage plan participants in behaviors that improve their health and to lower overall health care costs for plan sponsors and participants. CVS Caremark is a market leader in mail order pharmacy, retail pharmacy, specialty pharmacy, and retail clinics. We are also a leading provider of Medicare Part D Prescription Drug Plans. As one of the country's largest pharmacy benefit managers (PBMs), we provide access to a network of approximately 60,000 pharmacies, including approximately 7,000 CVS/pharmacy stores that provide unparalleled service and capabilities. Our clinical expertise includes one of the industry's most comprehensive disease management programs.
вторник, 10 мая 2011 г.
Prescription Drug Makers Increasingly Develop Combination Pills
Prescription drugs increasingly are being offered as combination therapies, in which two or more medications are combined in a single dose, the Los Angeles Times reports. According to the Times, the trend in part is being driven by drug manufacturers facing patent expirations and competition from generic drug makers. For example, Pfizer's combination drug Caduet combines the blood pressure drug Norvasc and the cholesterol drug Lipitor. The patent for Norvasc, which has annual sales of $5 billion, expires this year. Lipitor's patent does not expire until 2010, but annual sales already have declined by billions of dollars because of competition from generic versions of Merck's cholesterol medication Zocor.
Physicians also hope combination drugs will help patients be more compliant with drug regimens. According to endocrinologist Daniel Berger, patients often see additional prescriptions as signs of increasingly serious illnesses and might not take them "out of denial." Multiple treatments combined into a single pill could make illnesses seem more manageable, Berger said.
In addition, some drugs work better in combination -- such as Augmentin, which combines amoxicillin with clavulanic acid. The clavulanic acid prevents amoxicillin from being broken down by the enzymes in the body. Berger added that such synergistic combinations could be prescribed at lower dosages, which could reduce side effects.
Some people taking combination drugs might be able to save money on insurance copayments, but costs largely depend on whether the combination treatment is covered. A study of 30 retail pharmacies and two online pharmacies by Beachhead Consulting shows that while some combination drugs can save patients money, others are more expensive than buying the drugs separately (Kritz, Los Angeles Times, 4/30).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
View drug information on Augmentin; Caduet; Zocor.
Physicians also hope combination drugs will help patients be more compliant with drug regimens. According to endocrinologist Daniel Berger, patients often see additional prescriptions as signs of increasingly serious illnesses and might not take them "out of denial." Multiple treatments combined into a single pill could make illnesses seem more manageable, Berger said.
In addition, some drugs work better in combination -- such as Augmentin, which combines amoxicillin with clavulanic acid. The clavulanic acid prevents amoxicillin from being broken down by the enzymes in the body. Berger added that such synergistic combinations could be prescribed at lower dosages, which could reduce side effects.
Some people taking combination drugs might be able to save money on insurance copayments, but costs largely depend on whether the combination treatment is covered. A study of 30 retail pharmacies and two online pharmacies by Beachhead Consulting shows that while some combination drugs can save patients money, others are more expensive than buying the drugs separately (Kritz, Los Angeles Times, 4/30).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
View drug information on Augmentin; Caduet; Zocor.
понедельник, 9 мая 2011 г.
Women With Osteoporosis Prefer One Tablet Per Month, Study Shows
New US and European clinical data, presented for the first time at the Sixth European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ECCEO), reveal more than 70% of postmenopausal women with osteoporosis* preferred a once-monthly bisphosphonate, finding it more convenient than a once-weekly option.(1)
In the study, the most common reason women gave for their preference was that one tablet a month is easier to follow for a long time. (1) This finding is important as staying on treatment is a major issue in the management of osteoporosis - up to 60% of patients taking a once-weekly bisphosphonate stop treatment within a year, (2-5) so missing out on the bone building benefits these drugs can only provide over time. The authors conclude that a less frequent dosing regimen may help patients stay on their osteoporosis treatment for longer,(1) which ultimately should reduce the risk of fracture.(6) With the number of osteoporotic fractures in Europe estimated at 3.79 million,(7) improvements in the management of this disease are essential.
