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HealthWinks by Pleio

2012-01-09T22:09:00.000-05:00

Special thanks to Mike Fiorentino, Regina Mears and Diogo for their dedication to bringing the Pleio HealthWinks to life!

Aetna to Cut Co-Pays for Heart Patients to Increase Drug Use - But Are Out-Of-Pocket Costs The Problem?

2011-11-24T15:27:00.001-05:00

Would you be more likely to take medicine for a chronic health condition if you didn't have to pay for it? A recent study conducted by the Harvard-affiliated Brigham and Women's Hospital in Boston and sponsored by health insurance company Aetna has shown that, for many people with heart disease, the issue isn't as black and white as it may seem.

The research, reported today at the American Heart Association meeting in Orlando, Florida, found dropping co-pays helped 40 to 55 percent of patients take drugs as prescribed, compared with 36 to 49 percent. The move lowered heart attack and stroke risk by 14 percent, according to the study.

“We’re moving in the right direction and pushing up patient adherence to prescriptions,” said [Lonny] Reisman, a cardiologist and study co-author. “The bad news is there are a lot of other things getting in the way of patients taking their medicines and even with no co-pays only about half of people are complying.”

Read the full story here.

Retail Pharmacists Part of Prescription to Improve Medication Adherence

2011-11-24T14:59:00.001-05:00

Want to improve medication adherence in patients? Make retail pharmacists part of the prescription, recommends new market research from the Healthcare Intelligence Network.

The use of motivational interviewing, often by retail or community pharmacists, scored high on the list of tools to improve medication adherence levels.

Download this white paper on improving medication adherence and compliance here.

Can Social Media Assist With Medication Adherence?

2011-11-24T14:30:00.000-05:00

An interesting blog post from Jason Boies at the Radian6 Community Engagement Team explores the uses of social media in promoting adherence:

- The University of Iowa Children’s Hospital has turned to Facebook to remind teenagers to take their medications on time with their Iowa Medminder application. Indeed, healthcare professionals have realized that with the younger demographics, it’s not official until it’s on Facebook.

Read the full post here.

Patient Empowerment: Good for Patients and Physicians Alike

2011-11-24T14:27:00.001-05:00

As physician Jay Parkinson notes [...] “Most health solutions aren’t medical — they’re social.”

A brief, insightful article on patient empowerment from NumeraHealth.

Pleio Recognized on Capitol Hill

2011-11-20T19:15:00.001-05:00

URAC Presentation - Supporting Patient Medication Adherence: Ensuring Coordination, Quality and Outcomes

Meet the Pleio GoodStarters

2011-05-11T09:07:00.000-04:00

Pleio GoodStart Effect Different for Men and Women

2010-10-15T16:17:00.003-04:00

Our partners at Kerr Drugs did a great job rolling out their Pleio GoodStart program. Men aged 40-70 refilled an average of four extra prescriptions over 18 months and women refilled an average of 2 more prescriptions. LINK

Pleio GoodStart Adds 84 Pills/Patient over 18 Months

2010-08-16T23:58:00.004-04:00

We've been analyzing data on our first pilot program for a few weeks and excited to report strong long-term results. We'll be issuing a press release this week and explaining the results in more depth at upcoming conferences in San Diego and Philadelphia. Here's the release:

Montreal, QC, Canada — August 17, 2010
Pleio Helps Chains Boost Adherence in Boomers: 84 More Pills per Patient Over 18 Months

Prescription data collected by three pharmacy chains over two years reveals that ‘baby boomers’ who participated in a Pleio GoodStart™ Program offered by their pharmacy took an average of 84 additional doses of their blood pressure medication over their first 18 months of therapy compared to a similar control group.

Pleio GoodStart™ helped chains improve adherence to a once-daily blood pressure medication regimen through its integrated offering of phone-based coaching, daily voice and text message reminders, and medication therapy management services carried out by chain pharmacists. Patient enrolment occurred from May 2008 to March 2009.

Thirty months of prescription data for 404 patients was collected from pharmacies in North Carolina, Virginia, and Maryland for the period of January 2008 to June 2010. Patients of comparable age and sex were selected for the 670-person control group.

About Pleio Health Support Systems and Pleio GoodStart™

Pleio Health Support Systems partners with pharmacy chains in 48 US states and 3 Canadian provinces to deliver Pleio GoodStart medication adherence programs. Pleio’s GoodStart program, now in its third year, helps pharmacy chains improve medication adherence through Rx refill trend analysis, management of medication adherence protocols, execution of programmable text and voice messaging, and live patient contact services.

Non-adherence with medication therapy hurts patients and their families, employers and insurers, pharmaceutical manufacturers and pharmacy chains. According to a 2009 New England Healthcare Institute report, patients who do not take their medications as prescribed by their doctors cost the U.S. health care system an estimated $290 billion in avoidable medical spending every year.

Learn More

Pleio will release more details on Pleio GoodStart™ results and opportunities at the National Association of Chain Drug Stores Technology Conference in San Diego, CA on August 28, 2010, and at the Patient Engagement and Adherence Conference in Philadelphia, PA on October 19, 2010.

Contact
Jean Lalonde, Co-CEO
(956) 566-5729 or (514) 369-9995
info@pleio.com
Pleio Health Support Systems, Inc.
5890 Monkland Ave. suite 11
Montreal, Canada H4A 1G2
www.pleio.com

Computer-Controlled Self-Administration Injection System Approved

2010-05-03T10:06:00.000-04:00

Milestone Scientific Receives Notice of Allowance From US Patent and Trademark Office for Computer-Controlled Self-Administration Injection System

Feel Better in 10 Seconds for Just $10: Text "HAITI" to 90999

2010-01-15T17:21:00.006-05:00

If you haven't donated yet, you can text “HAITI” to 90999 to give $10 to Red Cross relief efforts in Haiti.

