Tuesday, November 20, 2007
A News Report about Medication Non-adherence
Everyone loves to watch TV. A non-adherence news report.
Sunday, November 18, 2007
It Is Not A Small World (or US) After All
I found this article in Synapse, the USCSF, the student paper. I'm not one to talk being 15 lbs over my optimum weight, but if you go to the entertainment parks and anywhere large amounts of people congregate, you will actually see that there is a big problem in the US with obesity.
A New Motto for Weight Loss: Keep Disneyland Open By Alison Silvis
Look to Disneyland for the latest symptom of the obesity epidemic. The park’s “It’s a Small World” ride is simply too small to accommodate the extra 24 pounds the average American has packed on since 1960. Stalls and stops are so common that extra platforms have been built at problem hotspots along the ride. Now, the ride will be closing for ten months beginning in January for refurbishment with larger flume cars and deeper waterways.
As future health-care professionals, this is one more sign of the environment in which we will be practicing. Patients are getting heavier, more sedentary and in greater need of preventative care and support for behavior change. Evidence-based medicine should be the gold standard for such care. But we still cannot answer the simple question: how much weight gain is bad? And how much is good?
The November 7 issue of JAMA contains an article that adds to our understanding of the already-complex relationship between weight and health, but raises many questions about the supposed protective effect of being overweight. Knowing how to interpret articles and how to individualize research findings to a patient is our responsibility. But this is only one component of employing evidence-based medicine. It also means making sure patients understand the information, and then following up to see how they apply that information to their lives. This is easier said than done, of course, but that does not justify giving up.
The same issue of JAMA offered some hope in how to support long-term weight management behaviors, in the discussion of one physician’s efforts to manage the care of an obese patient with several health complications (“Clinical Crossroads: A 63-Year-Old Man with Multiple Cardiovascular Risk Factors and Poor Adherence to Treatment Plans”). The author, Dr. Bodenheimer, emphasized the importance of clinical care teams that work to merge a patient’s goals with clinicians’ goals. A patient’s participation in her care may be the single most important factor in adherence to medication, and presumably plays a fundamental role in determining adherence to behavior change.
In this sense, a clinician’s role may evolve into one of “self-management support,” providing information and resources to initiate and maintain healthy behavior outside of clinic visits. One promising model of this type of chronic care is at Health Partners Medical Group in Minnesota. There, patients receive previsit, visit, postvisit, and between-visit care from a variety of health professionals. Clearly, collaboration within the health professions and between clinicians and patients is essential to this model. Whether or not it improves patient outcomes is yet to be determined, but the current system is clearly failing.
We cannot afford to ignore the painful reality of the obesity epidemic. In Disneyland, when heavy patrons are disgruntled at being asked to step off the ride, they are offered a food voucher. In the world of evidence-based medicine, we need to challenge patients to confront the reality of their daily lifestyle choices, and then work with them to modify those that are unhealthy. We owe it to them.
A New Motto for Weight Loss: Keep Disneyland Open By Alison Silvis
Look to Disneyland for the latest symptom of the obesity epidemic. The park’s “It’s a Small World” ride is simply too small to accommodate the extra 24 pounds the average American has packed on since 1960. Stalls and stops are so common that extra platforms have been built at problem hotspots along the ride. Now, the ride will be closing for ten months beginning in January for refurbishment with larger flume cars and deeper waterways.
As future health-care professionals, this is one more sign of the environment in which we will be practicing. Patients are getting heavier, more sedentary and in greater need of preventative care and support for behavior change. Evidence-based medicine should be the gold standard for such care. But we still cannot answer the simple question: how much weight gain is bad? And how much is good?
The November 7 issue of JAMA contains an article that adds to our understanding of the already-complex relationship between weight and health, but raises many questions about the supposed protective effect of being overweight. Knowing how to interpret articles and how to individualize research findings to a patient is our responsibility. But this is only one component of employing evidence-based medicine. It also means making sure patients understand the information, and then following up to see how they apply that information to their lives. This is easier said than done, of course, but that does not justify giving up.