Commenting on the results, Dr Peyman Hadji, lead author and Head of the Department of Endocrinology, Osteoporosis and Reproductive Medicine at Philipps-University of Marburg, Germany said: "While we have a range of treatments shown to be effective in clinical studies, they only work if they are taken on a consistent and ongoing basis. From these data, it seems the majority of women with postmenopausal osteoporosis prefer to take just 12 tablets a year rather than 52. The main reason for their choice is that a monthly regimen is easier to follow for a long time. This study suggests that once-monthly dosing has the potential to enhance therapeutic adherence and improve overall treatment effectiveness in osteoporosis - welcome news for physicians."
Poor adherence has a negative effect on treatment outcomes. It leads to a significantly greater risk of fractures,(6,8) and smaller changes in both bone mineral density (BMD)(9,10) and the rate of bone turnover.(9)
Bonviva® has shown a reduction in the occurrence of new vertebral fractures of 62% over three years (11) and, as the first and only once monthly oral treatment for postmenopausal osteoporosis, has proven superior efficacy in increasing spine and hip bone mineral density (a method used by physicians to assess osteoporosis and the accepted way to measure risk of fracture) compared with once-daily Bonviva.(12) Vertebral fractures are the most frequently observed fractures in patients suffering from osteoporosis.
The BALTO (Bonviva ALendronate Trial in Osteoporosis) II study, presented at the Sixth European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ECCEO) in Vienna, was conducted in centres across the US and Europe and examined the treatment preferences of 321 women with postmenopausal osteoporosis. Of the 93% who expressed a preference, 70.6% preferred treatment with Bonviva taken once a month and 76.6% found it more convenient than Fosamax® (alendronate sodium) taken weekly.(1)
Elisabeth Steinm?ller, one of the women who took part in the study, said: "Many people don't appreciate how difficult it can be living with osteoporosis. I know it's important that I take my treatment but it can be hard. It's not as easy as just swallowing a tablet, because of the strict requirements that have to be followed, like staying upright and fasting. I preferred the once-monthly option as it was more convenient, and ultimately means I'm less likely to give up and stop altogether."
*Who had tried both monthly and weekly treatments and who expressed a preference
About BALTO II
BALTO II is a six-month, prospective, randomised, open-label crossover trial that included 321 women with postmenopausal osteoporosis who took both once-monthly oral Bonviva and once-weekly oral alendronate (70 mg) at separate times during the study. As is standard practice, the physicians involved in the study were aware of existing clinical data for both study medications and were therefore able to ensure all patients enrolled were suitable for either medicine. By the end of the trial, the majority of women reporting a preference (n = 299) chose the once monthly Bonviva regimen (70.6%). Of those reporting on convenience, 76.6% found the monthly Bonviva dose more convenient than weekly alendronate.
About Bonviva
-- Bonviva, a potent and highly effective bisphosphonate, has been studied to date in clinical trials involving over 12,000 patients.
-- Once-monthly Bonviva is indicated for the treatment of osteoporosis in postmenopausal women. It works by reducing elevated bone turnover, increasing bone mineral density and reducing the incidence of vertebral fractures.
-- Studies specifically designed to demonstrate reductions in non-vertebral or femoral neck fractures have not been conducted with Bonviva.
-- Bonviva is the only nitrogen containing bisphosphonate that has demonstrated a reduction in vertebral fracture risk using a drug-free interval of more than one day.(11)
-- Bonviva, like other bisphosphonates administered orally, may cause upper gastrointestinal disorders such as dysphagia, oesophagitis and oesophageal or gastric ulcer.
-- Once-monthly oral Bonviva received European Union approval in September 2005 and Swissmedic approval in August 2005.
Roche/GSK Collaboration
In December 2001, F Hoffmann-La Roche (Roche) and GlaxoSmithKline (GSK) announced their plans to co-develop and co-promote Bonviva for the treatment and prevention of postmenopausal osteoporosis in a number of major markets, excluding Japan. The Roche/GSK collaboration provides expertise and commitment to bringing new osteoporosis therapies to market as quickly as possible.