Mail-Order May Help People Stick to Med Regimens

2010-01-14T15:57:00.007-05:00

A new study shows that 84.7% of people who order their medications by mail stick to their routines, whereas local pharmacy purchases only saw a 76.9% adherence rate.

"Our findings indicate that mail-order pharmacies streamline the medication acquisition process, which is associated with better medication adherence," said lead researcher Dr. O. Kenrik Duru.

LINK

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Aging group awards first IT grants to support med adherence

2010-01-12T06:14:00.006-05:00

Showing strong support for technology dissemination, the Center for Technology and Aging has awarded $477,000 to five groups in an effort to boost medication adherence among older patients with chronic conditions

LINK

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TabSafe introduces web-accessible med dispenser

2010-01-11T02:52:00.008-05:00

TabSafe's new device is designed to securely store and dispense a patient's medication according to their prescription. Web accessibility allows caregivers to check and refill prescriptions and monitor their daily metrics.

LINK

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Mr. Adherence Goes To Washington

2010-01-09T15:01:00.006-05:00

A broad coalition of 27 large-scale healthcare organizations painted a stark picture of the costs of medication non adherence for members of The House and Senate this past November, appealing to lawmakers to tackle the stubborn problem of patient noncompliance in health-reform proposals advancing in Congress.

LINK

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Why Do Patients Skip Diabetes, Pain Meds?

2010-01-08T15:24:00.005-05:00

According to a study of 245 patients in the December issue of Diabetes Care, economic pressures, mood disorders and negative opinion of medication figure into non-adherence patterns.

LINK

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Don't knock it till you try it

2010-01-08T15:02:00.005-05:00

In those critical first 30 days of therapy, discontinuation rates for medication-naïve patients are reportedly 17.4 to 42.6 per cent higher than for medication-experienced patients, regardless of the drug class prescribed.

LINK

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Employers Have Adherence On The Brain

2009-12-28T14:51:00.007-05:00

89% of employers agree: medication adherence is an important factor in employee health and well-being. According to the NPC sponsored study, 95% of employers surveyed say they are taking action via employee education and prescription reminders by e-mail.

LINK

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Medication Adherence Varies Between Races

2009-12-28T14:10:00.007-05:00

Elderly black Americans use fewer medications than whites and are more likely to skip taking their meds, as detailed in a recent study comprised of 200 patients aged 60 and older.

The most common problems for both whites and blacks were: medication non-adherence (42 percent vs. 68 percent), under treatment (83 percent vs. 87 percent), suboptimal drug use (59 percent vs. 66 percent), and suboptimal dosing (48 percent vs. 56 percent).

LINK

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Peer support and text reminders can only do so much for HIV treatment adherence

2009-11-23T06:15:00.001-05:00

In the case of antiretroviral treatment, adherence programs have been found to be only partially effective. Peer support improved adherence in the short-term, whereas text messaging had no effect on reported pill-taking.

Antiretroviral treatment can significantly improve the health and life expectancy of HIV-positive people if taken rigorously; however, many patients do not achieve high levels of adherence.

LINK

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We Get More Time With Our Doctors – Not Less

2009-11-16T23:39:00.005-05:00

Despite decreasing income and increasing pressures for greater efficiency among primary care doctors, Massachusetts researchers have reported that between 1997 and 2005, the average visit with their adult patients increased from 18 minutes to nearly 21.

The data shows doctors spending more time with older patients and less time with racial/ethnic minority groups. The extra face-time led to improvement in disease-screening, but no impact on the quality of drug prescription or diet/exercise counseling.

LINK

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Link Between Adherence, Asthma & Honesty

2009-11-02T12:59:00.007-05:00

A significant proportion of patients with difficult-to-control asthma do not adhere to prescribed corticosteroid therapy according to a study conducted by researchers in Northern Ireland. Of 182 patients, 63 filled 50% or fewer inhaled medication prescriptions. 88% admitted poor adherence with inhaled therapy after initially denying this.

LINK

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GoodStart Pilot Adds 2 Refills per Patient Over 9 Months

2009-10-26T18:36:00.011-04:00

Retrospective analysis of retail pharmacy prescription data from 1,776 patients taking a chronic cardiovascular medication between May 2008 and September 2009, revealed that Pleio GoodStart™ had a highly significant impact on medication adherence, resulting in patients refilling an average of two additional 30-day prescriptions during their initial 9-month period on the medication (p<0.001).

Data also showed that patients who participated in the GoodStart™ program refilled their prescriptions an average of ten days sooner than control group participants. Collectively, these data demonstrate a significant, sustained improvement in patient medication adherence with the Pleio GoodStart™ program.

"Improving people's experience with new prescription medications involves many disciplines. Pleio's technology, pharmacy and manufacturer partners are equally dedicated to improving the patient experience with new prescriptions. These results show that when elderly patients are carefully listened to, stimulated in language they can relate to, and empowered with performance support, adherence challenges are easily overcome."

Pleio GoodStart connects physicians, patients, pharmacies, families and pharmaceutical manufacturers toward their common goal of improved patient adherence. Physicians gain the assurance that their patients will be well-supported and that future patient appointments can be more effective. Pharmacies are provided a new perspective on C&P through training and feedback on patient progress. Patients receive unprecedented interest in their welfare throughout the medication adoption phase, with up to 75 contacts during their first 100 days on therapy. Family and friend support is stimulated through awareness of the issue of adherence and their potential to be an advocate.

