Today's medical adherence abstract comes to you from Diabetes Care.
OBJECTIVE
The study aim was to determine if multisystemic therapy (MST), an intensive home-based psychotherapy, could reduce hospital admissions for diabetic ketoacidosis (DKA) in youth with poorly controlled type 1 diabetes over 24 months. Potential cost savings from reductions in admissions were also evaluated.
RESEARCH DESIGN AND METHODS
A total of 127 youth were randomly assigned to MST or control groups and also received standard medical care.
RESULTS
Youth who received MST had significantly fewer hospital admissions than control subjects (2 = 11.77, 4 d.f., n = 127; P = 0.019). MST-treated youth had significantly fewer admissions versus their baseline rate at 6-month (P = 0.004), 12-month (P = 0.021), 18-month (P = 0.046), and 24-month follow-up (P = 0.034). Cost to provide MST was 6,934 USD per youth; however, substantial cost offsets occurred from reductions in DKA admissions.
CONCLUSIONS
The study demonstrates the value of intensive behavioral interventions for high-risk youth with diabetes for reducing one of the most serious consequences of medication noncompliance.
Thursday, August 28, 2008
Monday, August 25, 2008
BarCamp | HealthCampDC
I will be attending HealthCamp DC on September 12th.
I really do not know what to expect from this unconference, as I have never attended one before. Several Health 2.0 and patient advocates will be there who I have connected with on Twitter, through email and via the good old telephone will be there, so I am looking forward to meeting them in person.
If anyone would like to get together to talk about medication adherence, Health 2.0 or how Intelecare can help your organization on the 11th, please let me know: Alex.Sicre [at] Intelecare [dot] com, as I will line up a few meetings the day before.
Look forward to seeing you there!
I really do not know what to expect from this unconference, as I have never attended one before. Several Health 2.0 and patient advocates will be there who I have connected with on Twitter, through email and via the good old telephone will be there, so I am looking forward to meeting them in person.
If anyone would like to get together to talk about medication adherence, Health 2.0 or how Intelecare can help your organization on the 11th, please let me know: Alex.Sicre [at] Intelecare [dot] com, as I will line up a few meetings the day before.
Look forward to seeing you there!
What I Found Today
Lots of news about medication adherence today. As part of my job, I often educate people about the effects of medication non-adherence when pitching them our services. It is surprising how many people are unaware of the pandemic, even though there has been so much research over the last 20 years about it.
I am always looking around the web for more information, and today I have found a few companies attacking medication non-adherence through a variety of ways.
At The Earth Times, a press release about Pleio launching their GoodStart program with the Outcomes Personal Pharmacy Network. I have been following this Canadian company for awhile, and it is great to see they are in the marketplace. Their niche is helping patients stay adherent to their medications for the 1st 100 days through a handful of interventions at the pharmacy level.
It is great to use the pharmacist in the intervention, however how will this slow down the fulfillment procedures at the pharmacy? Patients are already yearning for a more automated system, what if they have to wait even longer for the 1st time fill, and wait for the people ahead of them to enroll in the program?
Two stories from MarketWatch. The first, a press release about HC Innovations signing a LoA to use InforMedix's Med-eXpert System for up to 500 of ECI's complex patients. I have been following InforMedix for over a year, and they have made some great steps toward increasing medication adherence pill dispenser /monitor. In fact, it is being used in AETNA's Medication Adherence Lottery Clinical Trial.
I am surprised there is not more news from the NACDS Conference this weekend, since I have only seen this press release about ValueTrak from ValuCentric and PDX. Their new program allows for linking of ValueCentric's trade data with PDX-Rx.com's prescription data to give manufacturers a "full visibility of their product activity".
And finally this weird story from The Chicago Tribune about a man who stole the identity of a mentally disabled friend to get heart by-pass surgery.
"You can't just walk in with somebody's Medicaid card like it's a credit card and have heart surgery done," said Jeff Nelligan, spokesman for the federal Centers for Medicare and Medicaid Services. "A doctor would need to know blood type, cardiac history, medical history and other comprehensive records that just couldn't be faked. This doesn't make sense."
Very bizarre that this would happen with all of the checks and balances in place at a hospital for such an expensive procedure.
Enjoy the news!
