JOURNAL FOR<strong>PATIENT</strong> <strong>COMPLIANCE</strong>✓Strategies to enhance Adherence and Health OutcomesPharma patient adherence budgets have increased 281percent in four yearsPatient adherence is a hot topic for the healthcare industrybecause it can impede or undermine patients’ recovery or achronic condition. Non adherence costs an estimated $290billion in hospitalization stemming from complications. Forthe pharmaceutical industry, improving it could provide away to save millions in lost revenue. An effective plan by apharmaceutical company could pave the way to a favorablespot on a formulary.As startups, providers and pharmaceutical firmsdevelop ways to solve this critical problem, a new reporthas highlighted some interesting trends. Pharmaceuticalcompanies are devoting more budget spend to patientadherence teams and allocations to digital programs havespiked in the past year.In the past four years US pharmaceutical companies’patient adherence budget allocations have jumped 281percent from $400,000 in 2009 to $1.5 million in 2012.But more importantly there is an increasing recognitionthat understanding patients and their motivations will helppharmaceutical companies better engage them and makeadherence programs more successful. Here are some of themost interesting findings in a patient adherence survey byCutting Edge Information in Durham, North Carolina.JCS – Staff Writer – Maria AlvarezPatient Portals – From Doctor to PatientWith the advent of social media platforms such asFacebook and Twitter, a tremendous hype was generatedby being in constant touch with one another. By virtueof this phenomenon, staying in touch round the clockvia instant messaging where any physical boundariesor restrictions were absent became the new norm. Thissimple and effective means of communication delivereda great value for all business entities alike. The absenceof employing such useful technology would project anegative image into the mind of your clients. Health ITvendors could not afford to lose in this department; hence,to provide a solution to this predicament patient portalsemerged. Through the introduction of patient portals byestablished EMR vendors, hassle for patients along withphysicians was significantly reduced.’Patient Portals provide a platform for patients to stayconnected with their providers. Instantaneous access toall the patients’ reports, scheduling appointments etc. hasmade life easy for patients comprehensively. These portalseliminate the requirement for making phone calls everytime a patient might have a health related query. It wasnever as simplistic to manage your patients’ health priorto patient portals’, says an Ohio based physician.For the healthcare industry today, the Patient Portalhas emerged as the definitive platform for better patientengagement. The technology is so simplistic in nature thatpatients find it very user friendly to utilize and can operateit almost immediately with little or no training. All anypatient has to do is simply login to the online web basedportal in order to remain connected with their doctor.They can do this from any place and at any time;needless to say that this freedom of mobility ensued innumerous benefits. Now both patients and doctors didn’thave to incur the unnecessary costs on lengthy phone callsto one another. Reports could be obtained online, alongsideother relevant medical information. Even requesting refillsand scheduling appointments was made simple, at theconvenience of just a few clicks away.Source: Cutting EdgeOnline survey on the management of patient adherenceResearchers at Keele University have launched an onlinesurvey to learn about health care professionals’ (doctors,pharmacists and nurses) approach to supporting patientswith taking medicines and promoting adherence.Dr Wendy Clyne and colleagues at NPC Plus, KeeleUniversity, are coordinating the survey which is part ofa larger project on medicines adherence called the ‘ABCproject’ (www.abcproject.eu/) funded by the EuropeanCommission. The survey is taking place in countries acrossEurope including Austria, Belgium, France, Germany,Greece, Hungary, Italy, Portugal, Poland, Switzerland, TheNetherlands and England. The survey will run until the endof March 2012.The survey aims to investigate health care professionals’perceptions of the extent and nature of non-adherence,as well as the things that health care professionals do tosupport patients with medication taking.54 Journal For Patient Compliance Strategies to enhance Adherence and Health OutcomesVolume 2 - Issue 4