The same issue of JAMA offered some hope in how to support long-term weight management behaviors, in the discussion of one physician’s efforts to manage the care of an obese patient with several health complications (“Clinical Crossroads: A 63-Year-Old Man with Multiple Cardiovascular Risk Factors and Poor Adherence to Treatment Plans”). The author, Dr. Bodenheimer, emphasized the importance of clinical care teams that work to merge a patient’s goals with clinicians’ goals. A patient’s participation in her care may be the single most important factor in adherence to medication, and presumably plays a fundamental role in determining adherence to behavior change.
In this sense, a clinician’s role may evolve into one of “self-management support,” providing information and resources to initiate and maintain healthy behavior outside of clinic visits. One promising model of this type of chronic care is at Health Partners Medical Group in Minnesota. There, patients receive previsit, visit, postvisit, and between-visit care from a variety of health professionals. Clearly, collaboration within the health professions and between clinicians and patients is essential to this model. Whether or not it improves patient outcomes is yet to be determined, but the current system is clearly failing.
We cannot afford to ignore the painful reality of the obesity epidemic. In Disneyland, when heavy patrons are disgruntled at being asked to step off the ride, they are offered a food voucher. In the world of evidence-based medicine, we need to challenge patients to confront the reality of their daily lifestyle choices, and then work with them to modify those that are unhealthy. We owe it to them.
Wednesday, November 14, 2007
Diabetes in the West Indes
You forget that even in paradise there are chronic diseases and medication adherence is important. To that statement, here is a diabetes program in St. Kitts/Nevis to celebrate World DIabetes Day.
From the Sun St.Kitts/Nevis by Akedia Christopher
The Rotary Club of St. Kitts is hosting a ‘Diabetes Day Camp’ Saturday at the St. Johnson’s Community Center in recognition of World Diabetes Day celebrated today.
President of the club, Leah Sahely, told the SUN in an interview that the event was organised in hope of helping diabetics “find answers to questions about managing this disease.” She added the “disease is serious and we are going to cover all aspects of diabetes.”
The day, as described by the Sahely, is going to consist of breakdown sessions which would enable question and answer segments at the end of each presentation. She added that letters were sent out to health centres and doctors alike asking them to identify patients to participate in the event.
She further mentioned they were presenting educational opportunities by way of lectures, on how to control the disease and “to reinforce the need for compliance.” This, she said, would act as a source of encouragement for diabetics to follow doctors’ orders and also to live healthy lives.
Sahely also mentioned that some of the doctors who will be making presentations include Bichara Sahely who would present an overview of the disease, Cavelle Hobson who would discuss medication availability and consequences of non-compliance and also Dr. Caroline Lawrence who would address cardiovascular complications which can be created and the importance of monitoring the disease .
Earl Clarke is also among the team, according to Sahely, and he is going to speak to the need for exercise and the value of it, along with dietician Magaret Stevens “who is going to talk about eating habits.”
From the Sun St.Kitts/Nevis by Akedia Christopher
The Rotary Club of St. Kitts is hosting a ‘Diabetes Day Camp’ Saturday at the St. Johnson’s Community Center in recognition of World Diabetes Day celebrated today.
President of the club, Leah Sahely, told the SUN in an interview that the event was organised in hope of helping diabetics “find answers to questions about managing this disease.” She added the “disease is serious and we are going to cover all aspects of diabetes.”
The day, as described by the Sahely, is going to consist of breakdown sessions which would enable question and answer segments at the end of each presentation. She added that letters were sent out to health centres and doctors alike asking them to identify patients to participate in the event.
She further mentioned they were presenting educational opportunities by way of lectures, on how to control the disease and “to reinforce the need for compliance.” This, she said, would act as a source of encouragement for diabetics to follow doctors’ orders and also to live healthy lives.
Sahely also mentioned that some of the doctors who will be making presentations include Bichara Sahely who would present an overview of the disease, Cavelle Hobson who would discuss medication availability and consequences of non-compliance and also Dr. Caroline Lawrence who would address cardiovascular complications which can be created and the importance of monitoring the disease .
Earl Clarke is also among the team, according to Sahely, and he is going to speak to the need for exercise and the value of it, along with dietician Magaret Stevens “who is going to talk about eating habits.”