Community pharmacists are the key to adherence and lower healthcare costs

2009-10-21T06:07:00.003-04:00

Americans are leaving billions of dollars on the health care table through the improper use of prescription medication - $290 billion annually to be exact – and community pharmacists are in the best position to help people get a handle on soaring health care bills by encouraging adherence.

LINK

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Patients with diabetes calling their own shots

2009-10-21T06:04:00.007-04:00

In an effort to involve diabetes patients more in their treatment and medication choices, scientists have developed and tested a series of decision aid cards that describe the effects of their medication on factors including weight change, blood sugar, lifestyle and side effects.

LINK

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New URAC standards address adherence

2009-10-21T06:01:00.004-04:00

URAC, the nation's leading health care accreditation and education organization, has introduced new performance measures addressing areas such as medication possession ratios to assist with medication adherence and dispensing rates for generic medications.

LINK

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Big Brother, Little Pill

2009-10-21T05:54:00.007-04:00

What if that prescription pill you just swallowed was fitted with a digestible microchip - an internal spyware - that could transmit key information about your medication adherence and vital signs to your doctor?

Read the full story in plain, non-Vulcan English.

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Texting teens may improve liver transplant outcomes

2009-10-21T05:52:00.004-04:00

They wouldn't listen to their parents, so now researchers have successfully tested text message reminders as a way of getting young liver transplant patients to take their immunosuppressive medications.

Texting May Help Young Transplant Recipients

Two healths make one right: Healthways Buys HealthHonors

2009-10-21T05:45:00.002-04:00

Healthways Inc. has acquired HealthHonors with plans to integrate their innovative incentive strategy with Embrace, HWAY’s information system geared towards sustained adherence to clinical and behavioral regimens. The purchase price includes an upfront cash payment of $14.7 million and a multi-year earn-out arrangement.

LINK

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YTD: Pharmaceutical ad spending fell 11.3% to $1.87 billion

2009-09-08T23:22:00.009-04:00

LINK

Customization, Physician and Pharmacist Involvement Top Pharma Priorities in Patient Retention Programs

2009-09-02T01:50:00.009-04:00

We conducted a short survey among Dots newsletter readers and through open invitations on LinkedIn. The survey attracted 40 responders from 5 countries and diverse healthcare niches. Responders from 20 European and North American Pharma companies emphasized customization, physician and pharmacist involvement as the most desired attributes of patient retention programs.

What is the thing you hate most about taking your medication?"

2009-08-31T06:38:00.006-04:00

Asking the right question the right way at the right time: "What do you hate the most about taking your medication?" works better than "Can you tell me why you are not taking your pills at present?" according to study of 57 New Zealand patients.

LINK

Pharmacy Chains Poised for Growth in Adherence & Disease Management

2009-08-31T06:35:00.004-04:00

Retail pharmacy is in a key position to take advantage of disease management growth trends and deliver DM services effectively and profitably, according to "Disease Management and Retail Pharmacies: A Convergence Opportunity," a new paper from the Deloitte Center for Health Solutions.

Pharmacists can be center of medical home - - Modern Medicine

CVS Study: Gen Xers Also Avoid Adherence

2009-08-31T06:30:00.014-04:00

Several friends emailed me a link to this article. I guess it's one of the few studies on non-adherence in younger (Gen X) populations. According to CVS, most people under 45 do not adhere to cholesterol meds. Their new Adherence to Care program intends to change that through letters and outreach.

LINK

Photo: Flickr, Berzer

Ka-Ching: Non-Adherence Costs $290B/Year

2009-08-31T06:26:00.011-04:00

New England Healthcare Institute (NEHI) 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. LINK

NZ Study Shows 93% of ePrescriptions Written Were Filled Within a Week

2009-07-21T15:41:00.007-04:00

Researchers in Auckland, New Zealand suggest a simple screening method that could be used to direct attention to those with the greatest adherence challenges.

"RESULTS: Out of 646 patients prescribed at least one of the six medications by the practice during the 15-month period, 50% of patients maintained high adherence (MPR >/= 80%) to all (out of the 6) medications that they were prescribed over the period, with rates of high adherence to individual medications ranging from 68 (felodopine) to 55% (metformin). In 93% of 4043 cases where there was a prescription in the general practice data, a subsequent dispensing record for the same patient and drug was present with a time-stamp no more than seven days later. PPR < 80% demonstrated a positive predictive value (PPV) of 81.4% (95%CI 78-85%) and negative predictive value (NPV) of 76.3% (95%CI 73-79%) for MPR < 80%."

LINK

Patients Have Poor Techniques in Glaucoma Self-Care

2009-07-21T15:40:00.005-04:00

Dr. Alan L. Robin and colleagues at Johns Hopkins University have conducted a study on a glaucoma patient’s ability to use eye-drops appropriately. Of the 139 patients tested, 92.8% reported no problems, 61.9% reported never missing their eye, 79.2% said they never touched their eye with the tip, and 61.9% reported washing hands before usage. After examination of video recordings only 30.8% didn’t touch the eye even with the larger bottle, and only 1.7% actually washed their hands. Dr. Robin believes that training for patients is left-out by hurried doctors used to prescribing only pills.

LINK

photo: gburneau, flickr

Automated Letters and Robo-calls Fail to Stimulate Adherence

2009-07-15T15:27:00.007-04:00

One of the most recent attempts to improve adherence has come up short. In this particular intervention, 1867 patients with osteoporosis and 436 primary care physicians were studied. The intervention group received letters and automated telephone calls, while their physicians received education by trained pharmacists. The control patients and physicians received no education. MPR was assessed at 10 months after the start of the intervention. The average MPRs were nearly identical between groups with 74% (IQR, 19%-93%) for intervention and 73% (IQR, 0%-93%) for controls. The median number of days to discontinuation post-intervention were 85 (IQR, 58-174 days) and 79 (IQR, 31-158) respectively.