About Roche
Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of disease, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is a world leader in diagnostics, the leading supplier of medicines for cancer and transplantation and a market leader in virology. In 2005 sales by the Pharmaceuticals Division totalled 27.3 billion Swiss francs, and the Diagnostics Division posted sales of 8.2 billion Swiss francs. Roche employs roughly 70,000 people in 150 countries and has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai. Additional information about the Roche Group is available on the Internet (roche).
About GSK
GSK, one of the world's leading research-based pharmaceutical and healthcare
companies, is committed to improving the quality of human life by enabling people to do more, feel better and live longer. gsk
References
1. Hadji P, Benhamou C-L, Devas V, Masanauskaite D, Barrett-Connor E. Women With Postmenopausal Osteoporosis Prefer Once-Monthly Oral Ibandronate to Weekly Oral Alendronate: Results of BALTO II. Abstract presented at 6th European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, Vienna, Austria 15-18 March 2006.
2. Cowell W, Fulford-Smith A, Poultney S. Adherence with bisphosphonate treatment for osteoporosis in UK patients. Poster presented the second joint meeting of the European Calcified Tissue Society and the International Bone Mineral Society, Geneva, 25-29 June 2005.
3. Fardellone P, Gaudin AF, Cotte FE, Lafuma A, Marchand C et al. Comparison of the persistence of daily and weekly bisphosphonates in French female patients treated for osteoporosis. Poster presented at presented at 27th Annual Meeting of the American Society of Bone and Mineral Research, Nashville, USA 23-27 September 2005.
4. Bartl R, Goette S, Hadji P, Hammerschmidt T. Persistence and compliance with daily and weekly-administered bisphosphonates for osteoporosis treatment in Germany. Poster presented at 5th European Congress on Clinical and Economic Aspects of Osteoporosis and Ostheoarthritis,16-19 March 2005, Rome, Italy.
5. Cramer J, Amonkar M, Hebborn A, Altman R. Compliance and Persistence with Bisphosphonate Dosing Regimens Among Women with Postmenopausal Osteoporosis. Current Medical Research and Opinions 2005; 21(9): 1453-60.
6. Sebaldt R, Shane LG, Pham BZ, Cook RJ, Thabane L. et al. Impact of non-compliance and non-persistence with daily bisphosphonates on longer-term effectiveness outcomes in patients with osteoporosis treated in tertiary specialist care. J Bone Miner Res 2004;19 (Suppl. 1): (Abstract M423)
7. Kanis JA and Johnell O. Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 2005; 16:229.
8. Caro JJ, Ishak KJ, Huybrechts KF, Raggio G, Naujoks C. The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporos Int 2004;15:1003-8.
9. Eastell R, Garnero P, Vrijens B, van de Langedjc L, Pols, AP. et al. Influence of Patient Compliance with Risedronate Therapy on Bone Turnover Marker and Bone Mineral Density Response: The IMPACT Study. Calcif Tissue Int 2003;72:408.
10. Data on file, NDC Health Study. (Ref. 161-011), Hoffman-La Roche Inc, Nutley, NJ.
11. Chesnut CH, Skag A, Christiansen C, Recker R, Stakkestad JA et al. Effects of Oral Ibandronate Administered Daily or Intermittently on Fracture Risk in Postmenopausal Osteoporosis. Journal of Bone & Mineral Research 2004;19(8):1241-49.
12. McClung MR, Drezner MK, Reginster J-Y, Bolognese M, Hughes C et al. Once-Monthly Oral Ibandronate Is At Least As Effective As Daily Oral Ibandronate In Postmenopausal Osteoporosis: 2-Year Findings from MOBILE . Abstract presented at 27th Annual Meeting of the American Society of Bone and Mineral Research, Nashville, USA 23 - 27 September 2005.
