Tuesday, June 24, 2008

It is Always Nice to Be Recognized - Part 2

As I have mentioned in previous posts, it is nice to get a mention in another healthcare blog every now and again. George Van Antwerp from the Patient Centric Healthcare blog mentioned Medication Non-adherence and added it to his blogroll.

His blog provides insightful comments from one who has worked in a few different positions in the healthcare industry, not only about healthcare, but the economy and the state of America. I often read and comment if I have something to add to the discussion, and have liberally lifted a theme or two for this blog - with attribution of course.

Thanks George!

Monday, June 23, 2008

Aetna To Fund UPenn Medical Adherence Lottery Study

A UPenn SOM study funded by Aetna Foundation has an interesting take on using a lottery system to see if patients will be adherent to their medications. If a patient takes their pills, they have an opportunity to wine $100 a day. Full article at courant.com.

Workplace Violence In the Healthcare Industry

Hat tip to George Van Antwerp from Patient Centric Healthcare about this horrible state of affairs.

"people employed in the health care sector are 16 times more likely to be faced with violence while they are at their job than workers in any other service profession."

Full article here.

Friday, June 20, 2008

More American Well

Here is an article written by Wade Roush from Xconomy.com that tells the American Well story much better than I can - as well as their new deals with Microsoft Health Vault and Hawaii Medical Service Association (HMSA).


1st Blog Birthday

Is this even the right phrase? The anniversary of my first blog post came and went 8 days ago, and I just realized. Since starting this blog, there have been many articles written about medication non-adherence and I have spoken with hundreds of people, educating them about the affects of this pandemic.

Over the past year, the tone of this blog has turned from regurgitating articles I have found, into my own personal views on the healthcare industry and its problems. Thus, I have changed the header, and will continue to write my own thoughts and experiences in this blog, as well as transmit my findings in the world of medication non/adherence - since it is a topic that needs to be addressed every day, until we can reduce the numbers.

1 in 2 patients are non-adherent
$300 Billion annually in unnecessary healthcare costs and lost revenue
84% of patients simple forget
Poor outcomes and higher healthcare costs

This is my mantra. Medication adherence is America's biggest drug problem, but it need not be.

i2y Stupid Cancer Gala

Last night I attended the I'm To Young For This! Cancer Foundation's 2nd Annual Stupid Cancer Gala. I got to meet the founder, Matthew Zachary, with whom I have been emailing with for the last few weeks. i2y is a fantastic resource for cancer patients and survivors under 40. Matthew is a cancer survivor and was surprised there wasn't a voice for him and others like him, so he founded i2y 16 months ago. Since then, he has been on a whirlwind of promotion and fundraising, even garnering a spot in Time's 2007 Top Websites.

The mood at the Gala was very upbeat, with patients, survivors, family, and volunteers all supporting each other, sipping on drinks and making merry. From what I can tell about the vibe of the foundation, "having cancer really sucks", but you should not let it ruin your life. Unfortunately, I could not stay longer, since I had to go back to CT, but it has been very moving and inspirational for me to learn about and participate in i2y.

If you or anyone you know can benefit from their services, I strongly recommend visiting their site and finding the resources you or your loved one needs.

Wednesday, June 18, 2008

Non-adherent Epileptics 3x More Likely To Die

This is an article from MedPage that really speaks to the importance of medication adherence.

Here is just the first paragraph or so:

BIRMINGHAM, Ala., June 18 -- Faithfully taking epilepsy medication may be a matter of survival, according to findings of a large observational study.

Patients in three state Medicaid databases who took prescribed epilepsy medication less than 80% of the time were three times more likely to die than those who took their medication regularly over the course of a three-month period, found Edward Faught, M.D., of the University of Alabama at Birmingham, and colleagues

American Well Launches Today

Here is a link to their press release

I have been following this company for the better part of this year. I watched their online demo, have spoken with doctors, and Health 2.0 types - all to very mixed responses.

I am interested to see the adoption and the value of the service. Is this the next wave of boutique healthcare?

Also launching soon is Hello Health from Jay Parkinson, who emailed me today to say the it is imminent - having pushed it back from June 1.

They are blending home /office visits with online tools and virtual visits to care for patients in a 2.0 method.

Very interesting to see where all of this goes. I am going to the doctor tomorrow, and would rather just have a consult from my office, but I live in CT where we are slow to adopt to new healthcare technology!

Tuesday, June 17, 2008

Cost-Shifting and Medication Adherence

Great Article by our friend Dr. David Nash in MedPage Today.