LINK

Low Co-Pays vs. No Co-Pays

2009-07-14T13:13:00.003-04:00

A recently published study on the effects of co-pay levels shows that the only way to guarantee an increase in adherence through financial discounts is to reduce co-payments to $0. Researchers assessed MPR using claims data for 327, 629 patients (for hypercholesterolemia, hypertension, hypothyroidism, seizure disorders, or type 2 diabetes) with a new generic-only or brand-only drug therapy prescription. An MPR of ≥ 80% in the above conditions was found for 53.2%, 53.4%, 66.2%, 42.2% and 52.0% of patients respectively. Generics (lower co-pays) increased adherence in patients with hypercholesterolemia or diabetes (P < .05), but decreased adherence for hypertension and hypothyroidism (P <.05). The rate of adherence (MPR = 80%) increased for all conditions with copayments of $0 (AOR of 1.32 – 1.45 according to condition; 95% CI)

C&P in GERD Medications

2009-07-10T22:11:00.002-04:00

Using national claims data, researchers have now compiled adherence information on 10,159 patients with Barrett’s esophagus (BE) and 48,965 patients with gastroesophageal reflux disease (GERD) diagnosed between 2000 and 2005 who were taking oral proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs). On average the mean duration of filled PPI or H2RA prescriptions accounted for only 31.7% of the year and only 66.6% (BE) or 60.4% (GERD) of patients actually filled PPI prescriptions. The average therapy duration was 241 days for PPIs, and 159 days for H2RAs. Finally, those without BE diagnoses were less adherent, as were individuals diagnosed in 2005 vs. 2000. Overall, this shows a similar pattern to other chronic conditions, which show generally poor adherence and persistence with more severe diagnoses being associated with greater compliance.

LINK

Intervention Enhances Compliance with Hypertension Medication and Lifestyle Changes

2009-07-10T22:10:00.003-04:00

The following study targeted physician awareness, and evaluated pre- and post-intervention compliance in 697 hypertensive patients who also had other vascular risk factors. The interventions included 7 physician training meetings, print materials for participants, and the 1-page evaluation forms. Significant increases were found in the number of patients who achieved target blood pressure levels (p<0.0001). Non-diabetic patients also achieved significant reduction in vascular risk (down 41%) (p<0.0001). The study is the first to show significant improvements across multiple intervention targets for hypertensive out patients.

LINK

Perceptions of Self-Care for Low-Income Patients with Diabetes

2009-07-10T22:09:00.002-04:00

In this study, 35 low-income diabetic patients participated in focus group discussions regarding their experiences with diabetes treatment. The full article is highly informative and includes multiple examples of specific patient responses for each of the barriers discussed. In particular, patients found making all the changes to be emotionally exhausting, and they frequently reported denial as a significant barrier to healthy life-style goals. Patients also highlighted significant gaps in patient services, and demonstrated very poor understanding of their condition, specifically with regards to A1C. These results highlight the importance of education and support while patients cope with extensive life-style changes, a great deal of information, and the sheer magnitude of their condition.

LINK

If Patients Feel Monitored, Adherence Increases

2009-06-30T00:41:00.006-04:00

Studies show that when trying to make a good impression, adults will lie on average 2-3 times in 10 minutes. The doctor’s office is not off-limits. One study showed that of 40 patients who claimed to have quit 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

2009-06-26T18:35:00.002-04:00

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

2009-06-20T14:06:00.003-04:00

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

Sanofi to Donate Swine Flu Vaccine

2009-06-20T14:04:00.004-04:00

The drug company Sanofi-Aventis will donate 10 percent of it’s A(H1N1) virus vaccines to the World Health Organization in an attempt to stem the spread of the influenza in more vulnerable populations. The goal, according to CEO Christopher A. Viehbacher is to help those in the poorest regions of the world. He goes on to ensure us that this acts towards the international collective responsibility to make health care treatments available to all people.

LINK

Nurses Helping Docs Identify Non-adherent Patients in NZ

2009-06-16T00:48:00.005-04:00

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

2009-06-15T19:30:00.007-04:00

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…

2009-05-25T15:21:00.005-04:00

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

2009-05-19T22:00:00.002-04:00

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

2009-05-19T20:55:00.004-04:00

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

2009-05-14T17:20:00.006-04:00

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

Merck / Cigna Deal Depends on Adherence

2009-05-13T12:33:00.008-04:00

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

2009-05-13T08:32:00.000-04:00

E&Y: Top 5 Risks to Life Sciences Companies

2009-05-12T11:07:00.007-04:00

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

Conference Report: New C&P Programs Connect Multiple Tactics

2009-05-11T19:37:00.067-04:00

CBI's adherence conference in Philadelphia April 28 & 29 attracted 120 participants involved in adherence program sponsorship, development, distribution and analytics.

Pharma adherence experts like Steve Basiago from Walgreens, Tracy Clemmer (Merck), Richard Baron (Boehringer Ingelheim), Neil Potter (Pfizer), Jeff Haresnape (GSK), Tom Brown (BMS) and Nicole Gaul from Sanofi Aventis and Lovena Chaput from Amylin shared their views with peers and suppliers like McKesson, Dendrite, Pleio and others. On day one, several presenters outlined the latest thinking on adherence program design and metrics while day two focused more on workshops and afternoon discussion groups. My Day 1 Takeaway: Adherence programs are getting smarter and more customized to patient needs than ever. My Day 2 Takeaway: Pharma wants to focus on the patients' first 100 days of therapy, and everyone wants support getting programs through legal approval. What were your takeaways from the conference?