I am always looking around the web for more information, and today I have found a few companies attacking medication non-adherence through a variety of ways.
At The Earth Times, a press release about Pleio launching their GoodStart program with the Outcomes Personal Pharmacy Network. I have been following this Canadian company for awhile, and it is great to see they are in the marketplace. Their niche is helping patients stay adherent to their medications for the 1st 100 days through a handful of interventions at the pharmacy level.
It is great to use the pharmacist in the intervention, however how will this slow down the fulfillment procedures at the pharmacy? Patients are already yearning for a more automated system, what if they have to wait even longer for the 1st time fill, and wait for the people ahead of them to enroll in the program?
Two stories from MarketWatch. The first, a press release about HC Innovations signing a LoA to use InforMedix's Med-eXpert System for up to 500 of ECI's complex patients. I have been following InforMedix for over a year, and they have made some great steps toward increasing medication adherence pill dispenser /monitor. In fact, it is being used in AETNA's Medication Adherence Lottery Clinical Trial.
I am surprised there is not more news from the NACDS Conference this weekend, since I have only seen this press release about ValueTrak from ValuCentric and PDX. Their new program allows for linking of ValueCentric's trade data with PDX-Rx.com's prescription data to give manufacturers a "full visibility of their product activity".
And finally this weird story from The Chicago Tribune about a man who stole the identity of a mentally disabled friend to get heart by-pass surgery.
"You can't just walk in with somebody's Medicaid card like it's a credit card and have heart surgery done," said Jeff Nelligan, spokesman for the federal Centers for Medicare and Medicaid Services. "A doctor would need to know blood type, cardiac history, medical history and other comprehensive records that just couldn't be faked. This doesn't make sense."
Very bizarre that this would happen with all of the checks and balances in place at a hospital for such an expensive procedure.
Enjoy the news!
Thursday, August 21, 2008
Some Quickies From Around the Web
I have been working on a couple of interesting blog posts, specifically one about Twitter for health. I am working on the proper angle, outlining how I use the service, and how others can as well. It is taking longer than I thought, so I appologize.
Here are some quick snippets of news from other sources that I have seen this week so far. Sorry for the retread.
At Psychiatry MMC, there is an abstract about short-acting versus long-acting medications for the treatment of ADHD:
"Medication adherence is also a well-known problem in a chronic disorder like ADHD, with only about 20 percent of patients remaining on the same medication 15 months after first being prescribed that medication. The need for multiple daily dosing of immediate-release medications only further increases the risk of nonadherence in children, adolescents, and adults.
As there is a significant likelihood that one of the parents of a child with ADHD will also have ADHD (often undiagnosed), or another psychiatric disorder, there is potentially a significant risk that the parent will forget to give the additional immediate-release doses of medication to the child every 4 to 6 hours."
Over at MedTrack Alert, they discuss how juices can interfere with medication absorption:
"Researchers say grapefruit juice has been known to dangerously increase the amount of medication absorbed into the body--particularly drugs for high cholesterol and high blood pressure. But a new study by the same researchers has found that apple, orange, and grapefruit juice may also decrease the absorption of some meds, including drugs commonly used to treat diabetes, cancer, allergies, and some antibiotics."
Dr. Showalter at Alignmap discussed the new medication adherence tool: Zuri. FD it is kind of a competitor to Intelecare, however you do not have to spend $200 on a new device and adapt to new technology - Intelecare works with your existing cellphone, land line and computer. Also, you don't have to pay $40 - $50 a month for online services.
The Healthcare Blog now has it's own channel on ICYou. Hat tip to @mindofandre on Twitter.
SHPS to present at Harvard Colloquium about Six Sigma Principles Drive Healthcare Behavior Change -- Using Medication Compliance to Improve Healthcare Outcomes.
Over at Health Management Rx, Jen gets exited about the NextHealth Model launching in beta soon.
That is it for now. You can follow me on Twitter and contribute to the conversation.
Here are some quick snippets of news from other sources that I have seen this week so far. Sorry for the retread.
At Psychiatry MMC, there is an abstract about short-acting versus long-acting medications for the treatment of ADHD:
"Medication adherence is also a well-known problem in a chronic disorder like ADHD, with only about 20 percent of patients remaining on the same medication 15 months after first being prescribed that medication. The need for multiple daily dosing of immediate-release medications only further increases the risk of nonadherence in children, adolescents, and adults.