Cost-Shifting and Medication Adherence

By David B. Nash, M.D., M.B.A., F.A.C.P.; Brian Leas,, MS, MA | June 16, 2008

A broad array of new medications have become available over the past decade to help patients control elevated cholesterol, hypertension, diabetes, depression, and a host of other serious chronic conditions. These drugs have expanded the available tools in the physician's arsenal and are key ingredients in maintaining the health of millions of people worldwide.
But no medication -- whether an old standby or a new blockbuster -- will work unless patients fill their prescriptions and take the right dose at the right time.

In reality, prescriptions often go unfilled and pills are not taken on schedule. Studies consistently show that 25% to 40% of medications are not taken as prescribed.

Among the factors that contribute to poor medication adherence are the impact of side effects, the challenge of managing a complex regimen of multiple medications, and simple forgetfulness.

One factor that warrants special attention in the current healthcare environment is the patient's out-of-pocket cost for prescription drugs. Today, nearly all insured patients face co-pays or co-insurance, and those who don't have insurance foot the entire retail price.

Not surprisingly, research shows that medication costs influence patient behavior.

The landmark RAND Health Insurance Experiment, conducted more than 20 years ago, demonstrated that increasing a patient's share of medical costs leads to a reduction in the use of services, including prescription drugs.

Subsequent studies confirmed the connection between the level of cost incurred by patients and their likelihood to adhere fully to a medication regimen.

Patients faced with high medication costs may decide to take smaller doses, or to take doses less frequently so that they can extend the time between refills.

Those who need multiple medications -- half of all Americans over age 60 take at least 3 medicines every day, and 10% take at least 7 -- may be faced with choosing which drugs they can afford to take and which prescriptions to leave unfilled.

Some patients may alternate pills from day to day to make each prescription last longer; others will opt to take a medication only when they experience symptoms.

These cost-saving strategies are ineffective at best and represent dangerous behavior for many diseases.

Poor medication adherence has broad health and economic consequences. Patients who don't take their medications as prescribed are more likely to experience poor health and increased risk of comorbidities.

On a population level, improper management of chronic disease can result in greater direct healthcare costs arising from preventable hospitalizations or visits to the emergency department.

Researchers have found that improving medication adherence can cut medical costs in half for patients with diabetes and high cholesterol. Likewise, children with asthma are far less likely to need emergency care or be hospitalized when they use medications appropriately.

Finally, poorly controlled chronic conditions are associated with lost productivity and other indirect economic costs.

Although the twin issues of medication adherence and prescription drug costs have been a subject of research and policy debates for a long time, there is now a heightened sense of significance as employers and insurers seek to use cost-shifting as an important tool for managing their spiraling health care costs.

Rising co-pays, restrictive formularies, and the expansion of high-deductible health plans all serve to increase the financial burden on patients. It will be important to understand the impact of these strategies on patient utilization of necessary medications.

Several recent initiatives have sought to improve medication adherence by tempering the financial barrier of medications. The city of Asheville, N.C., often cited as a model in this area, reduced or eliminated co-pays for city employees diagnosed with certain chronic diseases. Pitney-Bowes has emerged as a leader in the corporate world for a similar type of program.

The researchers monitoring these programs have concluded that reducing the costs of key drugs for selected conditions (along with educational and medication management programs) has resulted in improved medication adherence and lowered overall healthcare costs.

As the retail pharmacy market continues to experiment with highly discounted generic drugs, and as Medicare begins to reflect on the early impact of Part D coverage, it will be important to conduct an ongoing assessment of the real impact of direct drug costs on patient adherence.

The debate over shifting costs to patients remains to be settled.

Want More on Health Policy?

Read David Nash's blog at http://departmentofhealthpolicy.blogspot.com.

Thursday, June 5, 2008

Kevin Aniskovich's DM Colloquium Presentation

As Director of Corporate Development for Intelecare, I sometimes blog about what we are doing as a company and how we are helping the various stakeholders in healthcare by enabling patient medical adherence. I would be remiss not to mention our CEO's (Kevin Aniskovich) presentation at the DM Colloquium last month.

The title: Effectively Increasing Patient Adherence as a 360 Degree Approach. He also introduced the term Adherence 2.0 (in line with Health 2.0) and released the preliminary findings of a survey on the utilization of employee wellness programs.

Hope you enjoy!

Tuesday, June 3, 2008

50 Web Apps to Help with Your Health

I was reviewing some twitter feeds and Matt C mentioned this link for 50 Web Apps in the Health 2.0 space. Many great web apps are not mentioned, but this is a good place to start!