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

I picked this up from lifesciencesworld.com, 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.

COMMENTS
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.

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.

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."

Medco Leads the Way in ePrescribing for Medicare Part D

This wire release is a few days old, but strengths my belief in Medco as a positive force in the dirty world of PMBs. Granted they had net revenue of $42 BILLION in 2006, and they wouldn't do anything that doesn't improve their bottom line, but sometimes, big companies do good things. Well, this could be a good thing if they prove it increases profits and they roll out the program! This leads me to another point which is doctor's doling out medications in the office. I have never been to an MDs office that fill scripts, but I think this would greatly reduce medication errors as well.

FRANKLIN LAKES, N.J., Feb. 12 /PRNewswire-FirstCall/ -- As Congress
considers a bill that would tie physicians' Medicare payments to their use
of ePrescribing technology, Medco Health Solutions, Inc. (NYSE: MHS) today
announced the launch of a national initiative to assist physicians of
Medicare Part D patients in switching from hand-written to electronically
generated prescriptions. The pilot program will also be used to study the
impact of ePrescribing on patient safety, increased generic drug use and
formulary compliance on the Medicare population.

"There is strong evidence that ePrescribing reduces medication errors
and increases the use of generic drugs and other lower-cost medication
options. We are proud that Medco will be the first Medicare prescription
drug plan (PDP) to research its impact on the Medicare population," said
John Driscoll, president of new markets at Medco. "The program is designed
to overcome the cost barriers that have prevented widespread physician
adoption of this technology and to verify the benefits of ePrescribing for
Medicare Part D beneficiaries."

Initially the study will include 500 physicians currently treating
enrollees in the Medco Medicare Prescription Plan(TM). Medco -- working
with RxNT, a leading provider of ePrescribing technology - will provide
these physicians with free RxNT ePrescribing software and training. Over a
six- month period, the physicians' rate of generic drug dispensing,
formulary compliance and generated safety alerts will be compared to a
control group of 500 doctors who did not receive ePrescribing software or
training. Ultimately, 2,000 doctors, primarily general practitioners and
internists, will participate in the ePrescribing program.

Advantages of ePrescribing

The Centers for Medicare and Medicaid Services (CMS) estimates that
nationally, use of e-Prescribing technology could eliminate as many as two
million harmful drug events each year. The benefits of ePrescribing
technology include reducing potentially harmful drug interactions by
alerting physicians to possible risks and eliminating illegible physician
hand-written prescriptions that can lead to medication dispensing errors.
Additionally, ePrescribing has been shown to promote the use of generic
drugs and increase formulary compliance, saving money for both patients and
health plans. Despite these benefits, only about three percent of U.S.
physicians actively use ePrescribing technology.

Medco Leads the Way on ePrescribing

This is Medco's second major ePrescribing effort. In 2005, Medco joined
forces with the three largest U.S. auto companies - General Motors, Ford
and Chrysler - to launch the Southeast Michigan ePrescribing Initiative
(SEMI). Between 2005 and 2007, approximately 2,700 participating physicians
have generated nearly 6.2 million prescriptions using ePrescribing
technology.

A recent analysis of SEMI found that ePrescribing substantially
improved patient safety by alerting physicians of risks related to drug
interactions and other potential medication errors and resulted in a
significant number of prescription changes that prevented potential adverse
events. Formulary compliance also improved. The review of 3.3 million
electronic prescriptions showed:


-- A severe or moderate drug-to-drug alert was sent to physicians for more
than 1 million prescriptions (33 percent), resulting in nearly 423,000
(41 percent) of those prescriptions being changed or canceled by the
prescribing doctor;
-- More than 100,000 medication allergy alerts were presented, of which
more than 41,000 (41 percent) were acted upon; and
-- When a formulary alert was presented, 39 percent of the time the
physician changed the prescription to comply with formulary
requirements.

"The SEMI program results show that ePrescribing can have a big impact
on patient safety and overall health care costs," continued Driscoll.
"Medicare Part D provides the right opportunity to introduce many more
physicians to ePrescribing, a key step toward improving patient safety for
this critical segment of the population and reducing the cost of
prescription health care in the Medicare program."

Dr. Nash's Blog

A few months back, I met with Dr. David Nash, The Dr. Raymond C. and Doris N. Grandon Professor and Chairman of the Department of Health Policy at Jefferson Medical College of Thomas Jefferson University in Philadelphia. He is one of the KOLs in Health Policy and had done a significant amount of research in medication non-compliance/adherence. In his latest Health Policy Newsletter, there is a mention of his blog. I checked it our today and found this presentation. It is on medication non-adherence and how reduced co-pays save employers money in the long run and improve healthcare outcomes, specifically with chronic diseases.

I have posted a link to his blog in my blogroll.

Enjoy the presentation.