I had the pleasure of hosting a lively roundtable workshop on collaborative development of adherence programs using a case-based approach. Based on the adherence campaign maps submitted by ten small teams in the workshop, it seems the trend in C and P is moving away from learning materials and other isolated outputs towards a blended, multi-channel approach that focuses on the first 3-4 months of a new prescription. No team had less than seven interventions over the patient's first 100 days of therapy, and all teams utilized at least four ways of reaching out to the patient. Personal interactions with real people, not just IVRs, provided the connection between assorted products and services including reminders, information pamphlets, and financial incentives. What were your takeaways from the conference?

For the Strategic Patient Adherence Award Winners, click here

Note: I like it when adherence conferences coincide with Springsteen concerts: LINK

Change Expert: "People Don't Like Change"

2009-05-06T19:40:00.014-04:00

Beginning a new prescription is difficult. According to Carlo DiClemente, professor and leading expert on Change Theory, change requires self-control. It’s a marathon, requiring motivation and training. Additional stresses make change even more difficult, and what could be more stressful than a life-threatening disease. So why, when people are offered a solution do they not take the treatment? It’s not that people aren’t motivated to be healthy, but they aren’t motivated to do what they have to do to get there. Coupled with poor self-observation and organization, DiClemente says patients would often rather go to another doctor than admit they have to do what they are told, than admit they have to change.

LINK
flickr photo: Marko K

Patients Trust Older Drugs, Distrust Branded Online Drug Info

2009-05-06T19:34:00.010-04:00

Results from a DDB survey (n=1,831) across 11 countries show that, despite consumers recognizing that new drugs are better, 70% trust older drugs more and in the US 69% would rather take generics. Consumers are also wary of online information provided by branded companies, which came in dead last for trusted sources (7%). Authors advise pharma companies to heed these worrisome trends in order to better serve patients, and retain customers.

LINK

Pleio GoodStart Increases Prescription Refills Up To 53%

2009-04-29T01:59:00.002-04:00

Pleio GoodStart(tm) improves compliance and persistence with chronic medications. Prescription refills increase up to 53% during patients' first 100 days of therapy. New free service offers coaching, reminders and pharmacist support to alleviate stress and confusion some patients experience while adopting a newly - prescribed medication.

Philadelphia, PA (PRWEB) April 28, 2009 -- Pleio Health Support Systems, Inc. (Pleio) announces early results of Pleio GoodStart™, the free medication adherence service. Prescription refill data revealed that Pleio's combination of customized medication reminders, phone-based coaching sessions and pharmacist counseling improves prescription refill activity by up to 53%. Data shows a 14% increase in the first prescription refilled, building to a 53% improvement by the third refill. Refill behavior data from 2,850 patients was compiled and analyzed by Pleio.

"For many people, adapting to a new prescription can be stressful and confusing. Adherence to medication is a process that takes time - and patients welcome the 100 days of free support that Pleio provides. The 53% Rx refill improvement suggests that Pleio's sustained, customized patient adherence support works. The medication adherence community will welcome these real-world results," said Jean Lalonde, Co-Chief Executive Officer of Pleio.

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MIT's AgeLab Simulates Elderly Living

2009-04-07T15:28:00.012-04:00

MIT has created a jumpsuit that is worn by students to teach them the difficulties of being a senior. This suit which has braces and elastics really lets the students feel exactly the way seniors go through life, in hopes of teaching the students empathy towards their elders. We thought children were the new tomorrow? Think again. The population of people over 60 is the fastest-growing age group on earth. So heres the question, if we make products specifically designed for elders will they use them, or run away?

At MIT's AgeLab growing old is the new frontier - The Boston Globe">LINK

Most original C&P solution ever

2009-04-01T13:50:00.005-04:00

Tuberculosis, antibiotics, cell phones, secret messages, peeing and prizes: a recipe for success in compliance and persistence. Jose Gomez-Marquez, program director for the Innovations in International Health program at M.I.T., along with his colleagues there, deserve credit.

"They figured out a simple paper-based test that detects metabolites of the TB drug in urine.” So if you take the drug and pee on a special piece of paper, a secret message appears. If you don’t take the drug, you can pee on it all you want, but it will not reveal the secret message. Every time the drug taker texts the secret message to the people in charge, he earns a prize, like cell phone minutes or cash."

An Ingenious Approach to Drug Compliance - Freakonomics Blog - NYTimes.com

Using Complementary Media in Patient Retention Programs

2009-04-01T09:20:00.021-04:00

The 8th Annual Forum on Compliance, Adherence and Persistency will take place in Philadelphia April 27th and 28th. Jean Lalonde, Co-CEO of Pleio will facilitate a workshop on building collaborative adherence solutions. Participants will be divided into groups to assemble their own adherence program using complementary media. Results should be interesting!
LINK

Did you know?

2009-04-01T00:34:00.003-04:00

An inspiring clip on what's going on in the world. Is pharma keeping pace?

Microsoft's Future of Healthcare

2009-04-01T00:17:00.004-04:00

I liked the medication reminder part...

News Flash: Reps in Decline

2009-03-31T23:34:00.002-04:00

With ROI on sales forces plummeting, drugmakers have slashed the number of feld reps from 102,000 to 92,000 since 2007, and ZS projects the number will drop to 75,000 by 2012.
LINK

One Year Before Death, Half of COPD Patients Stopping Medication

2009-03-31T12:41:00.005-04:00

Contrary to popular literature, in COPD, those with more severe symptoms are less adherent. A recent study has found that, in the final year of their lives, only half of the 11,376 patients had used any medication at all. For patients taking monotherapy, 40% discontinued after 30 days, and 70% discontinued after 90 days. A first in its kind, the study suggests that the lack of adherence seen in MI patients upon discharge may in fact be part of a trend involving less adherence in the most severe patients across disease populations.