In the study, the most common reason women gave for their preference was that one tablet a month is easier to follow for a long time. (1) This finding is important as staying on treatment is a major issue in the management of osteoporosis - up to 60% of patients taking a once-weekly bisphosphonate stop treatment within a year, (2-5) so missing out on the bone building benefits these drugs can only provide over time. The authors conclude that a less frequent dosing regimen may help patients stay on their osteoporosis treatment for longer,(1) which ultimately should reduce the risk of fracture.(6) With the number of osteoporotic fractures in Europe estimated at 3.79 million,(7) improvements in the management of this disease are essential.
Commenting on the results, Dr Peyman Hadji, lead author and Head of the Department of Endocrinology, Osteoporosis and Reproductive Medicine at Philipps-University of Marburg, Germany said: "While we have a range of treatments shown to be effective in clinical studies, they only work if they are taken on a consistent and ongoing basis. From these data, it seems the majority of women with postmenopausal osteoporosis prefer to take just 12 tablets a year rather than 52. The main reason for their choice is that a monthly regimen is easier to follow for a long time. This study suggests that once-monthly dosing has the potential to enhance therapeutic adherence and improve overall treatment effectiveness in osteoporosis - welcome news for physicians."
Poor adherence has a negative effect on treatment outcomes. It leads to a significantly greater risk of fractures,(6,8) and smaller changes in both bone mineral density (BMD)(9,10) and the rate of bone turnover.(9)
Bonviva® has shown a reduction in the occurrence of new vertebral fractures of 62% over three years (11) and, as the first and only once monthly oral treatment for postmenopausal osteoporosis, has proven superior efficacy in increasing spine and hip bone mineral density (a method used by physicians to assess osteoporosis and the accepted way to measure risk of fracture) compared with once-daily Bonviva.(12) Vertebral fractures are the most frequently observed fractures in patients suffering from osteoporosis.
The BALTO (Bonviva ALendronate Trial in Osteoporosis) II study, presented at the Sixth European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ECCEO) in Vienna, was conducted in centres across the US and Europe and examined the treatment preferences of 321 women with postmenopausal osteoporosis. Of the 93% who expressed a preference, 70.6% preferred treatment with Bonviva taken once a month and 76.6% found it more convenient than Fosamax® (alendronate sodium) taken weekly.(1)
Elisabeth Steinm?ller, one of the women who took part in the study, said: "Many people don't appreciate how difficult it can be living with osteoporosis. I know it's important that I take my treatment but it can be hard. It's not as easy as just swallowing a tablet, because of the strict requirements that have to be followed, like staying upright and fasting. I preferred the once-monthly option as it was more convenient, and ultimately means I'm less likely to give up and stop altogether."
*Who had tried both monthly and weekly treatments and who expressed a preference
About BALTO II
BALTO II is a six-month, prospective, randomised, open-label crossover trial that included 321 women with postmenopausal osteoporosis who took both once-monthly oral Bonviva and once-weekly oral alendronate (70 mg) at separate times during the study. As is standard practice, the physicians involved in the study were aware of existing clinical data for both study medications and were therefore able to ensure all patients enrolled were suitable for either medicine. By the end of the trial, the majority of women reporting a preference (n = 299) chose the once monthly Bonviva regimen (70.6%). Of those reporting on convenience, 76.6% found the monthly Bonviva dose more convenient than weekly alendronate.
About Bonviva
-- Bonviva, a potent and highly effective bisphosphonate, has been studied to date in clinical trials involving over 12,000 patients.
-- Once-monthly Bonviva is indicated for the treatment of osteoporosis in postmenopausal women. It works by reducing elevated bone turnover, increasing bone mineral density and reducing the incidence of vertebral fractures.
-- Studies specifically designed to demonstrate reductions in non-vertebral or femoral neck fractures have not been conducted with Bonviva.
-- Bonviva is the only nitrogen containing bisphosphonate that has demonstrated a reduction in vertebral fracture risk using a drug-free interval of more than one day.(11)
-- Bonviva, like other bisphosphonates administered orally, may cause upper gastrointestinal disorders such as dysphagia, oesophagitis and oesophageal or gastric ulcer.
-- Once-monthly oral Bonviva received European Union approval in September 2005 and Swissmedic approval in August 2005.
