Friday, March 28, 2008

Med-eMonitor Improves HIV Medication Adherence, BUT Look at The Test Group

I picked this up from, but it was on the PRWire as well. SEE my comments at the end.

ROCKVILLE, Md., March 26 /PRNewswire-FirstCall/ — InforMedix Holdings, Inc. (OTC Bulletin Board: IFMX), announced that results presented by Dr. David Bangsberg, an internationally renowned expert on medical adherence, at the Third International Conference on HIV Adherence, showed that HIV+ patients using its Med-eMonitor™ “smart pillbox” that monitors medication and care plan adherence, achieved an average 89.5% medication adherence rate.

The Med- eMonitor “smart pillbox” is linked to the Med-eXpert™ software system that analyzes patient information and provides Web-enabled reports and urgent outbound alerts to caregivers when patients miss medication or suffer declining health.

Approximately 1.2 million people in the US are living with HIV, with an additional 40,000 becoming infected each year, costing the US health care system approximately $50,000-$75,000 per year per patient, or $50 to $75 billion in total annual costs.

Average adherence to HIV antiretroviral therapy is under 70%, and 20-33% of HIV-positive patients will miss at least one of their doses over any given 3-day period. Given that a 10% difference in adherence by individuals is associated with a doubling of viral load, and a 21% increase in the risk of progression to full-blown AIDS; based upon the statistics above Med-eMonitor/Med-eXpert offers the potential for a 40% decrease in the risk of an HIV patient developing full blown AIDS.

The challenging population of 76 patients that were enrolled in the program not only suffered from HIV infection, but frequently were also suffering from drug abuse and severe mental illness, and were near-homeless.

As I always say, I applaud anything that encourages and enhances medication adherence. It am impressed by these raised adherence rates for HIV patients, but I think regular adherence rates are even lower. Here is my one question though, the sample group of 76 patients were near -homeless, and suffered from drug abuse and severe mental illness. This, to me, does not seem like an accurate test of the efficacy of Med-eMonitor™ - since it is in a controlled environment. I am not knocking the Med-eMonitor, but certain factors have to be in place to use it: #1 being a house to put it in, a fast internet connection, and a patient who waits for the machine to tell them when to take their pills.

With such a structured regimen as HIV medications, sometimes 10 - 20 medications a day, at certain times, one would have to be in front of the Med-eMonitor all day, waiting for the cue to take their meds. So how did the study go? Did the drug addicted, mental unstable near homeless stay in a shelter, rehab facility or mental institution and have their own Med-eMonitor programmed for them? Instead of the nurse coming around with their pills, it was the machine?

I will have to look further into this study to get a real understanding of it all. It just struck me as bizarre. If you are going to announce these results, maybe not mention that the patients were mentally ill, homeless drug addicts.

I still applaud the work and the use of Med-eMonitor and InforMedix for the software they have developed to increase medication adherence. I will have to look at AlignMap to see if Showalter has any comments.

Thursday, March 13, 2008

QuikMeds Dispensing in Doctor's Offices

I have always supported drug dispersal at the MD's office, considering 30% of prescriptions never get filled. My only concern (and why pharmacists are needed) is that medication errors can easily occur since their is no human interaction. Sure the nurse checks to make sure that it is the correct drug and dosage, but how can he/she be sure the label matches what is inside of the bottle?

Imagine seeing your doctor and getting a prescription filled all in one shot.

Now, a new in-office vending machine could save patients an extra trip to the drug store.

"It takes us two minutes, three minutes to process it," said Dr. Madeleine Weiser. "It's very quick."

Doctor Weiser says she installed the Quiqmeds system in her office to save patients time and money.

"You're giving the patient the exact same thing that you would be ordering at a pharmacy," said Dr. Weiser. "But you're able to deliver sometimes a larger quantity for a similar price or a better price."

The dispensing machine holds mostly cost-saving generics.

Instead of writing a prescription on a pad, the doctor logs into the system using a security code and orders the medication on a touch screen.

"I pick what kind of dosage I want to give, whether it's one teaspoon two times a day or three times a day," said Dr. Weiser. "So, I have full control over it. There's no confusion as to what I want."

While a printer churns out personalized instructions, the machine coughs up the medication.

"When it's right here and you can answer their questions and it really saves on the phone calls that go back and forth to clarify sometimes medication orders," said Dr. Weiser.

The prescription is at the front desk by the time the patient checks out.

Some doctors say the Quiqmeds system improves compliance among patients.

Depending on the state, doctors who use the machine make a minimal profit on each prescription.

Tuesday, March 11, 2008

Necklace to Help with Non-adherence

As we know, a new study reported that 84% of patients who are non-adherent to medication say they simply forget. I found this bit on the UPI and wonder what will happen when the patient forgets - will the necklace strangle them until they take their pill? This could be even more strict then Dr. Showalter's idea of RoboCop making one compliant!

ATLANTA, March 6 (UPI) -- U.S. researchers have created a sensor necklace that someday may help people remember the last time they took their pills.

The MagneTrace records the exact time and date when specially designed pills are swallowed and lets the user know if any doses are missed, Maysam Ghovanloo of the Georgia Institute of Technology said Wednesday in a news release.

The necklace contains an array of magnetic sensors that can detect when pills containing a tiny magnet passes through a person's esophagus. The sensors also can be incorporated into a patch attached to the chest.

"Forgetfulness is a huge problem, especially among the elderly, but so is taking the medication at the wrong time, stopping too early or taking the wrong dose," Ghovanloo said. "Studies show that drug noncompliance costs the country billions of dollars each year as a result of re-hospitalization, complications, disease progression and even death."