LINK
See the Pubmed article for a C&P breakdown by medication type

Simpler packaging doesn't improve compliance

2009-03-30T16:26:00.011-04:00

A study published recently in the Journal of General Internal Medicine showed that making medication labels easier to read did NOT significantly increase adherence. Adherence is complex, concluded researchers, though the labels will likely improve safety, they are simply not enough to address the bigger issue of non-adherence.
LINK
Flickr: Bartificial

Getting Creative With Kids and Asthma

2009-03-25T17:02:00.004-04:00

The University Medical Center in Chicago is coming up with some interesting results: by combining asthma treatment information with things kids enjoy, such as music and sports, children associate their medications with positive messages and experiences and are then more likely to take these medications. Adherence rates increased from 39% to over 70% according to author Dr. Giselle S. Mosnaim, who presented her findings at last week's American Academy of Allergy, Asthma and Immunology.

LINK

Health Literacy Predicts Adherence: New Study

2009-03-23T20:13:00.006-04:00

Though many studies have been used to show health literacy affects adherence, they have been limited by subjective adherence measures. This study used unannounced pill counts to assess adherence in HIV treatment in 145 patients. Health literacy predicted poor adherence, and adherence levels of 80% and 90% “over and above” other factors tested (OR = 3.94, 95%; OR = 4.96, 95% respectively).

LINK

Diabetic Patient and Doctor, Dr. Stephen Ponder Discusses Tricks of the Trade

2009-03-23T20:12:00.003-04:00

Dr. Ponder gives pointers on a few simple tricks that can bring down the unsuspecting diabetic patient. The first two involve misunderstandings; patients should not withhold medication due to normal blood sugar levels, or food due to high levels. Third, Dr. Ponder says that memory difficulties can create poor adherence, especially for additional medications many diabetic patients must take.

LINK

Emergency Department Discharge and Non-Adherence

2009-03-16T00:47:00.001-04:00

If taking medications is difficult for people when they have been prescribed them by a doctor in a clinic, what would it be like in an emergency care facility? Well... theoretically, the health problem is going to be more severe, or at least more obvious to the patient, but the situation is much more stressful, and the chance of follow-up with the same physician next to nil. This study, assessed adherence levels for 258 patients discharged with prescriptions from a hospital emergency ward. 19.8% did not fill their prescriptions and 40.3% did not adhere to 1 or more medications. In particular, co-prescriptions from emergency wards represented significant adherence challenges.

LINK

Persistence With Heart Failure Medication

2009-03-14T17:50:00.011-04:00

Though compliance is well known to be associated with increased risk in patients with heart disease, persistence may prove to be the more clinically useful, and is an important aspect of heart failure research. This study, published recently in the American Journal of Cardiology, was a prospective analysis of the effects of non-persistence. In their sample, 30% of patients were non-persistent. Non-persistence predicted all-cause and cardiovascular hospital readmission. The graph below shows percentage values for the different reasons for non-persistence (50% no reason).

LINK

How Effective is Email at Reaching Consumers?

2009-03-14T15:50:00.004-04:00

Epsilon Research recently released data from a survey performed in October 2008 on the effects of email communication from financial services companies on customer interest. They surveyed over 1500 consumers and found that 54% "have a more favorable opinion" of companies that send them emails. A further 63% of consumers accessed links present in the emails to learn more about products (42% typed the URL into their browser instead), 85% liked receiving permission-based emails, and 70% found that these emails affected their purchasing decisions. For full results see the link: Epsilon Research.

Information Pamphlets Scaring 1/3 of Patients Away From Meds

2009-02-17T15:24:00.007-05:00

In Denmark, pamphlets are provided by law in all medication containers. According to a Danish study published recently, they are read thoroughly by patients, particularly with regards to the information on side effects. Fear of adverse effects subsequently causes 32% of patients to stop taking their medication. The study also found that only 21% of patients trust the information from their doctors or pharmacists and do not feel the need to read further.

LINK

CVS Caremark Study: Non-Adherence Almost Doubles Risk of Hospitalization

2009-02-17T14:07:00.004-05:00

A recently published study by CVS Caremark has found that non-adherent heart failure patients are at an increased risk of almost 200% for subsequent re-hospitalization. In 12 months, non-adherent patients will on average be re-hospitalized 1.1 times, as opposed to only .6 times for adherent patients. Unfortunately, 49.9% of hospitalized heart failure patients are non-adherent. Dr. Brennan, Chief Medical Officer at CVS Caremark, encourages patients and doctors to be aware of the long-term clinical outcomes and financial consequences of non-adherence.

LINK

Patients Turn-down Their Meds to Cope With Economic Downturn

2009-02-17T10:54:00.005-05:00

To assess the impact of today's changing economy, the health care information company, Epocrates Inc., surveyed 700 physicians across the US. According to their results, 95% of doctors believe that the economic downturn is causing patients to make poor choices in health care. Patients are not filling prescriptions, and are skipping doses, and splitting pills in an effort to cut short-term costs. In addition, 55% of doctors surveyed recall writing more generic prescriptions in 2008 than in previous years.

LINK

Behavioral Targeting: Walk Softly, but Carry a Big Stick

2009-02-14T22:37:00.003-05:00

According to ChoiceStream, a provider of personalized online ad software, individuals are nervous about businesses using their browsing history in order to target them for marketing purposes... BUT they respond better to personalized ads. The survey showed that 41% of surfers were more likely to pay attention to personalized ads, and 39% were more likely to click on the links. The effect reached 50% in individuals who shop more often online (>$250 per six months). According to eMarketer research, investments in behavioral targeting are expected to reach $1.1billion in 2009.

