If Patients Feel Monitored, Adherence Increases

People lie all the time. On average, when trying to make a good impression, studies show that adults will lie on average 2-3 times in 10 minutes. The doctor’s office is no different. Studies show that from smoking to taking medications, patients lie and frequently. One study showed that of 40 patients who had said they quite smoking, saliva tests proved 10 of them were lying. The upside is that if patients are made to feel that someone is monitoring them, their adherence goes up dramatically. For example, in a study published in 2000, two groups using inhalers were evaluated. The first did not know they were being monitored: 30/101 were non-adherent. The second did know and only 1/135 was non-adherent.
LINK

Smart Inhaler Captures Essential Information on Patient Behavior

One of the problems with medical research in the field is that patient reports and medical records are often inaccurate or incomplete. A pilot study is now under way at the University of Wisconsin-Madison to evaluate asthma patients medication taking behavior using a ‘smart’ inhaler. The inhaler indicates the exact location and time of each use, essential for the understanding of asthma etiology, and patient behaviors.

LINK

The Effect of Knowledge on Adherence to Hypertensive Medication

Given that knowledge is likely to affect an individual’s ability to be adherent with therapy, researchers have investigated the effect of the amount and type of knowledge of 227 hypertensive patients on their medication-taking habits. Researchers found that 72% (163) were adherent and 28% (64) were non-adherent and that the type of knowledge patients had greatly affected their adherence. Knowing the duration of use of the medicine (OR=6.822; p=0.075), the reason for taking the medication (OR-2.828; p=0.018), the cause of hypertension (OR-3.447; p=0.037), and knowing the target blood pressure level (OR-12.859; p<0.001) increased adherence rates. Further, knowing the name (p=0.112) or the results of hypertension (p=0.719) had no effect, whereas knowing the side-effects had a negative effect on adherence (OR=0.607; p=0.005). See also the recently published article by Murray et al. demonstrating the association between poor health literacy and adherence, and the exacerbation of heart failure.

LINK

Nurses Helping Docs Identify Non-adherent Patients in NZ

A new study is beginning in New Zealand to test the effects of phone calls by practice nurses on the adherence rates of patients taking anti-hypertensives. 200 patients who have a pattern of being late for refill dates will participate. The three month support program involves three calls by nurses to encourage patients, and answer their questions. Doctors say the program is important because it is beyond their ability to identify non-adherent patients, and these patients really need this extra help to improve outcomes.

LINK

TXT MSGS REDUCE ORGAN REJECTION

Researchers at the Mt. Sinai Medical Centre have found that text-messaging reduces organ rejection in children who have recently received a liver transplant. The study consisted of 41 pediatric patients taking 1-3 medications daily. Text messages included a query, if the children did not respond in 15 minutes, their caregivers were notified. Researchers say that the simple text system helped get the children more involved in their own care and helped them take their medications properly resulting in 1/6^th the rejection episodes.

LINK

They May be “On Therapy”, But They Are Not Taking Their Meds…

An interesting presentation by Eli Lilly and Company at the 8^th European Congress on Menopause trumpeted recent study results showing that the majority of patients tested stayed on EVISTA for the first two years (96.4%, 80.5% and 62% of patients persisted at 12, 24, and 36 months respectively). What seems a little strange, however, is that the mean MPR was only 52.8%. Apparently, only 38.5% of patients were actually adherent (MPR <80%).

LINK

Pharmacist Interventions Reduce Adverse Drug Events

Problems in adherence are often associated with side-effects and other adverse events related to improper care. Two randomized controlled trials of pharmacist interventions were conducted using 800 patients with cardiovascular disease. Results showed a 34% reduced risk of an event (adverse event or medication error) in the intervention groups. This included a lower risk of adverse events (RR, 0.65, p=0.05), preventable adverse events (RR, 0.52, p=0.05), potential adverse events (RR, 0.70, p=0.05) and medication errors (RR, 0.63, p=0.05).

LINK

Communicating the Importance of Adherence

These two articles raise the important point of communication with patients, and the government. Social media offers invaluable access to patient trends and beliefs. Pharmaceutical companies are being held to higher standards by the public, and, given the importance of patient loyalty, it is time to address mistrust in the industry. Online communications provide the necessary insight and perhaps even the catalyst to begin the discussion. The last thing we want is for PhRMA to be a five letter word.

LINK to "The Science of Eavesdropping"
LINK to "The End of Adherence As We Know It"

Health, Humor & Hi-Tech Today, By Ross Martin, MD

My old friend Ross has an ability to put anything to song.

Merck / Cigna Deal Depends on Adherence

Merck is determined to prove the value of Januvia through their performance deal with CIGNA. If deals like these become more common, we can expect companies to invest much more seriously in well-designed adherence programs.
LINK

Flickr photo: Stovak

E&Y: Top 5 Risks to Life Sciences Companies

Government and private insurers are placing unprecedented pressures on Life Sciences companies to demonstrate value for the products they develop, according to The 2009 Ernst & Young business risk report, Life sciences. Insurers, governments and individuals are likely to increase demands to demonstrate value in the years ahead, as they confront mounting healthcare costs, a shrinking tax base, aging populations, and a mandate to provide care for a larger pool of citizens.

The top 5 risks facing Life Sciences companies:

1. Demonstrating value and pricing pressures

2. Capital access/capital allocation

3. Boosting R&D productivity

4. Revolutionizing business models

5. Ensuring safe products

LINK