JPC NewsThe study also aims to find out about any barriers tosupporting adherence as reported by doctors, pharmacistsand nurses. Dr Clyne, Head of the Medicines PartnershipProgramme at NPC Plus, said ‘With more patients takingmedicines than ever before, encouraging patients toget the most out of their medicines is essential to avoidunnecessary ill health as well as reduce waste andunnecessary cost. We are really interested to find outwhat healthcare professionals do to support patients withmedicine taking, and how effective they think their actionsare. At the end of the study we should have a really clearpicture of the role of these three key professional groups insupporting patients with medicines, how that support fitstogether, and whether we have a consistent picture acrossEurope, or whether there are variations in practice fromone country to another.’Source: Cutting EdgePatient adherence predicts ankle surgery healingFocusing on postoperative care may be the optimal wayof reducing healing complications following ankle fracturesurgery, say US researchers.The team from the Thomas Jefferson UniversityHospital in Philadelphia, Pennsylvania, reports thatsurgical debridement was required by just six (1.25%) of478 patients who underwent open ankle reduction andinternal fixation between 2003 and 2010. A further 14(2.9%) patients needed additional wound dressing or oralantibiotics during healing.Nevertheless, multivariate analysis identified several riskfactors for postoperative wound complications among thispopulation.Specifically, patients were significantly more likely tohave wound complications if they had diabetes (odds ratio[OR]=3.61) or an open fracture (OR=13.43), and if theyused wound-compromising medications (OR=6.75), such ascorticosteroids.Furthermore, delayed wound healing was a significant3.66 times more common in patients who were nonadherentto postoperative instructions, such as avoidance of weightbearing for at least 6 weeks, compared with patients whofollowed their physician’s advice.The risk for wound complications also rose significantlywith increasing patient age, say Adam Miller and co-authors.“While most risk factors cannot be controlled,postoperative care is an area of importance for woundhealing,”writes the team. “The adherence to postoperativeinstructions should be emphasized, and the treatingsurgeon should remain vigilant to the potential effect thatnoncompliance may have on wound-healing after surgicalintervention.”The researchers note in the US edition of the Journalof Bone and Joint Surgery that there was a trend towardan increased risk for wound complications in patients whounderwent surgery within 5 days of injury compared with ata later date, but that this did not reach significance.They were also unable to demonstrate any impact ofpreoperative swelling on the risk for wound complicationsin their study due to the subjective nature of the analysis.Believing these two factors may nevertheless havesignificance in wound healing, they add: “This conjectureneeds to be confirmed in a future randomized comparativestudy.”JCS – Staff Writer – Maria AlvarezAttitudes Predict Ability To Follow Post-Treatment AdviceWomen are more likely to follow experts’ advice on how toreduce their risk of an important side effect of breast cancersurgery - like lymphedema - if they feel confident in theirabilities and know how to manage stress, according to newresearch from Fox Chase Cancer Center presented at the2012 CTRC-AACR San Antonio Breast Cancer Symposiumon Saturday, December 8, 2012.These findings suggest that clinicians must do morethan just inform women of the ways they should changetheir behavior, says Suzanne M. Miller, PhD, Professor andDirector of the Psychosocial and Biobehavioral MedicineProgram at Fox Chase and study author. Doctors and nursesshould also provide strategies for women who feel lessempowered to make those changes, and have fewer skillsfor reducing their stress.“Women are in charge of their future, because there arethings they can do to minimize the effects of treatment,”says Miller. “If they get into a routine of doing them, it willreduce their stress and vulnerability.”The study, funded by the U.S. Department of Defense,focused on the side effect of surgery known as lymphedema- an incurable build up of fluid in the lymph nodes that cancause swelling and affect range of motion. In more severecases, it can be quite painful. The rate of lymphedema canvary, but a significant proportion - perhaps as many ashalf - of women will develop it after undergoing surgery toremove breast cancer.“That advice may sound easy to follow, but the realityis quite different,” says Miller. To truly follow theserecommendations, she says, women have to forever changeand monitor their behavior - moisturize the arm on the side ofsurgery several times per day, use an electric shaver insteadof a razor, wear gloves when doing housework or physicalactivity, avoid tight jewelry or clothes, stop carrying heavyobjects, and constantly protect the arm from being jostledor squeezed, for instance. “These changes are going to bevery intrusive into a woman’s everyday life,” says Miller.Source: NHS Health Newswww.JforPC.comJournal For Patient Compliance Strategies to enhance Adherence and Health Outcomes 55