Roche/GSK Collaboration
In December 2001, F Hoffmann-La Roche (Roche) and GlaxoSmithKline (GSK) announced their plans to co-develop and co-promote Bonviva for the treatment and prevention of postmenopausal osteoporosis in a number of major markets, excluding Japan. The Roche/GSK collaboration provides expertise and commitment to bringing new osteoporosis therapies to market as quickly as possible.
About Roche
Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of disease, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is a world leader in diagnostics, the leading supplier of medicines for cancer and transplantation and a market leader in virology. In 2005 sales by the Pharmaceuticals Division totalled 27.3 billion Swiss francs, and the Diagnostics Division posted sales of 8.2 billion Swiss francs. Roche employs roughly 70,000 people in 150 countries and has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai. Additional information about the Roche Group is available on the Internet (roche).
About GSK
GSK, one of the world's leading research-based pharmaceutical and healthcare
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References
1. Hadji P, Benhamou C-L, Devas V, Masanauskaite D, Barrett-Connor E. Women With Postmenopausal Osteoporosis Prefer Once-Monthly Oral Ibandronate to Weekly Oral Alendronate: Results of BALTO II. Abstract presented at 6th European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, Vienna, Austria 15-18 March 2006.
2. Cowell W, Fulford-Smith A, Poultney S. Adherence with bisphosphonate treatment for osteoporosis in UK patients. Poster presented the second joint meeting of the European Calcified Tissue Society and the International Bone Mineral Society, Geneva, 25-29 June 2005.
3. Fardellone P, Gaudin AF, Cotte FE, Lafuma A, Marchand C et al. Comparison of the persistence of daily and weekly bisphosphonates in French female patients treated for osteoporosis. Poster presented at presented at 27th Annual Meeting of the American Society of Bone and Mineral Research, Nashville, USA 23-27 September 2005.
4. Bartl R, Goette S, Hadji P, Hammerschmidt T. Persistence and compliance with daily and weekly-administered bisphosphonates for osteoporosis treatment in Germany. Poster presented at 5th European Congress on Clinical and Economic Aspects of Osteoporosis and Ostheoarthritis,16-19 March 2005, Rome, Italy.
5. Cramer J, Amonkar M, Hebborn A, Altman R. Compliance and Persistence with Bisphosphonate Dosing Regimens Among Women with Postmenopausal Osteoporosis. Current Medical Research and Opinions 2005; 21(9): 1453-60.
6. Sebaldt R, Shane LG, Pham BZ, Cook RJ, Thabane L. et al. Impact of non-compliance and non-persistence with daily bisphosphonates on longer-term effectiveness outcomes in patients with osteoporosis treated in tertiary specialist care. J Bone Miner Res 2004;19 (Suppl. 1): (Abstract M423)
7. Kanis JA and Johnell O. Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 2005; 16:229.
8. Caro JJ, Ishak KJ, Huybrechts KF, Raggio G, Naujoks C. The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporos Int 2004;15:1003-8.
9. Eastell R, Garnero P, Vrijens B, van de Langedjc L, Pols, AP. et al. Influence of Patient Compliance with Risedronate Therapy on Bone Turnover Marker and Bone Mineral Density Response: The IMPACT Study. Calcif Tissue Int 2003;72:408.
10. Data on file, NDC Health Study. (Ref. 161-011), Hoffman-La Roche Inc, Nutley, NJ.
11. Chesnut CH, Skag A, Christiansen C, Recker R, Stakkestad JA et al. Effects of Oral Ibandronate Administered Daily or Intermittently on Fracture Risk in Postmenopausal Osteoporosis. Journal of Bone & Mineral Research 2004;19(8):1241-49.
12. McClung MR, Drezner MK, Reginster J-Y, Bolognese M, Hughes C et al. Once-Monthly Oral Ibandronate Is At Least As Effective As Daily Oral Ibandronate In Postmenopausal Osteoporosis: 2-Year Findings from MOBILE . Abstract presented at 27th Annual Meeting of the American Society of Bone and Mineral Research, Nashville, USA 23 - 27 September 2005.
воскресенье, 8 мая 2011 г.