LINK

Adhering to Statins Leads to Lower All-Cause Mortality

2009-02-14T21:28:00.006-05:00

A recent study published in the Archive of Internal Medicine is showing that consistent statin therapy reduces all-cause mortality for both primary and secondary prevention groups. The study, evaluating clinical data for nearly 230, 000 individuals, found that if adhered to (at 90% or more), statin therapy reduces risk by 45% and 51% respectively. A noted strength of the study is that it did not use highly selected participants thus it was able to capture a greater picture of the beneficial effects of statin therapy.

LINK

Experiences More Powerful Than Possessions

2009-02-14T21:02:00.006-05:00

A researcher at San Franscisco State University has found that we are happiest when the purchases we make can be enjoyed as experiences with others, as opposed to merely contributing to our hoards of possessions. People adapt to possessions in 6-8weeks, but the social gains in experiences can endure for years. Howell goes on to ask what this could mean for policy makers in companies and governments trying to affect motivation and consumer decisions.

LINK

Patient Retention Survey Results

2009-01-28T23:34:00.023-05:00

Pleio thanks the 21 Dots readers who participated in our Patient Retention Survey this week. Here is what the experts from several pharmaceutical companies and a few pharmacy chains said:

Where are patient retention programs going over the next few years?
10% said they will remain stable
50% said they will grow
40% said they would grow rapidly
Interestingly, 0% said that patient retention programs would decline.

What matters most in patient retention programs?
1. Customization to patient needs
2. Measurement through Rx refill data
3. Pharmacist involvement
4. Guaranteed ROI
5. Physician involvement

Other attributes mentioned or selected included scalability,brand enhancement, continuous patient contact, system engagement, addressing patient needs as well as demographic and geographic targeting.

"Raisin" Will Monitor Drugs in Body

2009-01-27T00:03:00.005-05:00

In a few years, adherence measures such as "days on therapy" and "medication possession ratio" and tools like mems caps may become obsolete when patients can ingest the 'raisin' to measure drugs' presence in their body.
LINK

Less Reps and DTC: More Retention Programs

2009-01-26T23:10:00.008-05:00

Patient retention budgets seem to be growing as DTC and sales force spending contracts. The number of working sales reps in the US dropped below 93,000 in 2008, from an all-time high of 102,000 in 2005, according to an SDI report. Numbers are expected to decline further in 2009. DTC spending has also been targeted: Manufacturers spent 4% less ($3.69 billion) on consumer advertising during the first three quarters of 2008, down from $3.86 billion over the same period in 2007, according to Nielsen. Meanwhile, over a dozen major brands are making inroads with novel patient retention programs that leverage pharmacies, adherence counsellors and reminder programs.

DTC LINK

Motivating Adherence: Money vs. Pride?

2009-01-19T22:08:00.004-05:00

Is providing people with money for a job well-done a good way to promote healthy behaviors? Probably not. Researchers at the University of Pennsylvania have shown that paying people to lose weight acts as an extrensic motivator, and works... but only for short-term goals. Unfortunately, health is a long-term trek.
Psychologists have known for many years that regular rewards can greatly diminish intrinsic motivation and habit formation. That's how Christmas bonuses work... random prizes to stimulate workers' motivation. This is also how gambling works. Unfortunately, with something like health, there is no obvious short-term or even long-term reward. This is why health programs that are successful draw attention to a patient's successes, however small, and encourage patients to create short-term attainable goals in order to develop a sense of pride, a key motivating factor.

LINK

The 7 Barriers to Adherence in Hypertension

2009-01-13T21:09:00.006-05:00

Do you take all your medication? Why not? If you thought the person asking you would disagree with you, or would not understand your perspective, would you bother to tell them the truth? Personally, I would probably tell them I forgot. Studies on barriers to adherence are of course important, but until we start spying on patients or giving them polygraphs, results are still highly subjective.
This study, published in The Journal of Clinical Hypertension found that out of over 1430 participants, 28.4% reported difficulties with taking medication. The following graph shows % reported for the top 7 barriers:

LINK

Increased Risk of Seizure With Non-Adherence to AEDs

2009-01-09T12:26:00.003-05:00

A recently published study (ahead of print, full-text unavailable) composed of 18,073 participants between 21 and 64 years of age, each with 2 AED prescriptions showed an increased seizure risk of 21% among nonadherers (p=.0002). Non-adherence was evaluated using the medication possession ratio.

LINK

Behavioral Counseling Improves Adherence in Elderly

2009-01-05T22:14:00.004-05:00

The Department of Medicine at New York University has published a paper suggesting that behavioral counseling can make a big difference in adherence. The study, published in October, had 65 minority elderly participants. The intervention included a total of 8 behavioral counseling sessions for lifestyle changes important to the control of hypertension (medication adherence, diet, exercise, etc.). In addition to a significant reduction in systolic blood pressure of 13.0 (p=0.004), medication adherence and diet both improved substantially (26%, p=.03; and 23%, p=.03 respectively).

LINK

Alcohol Misuse Leads to Medication Disuse

2009-01-05T21:57:00.005-05:00

People do not really like talking about it, or admitting it, but drinking does affect our ability to function in an organized way on a day to day basis. This recently published article by Bryson et al., investigated the relationship between drinking and non-adherence in three populations of patients: hyperlipidemia (n=5473), hypoglycemia (n=3468), and hypertension (n=13, 729). Using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) questionnaire, authors found that increasing alcohol misuse was associated with decreasing adherence in both the hypertension and hyperlipidemia populations.