As there is a significant likelihood that one of the parents of a child with ADHD will also have ADHD (often undiagnosed), or another psychiatric disorder, there is potentially a significant risk that the parent will forget to give the additional immediate-release doses of medication to the child every 4 to 6 hours."
Over at MedTrack Alert, they discuss how juices can interfere with medication absorption:
"Researchers say grapefruit juice has been known to dangerously increase the amount of medication absorbed into the body--particularly drugs for high cholesterol and high blood pressure. But a new study by the same researchers has found that apple, orange, and grapefruit juice may also decrease the absorption of some meds, including drugs commonly used to treat diabetes, cancer, allergies, and some antibiotics."
Dr. Showalter at Alignmap discussed the new medication adherence tool: Zuri. FD it is kind of a competitor to Intelecare, however you do not have to spend $200 on a new device and adapt to new technology - Intelecare works with your existing cellphone, land line and computer. Also, you don't have to pay $40 - $50 a month for online services.
The Healthcare Blog now has it's own channel on ICYou. Hat tip to @mindofandre on Twitter.
SHPS to present at Harvard Colloquium about Six Sigma Principles Drive Healthcare Behavior Change -- Using Medication Compliance to Improve Healthcare Outcomes.
Over at Health Management Rx, Jen gets exited about the NextHealth Model launching in beta soon.
That is it for now. You can follow me on Twitter and contribute to the conversation.
Friday, August 15, 2008
How Hurricane Katrina Affected Medication Adherence
Today's medical adherence related abstract comes from The American Journal of The Medical Sciences:
Background:
Previous research indicates that many patients with hypertension ran out of medications and had difficulties getting refills immediately after Hurricane Katrina. The extended effect of Hurricane Katrina on antihypertensive medication adherence is not well characterized.
Methods:
Data were analyzed for 2194 participants who completed the baseline survey for the Cohort Study of Medication Adherence among Older Adults between August 2006 and September 2007. Based on pre-Katrina zip codes, the study population was categorized into high- and low-affected areas. Low medication adherence was defined as a score less than 6 on the 8-item Morisky Medication Adherence Scale.
Results:
Prevalence of low adherence was similar among participants living in high and low affected areas. Low medication adherence was similar for participants with greater than or less than 25% of the residence damaged by Hurricane Katrina and for participants with and without symptoms of post-traumatic stress disorder.
In high affected areas, nonsignificant associations were present for those who had moved since the storm and those with a friend or immediate family member who had died in the month after the storm. These factors were not associated with low medication adherence in low affected areas. In both high- and low-affected areas, lower scores on the hurricane coping self-efficacy scale were associated with low medication adherence (P < 0.05).
Conclusions:
The effect of Hurricane Katrina on patient adherence to antihypertensive medication was limited in the second year after the storm. Intrinsic patient factors, such as low coping self-efficacy, remain important factors associated with low adherence.
Background:
Previous research indicates that many patients with hypertension ran out of medications and had difficulties getting refills immediately after Hurricane Katrina. The extended effect of Hurricane Katrina on antihypertensive medication adherence is not well characterized.
Methods:
Data were analyzed for 2194 participants who completed the baseline survey for the Cohort Study of Medication Adherence among Older Adults between August 2006 and September 2007. Based on pre-Katrina zip codes, the study population was categorized into high- and low-affected areas. Low medication adherence was defined as a score less than 6 on the 8-item Morisky Medication Adherence Scale.
Results:
Prevalence of low adherence was similar among participants living in high and low affected areas. Low medication adherence was similar for participants with greater than or less than 25% of the residence damaged by Hurricane Katrina and for participants with and without symptoms of post-traumatic stress disorder.
In high affected areas, nonsignificant associations were present for those who had moved since the storm and those with a friend or immediate family member who had died in the month after the storm. These factors were not associated with low medication adherence in low affected areas. In both high- and low-affected areas, lower scores on the hurricane coping self-efficacy scale were associated with low medication adherence (P < 0.05).
Conclusions:
The effect of Hurricane Katrina on patient adherence to antihypertensive medication was limited in the second year after the storm. Intrinsic patient factors, such as low coping self-efficacy, remain important factors associated with low adherence.
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