Heart Medications: The More You Skip, The More You Risk
Although it might take some effort to find out why some patients skip taking their medicine, a new study finds that heart patients who most frequently miss a dose are more than twice as likely to suffer heart attack, stroke and death.
The findings are important because they pinpoint the size of the problem, said study co-author Mary Whooley, M.D., associate professor of medicine at the University of California at San Francisco. Just over 8 percent of the 1,015 patients surveyed said they fail to take their medicine at least 25 percent of the time.
"The next step is to figure out how we can change people's behavior," Whooley said. "It is so hard to convince people to lose weight, exercise and take their medicines as they're supposed to. If we could figure out ways to motivate people to change, that would have tremendous public health consequences."
Whooley and colleagues asked coronary heart patients taking part in a national study whether they took their medications over the past month as prescribed. Then they followed the patients for almost four years to see who died and who had survived a heart attack or stroke. The study results appear in the Sept. 10 issue of the Archives of Internal Medicine.
After the researchers adjusted the numbers to account for the effects of factors like depression and severity of illness, those who admitted not taking their medication more than 25 percent of the time were 2.3 times more likely to suffer serious problems including death when compared to the others. Close to 14 percent of patients who more regularly took their medications experienced cardiac events, compared with about 23 percent of those who more frequently skipped doses.
"Honestly, it's not really rocket science," Whooley said. "It's pretty intuitive that if you don't take your medications, you won't do as well."
Why do patients fail to follow their doctor's directions? Samuel Sears, Ph.D., professor of psychology and internal medicine at East Carolina University, said it is often a matter of miscommunication between the doctor and the patient.
Most patients do not intend to disobey doctor's orders, according to Sears. "I put the onus on our health care system and the providers to walk in the patient's moccasins a bit and look at why they can't get it done," he said.
One of his own patients, Sears said, did not follow instructions regarding diabetes medication. It took some questioning to reveal that she was afraid of needles.
While it is possible that other factors could affect the health of those who do not take their medications consistently, it is still important for doctors to ask a "simple question" about whether patients follow medication instructions and to follow up if they don't, said P. Michael Ho, M.D., staff cardiologist at Denver VA Medical Center.
Gehi AK, et al. Self-reported medication adherence and cardiovascular events in patients with stable coronary heart disease. Arch Intern Med 167(16), 2007
Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
hbns
The findings are important because they pinpoint the size of the problem, said study co-author Mary Whooley, M.D., associate professor of medicine at the University of California at San Francisco. Just over 8 percent of the 1,015 patients surveyed said they fail to take their medicine at least 25 percent of the time.
"The next step is to figure out how we can change people's behavior," Whooley said. "It is so hard to convince people to lose weight, exercise and take their medicines as they're supposed to. If we could figure out ways to motivate people to change, that would have tremendous public health consequences."
Whooley and colleagues asked coronary heart patients taking part in a national study whether they took their medications over the past month as prescribed. Then they followed the patients for almost four years to see who died and who had survived a heart attack or stroke. The study results appear in the Sept. 10 issue of the Archives of Internal Medicine.
After the researchers adjusted the numbers to account for the effects of factors like depression and severity of illness, those who admitted not taking their medication more than 25 percent of the time were 2.3 times more likely to suffer serious problems including death when compared to the others. Close to 14 percent of patients who more regularly took their medications experienced cardiac events, compared with about 23 percent of those who more frequently skipped doses.
"Honestly, it's not really rocket science," Whooley said. "It's pretty intuitive that if you don't take your medications, you won't do as well."
Why do patients fail to follow their doctor's directions? Samuel Sears, Ph.D., professor of psychology and internal medicine at East Carolina University, said it is often a matter of miscommunication between the doctor and the patient.
Most patients do not intend to disobey doctor's orders, according to Sears. "I put the onus on our health care system and the providers to walk in the patient's moccasins a bit and look at why they can't get it done," he said.
One of his own patients, Sears said, did not follow instructions regarding diabetes medication. It took some questioning to reveal that she was afraid of needles.