Tuesday, November 13, 2007
Voice Technology To Help The EU
Thanks to Dr. Showalter, I now know how to post a link that works!
From Eureka Magazine.co.uk, written by Tom Shelley:
Two very dissimilar applications – one in machinery, the other in medicine – are both being solved by relying on spoken rather than written information.
Printed instructions are said to be meaningless to around 20% of the European Population. This, combined with the 8 million blind and partially sighted people in Europe, contributes to nearly 200,000 deaths a year in the EU due to mis-dose and non-compliance of prescribed medication.
UK-based Pera has developed ‘talking packaging’ in the shape of Medi-Voice. The idea is to take current compliance monitoring, enhance it and combine it with speech technology in smart pharmaceutical blister packaging which than can give spoken instructions.
The packaging will be powered by thin film, flexible, photovoltaic laminates, with homogenisation of the photovoltaic and the polymer packaging through in-mould labelling. The speech system and compliance electronics will be developed onto a flexible PCB that will be incorporated by over-moulded into the packaging.
A piezo-electric sounder is also to be encapsulated into the polymer packaging during the injection moulding process. Dosage assurance will be achieved through the printing of conductive ink electrodes onto the blister sealing film that will input to the compliance circuitry.
Eureka Magazine Article
From Eureka Magazine.co.uk, written by Tom Shelley:
Two very dissimilar applications – one in machinery, the other in medicine – are both being solved by relying on spoken rather than written information.
Printed instructions are said to be meaningless to around 20% of the European Population. This, combined with the 8 million blind and partially sighted people in Europe, contributes to nearly 200,000 deaths a year in the EU due to mis-dose and non-compliance of prescribed medication.
UK-based Pera has developed ‘talking packaging’ in the shape of Medi-Voice. The idea is to take current compliance monitoring, enhance it and combine it with speech technology in smart pharmaceutical blister packaging which than can give spoken instructions.
The packaging will be powered by thin film, flexible, photovoltaic laminates, with homogenisation of the photovoltaic and the polymer packaging through in-mould labelling. The speech system and compliance electronics will be developed onto a flexible PCB that will be incorporated by over-moulded into the packaging.
A piezo-electric sounder is also to be encapsulated into the polymer packaging during the injection moulding process. Dosage assurance will be achieved through the printing of conductive ink electrodes onto the blister sealing film that will input to the compliance circuitry.
Eureka Magazine Article
Thursday, November 8, 2007
A Little Shamless Promotion
I am not that technologically savvy - I let our programmers handle that end of the business - but I learned how to post pictures yesterday and wanted to share our booth at the 2007 Working Mother WorkLife Congress. We were exhibiting to launch our product offering to employers. Intelecare's Personal Reminder Platform increases medication adherence by sending user created reminders via email, text and voice messaging. We serve the needs of patients and caregivers via our website, Intelecare.com, and with our API, our technology can be integrated into any exiting website as a fully branded adherence solution.
For example, Employer X has a wellness program on their website, with Intelecare's API, Employer X can offer medical reminders (ie. daily medication, refills, appointments, etc...) to their employees. Intelecare handles all the backend programming and message delivery. All the client needs to worry about it their front end design.
Reasoning? 23% of all employer health insurance costs are related to patient medication non-adherence. 64% of patients who are non-adherent cite they simply forget to take their meds. 45% of Americans are on medication. 50% of them are non-adherent. Thus shouldn't employers want to lower their healthcare costs by focusing on medication adherence - a very simple problem that costs the US $177 billion annually in lost revenue and unnecesssary healthcare costs? We think so.
Our API is also available to insurers, pharmaceutical companies, social health networks, EAP providers, and pharmacies. As part of our Enlighten Together program, we offer our Express (email only) solution to non-profits that focus on chronic diseases. All of our products and services are outlined on our website, Intelecare.com.
With that bit of promotion, I shall retire to find more information about this devastating pandemic that affects us all somehow. Please visit the NCPIE site, NCPIE Home to read their August report on medication adherence to find more facts and figures - as well as their call to action.
Stay adherent!
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