LINK

Short Patient Retention Survey from Dots (3 Questions)

2008-12-30T09:29:00.005-05:00

If you've been thinking about compliance, persistence, adherence, loyalty and outcomes, please answer our 3-question survey on patient retention programs: LINK

Most respondents will find a pleasant little surprise with the bonus question. The survey results will be posted on Dots in a few weeks.

Happy New Year!

Why titrate if patients are non-compliant?

2008-11-30T23:21:00.007-05:00

We know compliance and persistence cause poor patient outcomes. When you add the possibility of resistance, you end up with highly complex interactions that are very difficult to assess. Before changing doses or medications, the first goal, according to this article, is to address non-compliance. Doctors need to know what they’re measuring to make the best decisions for treatment. As frustrating as it may be, change is a process; and it can take a long time. The better the communication, the better the decisions, the better the outcome.

LINK

Family to Family Makes Difference in Mental Illness

2008-11-30T22:59:00.002-05:00

Family Education Program, provided by the National Alliance on Mental Illness, teaches family members about mental illness. Taught by trained individuals who themselves have family members with diagnosed illnesses, the program is proven to be effective , providing necessary information to empower families towards recovery. More than 115,000 family members have graduated so far.

LINK

Proactive, Customized Calls Improve Adherence

2008-11-28T11:50:00.004-05:00

"Findings indicate that customized, proactive telephone calls have good potential to improve long-term adherence behavior and clinical outcomes."

LINK

Outcomes MTM Network Expands to 20,000 Pharmacies with 'Good Neighbor' Involvement

2008-11-23T22:31:00.005-05:00

Pleio distribution partner Outcomes Pharmaceutical Health Care of Des Moines, Iowa announced a new distribution agreement with AmeriSource Bergen's 5,000 Good Neighbor pharmacies, bringing their national MTM network to 20,000 pharmacies, more than double their footprint one year ago.
LINK

Pharmacist Support + Improved Knowledge = Better COPD Outcomes

2008-11-19T22:38:00.014-05:00

In Northern Ireland, a new study reveals that pharmacist involvement and improved education to patients can improve adherence, cut emergency visits and hospital admissions in half for COPD patients.

LINK

Knowledge, Pride, Goals & Gifts Deliver 9% Adherence Improvement / 12 months

2008-11-19T01:24:00.015-05:00

An innovative year-long study among mainly African American women with hypertension showed that a mix of knowledge, personal pride, goal development, and occasional gifts was successful in improving adherence by 9% over one year.

Lead author Olugbenga Ogedegbe, MD discusses how the intervention group received bi-monthly phone calls and up to 6 thank-you gifts over the course of a year, while both groups received a workbook on hypertension.

LINK

Burlington, VT Healthiest Town in America

2008-11-18T23:39:00.004-05:00

One of my favorite places, Burlington, Vermont, was identified by the CDC as the healthiest town in America. Go Burlington!
LINK
PHOTO: Selv1a, Flickr

J&J Marries Hard & Soft Science Through Health Media Acquisition

2008-11-18T22:56:00.006-05:00

On October 28, J&J announced the acquisition of HealthMedia. The acquisition was not widely talked about, caught a lot of people in the industry by surprise. We found it to be a timely move ahead of the new Obama health agenda. The potential synergy between J&J and HealthMedia offerings could give J&J a competitive advantage in positioning their devices and drugs. It may become easier for J&J to blend the hard and soft sciences for greater therapeutic success.

J&J Purchase Is a Booster For Marketing - NJBIZ.com

Physicians Underestimate Non-adherence by 50% in Asthma Study

2008-11-09T19:14:00.011-05:00

Comparing physician estimates of compliance with actual pharmacy refill rates, physicians identified only 21 of 43 patients whose controller medication rate was less than 50 percent prescribed.

"According to Dr. Luskin, M.D., associate professor of medicine at the University of Wisconsin in Madison, risks for non adherence include:
• More than one medication, or more than one medication per day
• Worry about medication side effects
• Multiple asthma care givers
• Takes medication for other problems.
• Worries about too much or too little medication
• Has problems using the medicine or child refuses
• Feels medication is only somewhat effective
• Has trouble getting an appointment
• Doesn’t have medication in the house if needed"

Comment: Pleio GoodStart 100-Day adherence programs for asthma address patient and caregiver motivation, knowledge, skills, tools, rehearsal, reinforcement, assessment and feedback. The development of rituals or habits is also important and is seen as a 21-30 day process.

LINK

A Simple Form to Help Elderly Patients

2008-11-01T21:11:00.008-04:00

A simple form created as a med school project will soon be made available in the local clinics. The form is designed as a questionnaire and is meant to help elderly patients remember important information from their doctor's visit (LINK). This is in response to current research emphasizing the importance of simple, easy-to-use med-tables and their effect on the prevention of medication-related problems in the elderly.
LINK

HealthMedia Now a J&J Affiliate

2008-10-30T00:21:00.005-04:00

HealthMedia, with $23M in revenue, was acquired by Johnson & Johnson. Early VC investors see a 10X ROI. A very strategic acquisition on the part of J&J, recognizing that ultimately their product is not molecules or instruments, but outcomes - however they are achieved. LINK

IVR C&P Pilot Cancelled Due to Design, Integration Flaws

2008-10-15T19:06:00.009-04:00

A pilot study using an Interactive Voice Recognition system to examine the effectiveness of automated reminder messages for improving compliance had to be canceled after just 2 months due to patient and physician complaints. The responses of 38.4% of participants who actually commenced the trial revealed that participants did not appreciate the automated voice, there were multiple technical issues, and most patients had already gotten their refills when the calls came.

LINK

Photo: Gwen, Flickr