While it is possible that other factors could affect the health of those who do not take their medications consistently, it is still important for doctors to ask a "simple question" about whether patients follow medication instructions and to follow up if they don't, said P. Michael Ho, M.D., staff cardiologist at Denver VA Medical Center.
Gehi AK, et al. Self-reported medication adherence and cardiovascular events in patients with stable coronary heart disease. Arch Intern Med 167(16), 2007
Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
hbns
суббота, 7 мая 2011 г.
Pharmacy Care Program Helps Elderly Patients Take All Their Medications
A pharmacy care program for elderly patients increases medication adherence, which results in improved health outcomes, according to a study posted online on 13-Nov-2006 by JAMA. The study is being released early to coincide with its presentation at the American Heart Association Scientific Session. It will be published in the December 6 print issue of JAMA.
"Adherence to chronic pharmacological therapies is poor, leading to worsening disease severity and increased costs associated with higher hospital admission rates," the authors provide as background information. "Barriers to medication adherence are numerous, but include the prescription of complex medication regimens, treatment of asymptomatic conditions and convenience factors. These factors are particularly prevalent among the elderly population, placing them at increased risk for medication nonadherence."
Jeannie K. Lee, Pharm.D., and colleagues from Walter Reed Army Medical Center, Washington, D.C., report the results from the Federal Study of Adherence to Medications in the Elderly (FAME), a multi-phase investigation that included 200 community-based patients age 65 years or older taking at least four chronic medications. The FAME study, which was conducted from June 2004 to August 2006 consisted of three phases. First, all 200 patients entered a two-month run-in phase that provided a baseline for medication adherence using pill counts, and for blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) readings. Of these patients, 174 then entered a six-month intervention phase that included standardized medication education, regular follow-up by pharmacists and all medications dispensed in time-specified blister packs. Following the intervention phase, 159 patients were randomized to continue the pharmacy care program or return to their usual care for an additional six months.
The average age of the study patients was 78 years. Cardiovascular risk factors were prevalent and included drug-treated hypertension in 184 patients (91.5 percent) and drug-treated hyperlipidemia in 162 patients (80.6 percent). The patients took an average of nine different chronic daily medications. At the beginning of the first phase of the study, the researchers found the average medication adherence was 61.2 percent. "After six months of intervention, medication adherence increased to 96.9 percent and was associated with significant improvements in systolic blood pressure (133.2 to 129.9 millimeters of mercury) and LDL-C (91.7 to 86.8 milligrams per deciliter)," the researchers report. "Six months after randomization, the persistence of medication adherence decreased to 69.1 percent among those patients assigned to usual care, whereas it was sustained at 95.5 percent in pharmacy care." The pharmacy care group also had significant reductions in systolic blood pressure compared to the usual care group, but no significant differences between the groups in LDL-C levels or reductions.
"In this study, a comprehensive pharmacy program composed of patient education and custom blister-packed medications was associated with substantial and sustained improvements in medication adherence among elderly patients receiving complex medication regimens. The association of improved medication adherence with reduced levels of BP and LDL-C suggests that such a program could lead to meaningful improvements in health outcomes. The results of the FAME study call for greater emphasis within health care delivery systems and policy organizations on the development and promotion of clinical programs to enhance medication adherence particularly among the at-risk elderly population," the authors conclude. (JAMA. 2006; 296: (doi.10.1001/JAMA.296.21.joc60162).
Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: Challenges for Improving Medication Adherence
In a related editorial, Ross J. Simpson Jr., M.D., Ph.D., from the University of North Carolina at Chapel Hill writes "for chronic medical conditions, such as hypercholesterolemia and hypertension, a wide and persistent separation exists between evidence-based recommendations and the actual care patients receive."
"Patient characteristics that may lead to poor adherence include advanced age, cognitive impairment and depression as well as attitudes and beliefs about the importance of the medication, the disease being treated and the potential for adverse effects."
" - the study by Lee and colleagues adds important information about improving medication adherence in elderly patients and also highlights the challenges inherent in designing and conducting high-quality research in this critically important area. Multifaceted interventions that incorporate structural and counseling components and include appropriately skilled and motivated pharmacists appear useful to promote medication adherence and persistence. Future studies are needed to confirm that interventions incorporating these components will result in increased and sustained patient adherence and, better yet, will improve outcomes."
(JAMA. 2006:296: (doi:10.1001/jama.296.21.jed60074).
Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.
Contact: Allen J. Taylor, M.D.
JAMA and Archives Journals
"Adherence to chronic pharmacological therapies is poor, leading to worsening disease severity and increased costs associated with higher hospital admission rates," the authors provide as background information. "Barriers to medication adherence are numerous, but include the prescription of complex medication regimens, treatment of asymptomatic conditions and convenience factors. These factors are particularly prevalent among the elderly population, placing them at increased risk for medication nonadherence."
Jeannie K. Lee, Pharm.D., and colleagues from Walter Reed Army Medical Center, Washington, D.C., report the results from the Federal Study of Adherence to Medications in the Elderly (FAME), a multi-phase investigation that included 200 community-based patients age 65 years or older taking at least four chronic medications. The FAME study, which was conducted from June 2004 to August 2006 consisted of three phases. First, all 200 patients entered a two-month run-in phase that provided a baseline for medication adherence using pill counts, and for blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) readings. Of these patients, 174 then entered a six-month intervention phase that included standardized medication education, regular follow-up by pharmacists and all medications dispensed in time-specified blister packs. Following the intervention phase, 159 patients were randomized to continue the pharmacy care program or return to their usual care for an additional six months.
The average age of the study patients was 78 years. Cardiovascular risk factors were prevalent and included drug-treated hypertension in 184 patients (91.5 percent) and drug-treated hyperlipidemia in 162 patients (80.6 percent). The patients took an average of nine different chronic daily medications. At the beginning of the first phase of the study, the researchers found the average medication adherence was 61.2 percent. "After six months of intervention, medication adherence increased to 96.9 percent and was associated with significant improvements in systolic blood pressure (133.2 to 129.9 millimeters of mercury) and LDL-C (91.7 to 86.8 milligrams per deciliter)," the researchers report. "Six months after randomization, the persistence of medication adherence decreased to 69.1 percent among those patients assigned to usual care, whereas it was sustained at 95.5 percent in pharmacy care." The pharmacy care group also had significant reductions in systolic blood pressure compared to the usual care group, but no significant differences between the groups in LDL-C levels or reductions.
"In this study, a comprehensive pharmacy program composed of patient education and custom blister-packed medications was associated with substantial and sustained improvements in medication adherence among elderly patients receiving complex medication regimens. The association of improved medication adherence with reduced levels of BP and LDL-C suggests that such a program could lead to meaningful improvements in health outcomes. The results of the FAME study call for greater emphasis within health care delivery systems and policy organizations on the development and promotion of clinical programs to enhance medication adherence particularly among the at-risk elderly population," the authors conclude. (JAMA. 2006; 296: (doi.10.1001/JAMA.296.21.joc60162).
Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: Challenges for Improving Medication Adherence
In a related editorial, Ross J. Simpson Jr., M.D., Ph.D., from the University of North Carolina at Chapel Hill writes "for chronic medical conditions, such as hypercholesterolemia and hypertension, a wide and persistent separation exists between evidence-based recommendations and the actual care patients receive."
"Patient characteristics that may lead to poor adherence include advanced age, cognitive impairment and depression as well as attitudes and beliefs about the importance of the medication, the disease being treated and the potential for adverse effects."
" - the study by Lee and colleagues adds important information about improving medication adherence in elderly patients and also highlights the challenges inherent in designing and conducting high-quality research in this critically important area. Multifaceted interventions that incorporate structural and counseling components and include appropriately skilled and motivated pharmacists appear useful to promote medication adherence and persistence. Future studies are needed to confirm that interventions incorporating these components will result in increased and sustained patient adherence and, better yet, will improve outcomes."
(JAMA. 2006:296: (doi:10.1001/jama.296.21.jed60074).
Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.
Contact: Allen J. Taylor, M.D.
JAMA and Archives Journals
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