Tag Archives: Medication adherence

Remote monitoring is on the rise

Worldwide, 3 million patients have a remote monitoring device at home that is monitored by a professional caregiver. This states a new report by Berg Insight. IF this market will grow is not a question, but HOW this market will evolve that is the important question. Berg Insight sketches a future for connected medical devices with a compound annual growth rate (CARG) of 44.4 percent. It is estimated to reach €19.1 million connections by 2018.

remote-monitoring-device-market-by-Berg-Insight

Patients that use connected medical devices for various forms of personal health tracking are not included in this figure.

 

 

 

 

 

They claim revenues of remote patient monitoring has reached €4.3 billion in 2013. Between 2013 and 2018 they expect revenues will grow with 35 percent, reaching €19.4 billion. What kind of monitoring is now booming in this market?

  • Cardiac rhythm management; accounts for two-thirds or 2 million connections and will grow to 4 million by 2018
  • Sleep therapy; represents about 0.54 million people
  • Telehealth, medication adherence and airflow monitoring have 0.34 million connections. Interesting fact is that pharmaceutical companies will move into this space as well.

Vitaphone expects Berg Insight to be be right: this market will grow. We are definitely going to help to develop a better and more efficient healthcare by introducing cutting edge solutions in remote monitoring of vital signs.

Author: Indy Kavelaars

Source: Berg Insight

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Another reason to use a medication adherence support system

Nederlandse versie >

“Data from the National Health and Nutritional Examination Survey (NHANES) from 2007 till 2010 shows that 77.9 million adults in the United States (33.0%) have hypertension.”[1]

This shows hypertension is a big problem and has a great impact on the healthcare community. 81.5% of the subjects were aware of their high blood pressure and 74.9% was treated for this condition. In 52.5% of the subjects who got medication the blood pressure was under control, but with 47.5% it wasn’t.

“An effective reduction of blood pressure is associated with a reduction of cardiovascular (CV) risk and with less cerebrovascular events and related morbidity and mortality. Most patients with hypertension (~75%) need a combination therapy and some (~25%) need three anti-hypertensive medications to lower their blood pressure enough.”[1]

In the past decade the hypertension guidelines evolved towards combination therapies. Combination therapies do enhance the potential to control the blood pressure in an earlier stage, without increasing the incidence of complications. Patients need to commit to the more complex medication schedule. These complex medication schedules create a bigger chance on medication errors. Pharmacists, healthcare organizations, home care, parents and relatives need and must support medication users! With PICO, Vitaphone supports both patients and the environment in a simple and efficient way.

Auteur: Indy Kavelaars @ Vitaphone Netherlands

Source: [1] Pubmed, Review of blood pressure control rates and outcomes

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Nog een reden om een medicatie ondersteuningssysteem te gebruiken

English version >

“Gegevens van de National Health and Nutritional Examination Survey (NHANES) van 2007 tot en met 2010 laten zien dat 77.9 miljoen volwassen in de Verenigde Staten (33.0%) hypertensie hebben.”[1]

Hypertensie is een serieus probleem met een grote impact op de gezondheidszorg. 81.5% van de onderzochten wist af van hun eigen, te hoge, bloeddruk waarvan er 74.9% ook voor werd behandeld. Van de individuen die een behandeling kregen, had 52,5% de bloeddruk onder controle maar 47,5% had de bloeddruk niet onder controle.

“Effectieve daling van bloeddruk is geassocieerd met een reductie van het cardiovasculair risico en met minder cerebrovasculaire accidenten en daaraan gerelateerde morbiditeit en mortaliteit. De meeste hypertensie patiënten (~75%) hebben combinatietherapie nodig en sommigen (~25%) hebben drie antihypertensieve middelen nodig om de bloeddruk voldoende te verlagen.”[1]

In de afgelopen decennia zijn de richtlijnen steeds meer geëvolueerd richting het aanbevelen van combinatietherapie. Combinatietherapie verbetert inderdaad het potentieel om de bloeddruk op tijd te beheersen, zonder de incidentie en complicaties te verhogen. Het is wel zo dat patiënten zich aan het complexere medicatie schema moeten houden. Complexere medicatie schema’s leveren een grotere kans op medicatiefouten op. Hierbij kunnen en moeten de apotheken, zorginstellingen, thuishulp, ouders en naasten helpen! Vitaphone ondersteunt zowel de patiënten als de omgeving op een eenvoudige wijze met de PICO.

Auteur: Indy Kavelaars @ Vitaphone Netherlands

Bron: [1] Meerderheid van patiënten behoeft meerdere antihypertensiva om streefbloeddruk te behalen

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Infographic: It’s in the bag

Parata Systems sees the need of medication adherence improvement ( as we do ) and made an infographic! Points of interest:

  • Half of the Medicare patients who are readmitted within 30-days to the hospital where non-adherent to their medication;
  • 23% adherence improvement for at-risk patients using a pharmacy with an adherence program;
  • More than 70% of the people said they loved strip packaging* and would switch pharmacies for it.

* Working with the PICO, the “strip packaging” will be placed on a cartridge to facilitate the usage of this Medication Adherence Support System.

 

Adherence Infographic

Adherence Infographic

Source: Parata Systems

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41,000 emergency hospitalizations are medication related

Nederlandse versie >

“In the Netherlands 5.6% of all emergency hospitalizations are medication related. More than half of these admissions (19,000) are preventable.” According to the study “Early recognition of medication related problems in the elderly” by Carolien Sino, medication problems can be detected in an early stage and even be prevented with a standard observation checklist. Even more registration work for the care professional? Vitaphone believes that this registration should be less for the professional and can become more for the patient. Provide the patient with the correct tools so he or she can stay healthy.

We agree that the process in getting your medication in the Netherlands is very good, until it reaches the patient. After the medication reached the patients front door there is no support anymore. When the medication reached the patient he or she (or the care professional) is responsible for the medication intake. We are convinced that the patient needs more support at home. If the patient just takes the medication: no worries. But if this is not the case, the patient needs to get support. We trust the PICO in this; our medication adherence support system. The PICO supports the patient when the medication is not taken. In this way the patient can self regulate their medication and get the support from the care professional if needed.

Author: Indy Kavelaars @ Vitaphone Netherlands

Source: Zorgvoorbeter

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Fighting non-adherence

In a comprehensive publication in US Pharmacist, the Director of US Pharmacy’s Clinical Services, Mr. Meece, concludes that pharmacist-based assessment and monitoring can result in improved adherence to medication; in this case to insulin therapy. Mr. Meece found studies that report positive effect of pharmacist interventions on treatment outcomes and adherence. Medication therapy management (MTM) is a service designed to improve collaboration among pharmacists, physicians and other healthcare professionals and enhance communication between patients and their healthcare team. Another tool is motivational interviewing (MI): a method for interacting with patients.

Although the results are (very) positive related to adherence, quality of life and healthcare costs (less hospitalizations), the pharmacist’s efforts to get these results are not the average activities in a pharmacy. It’s up to regulators to find the right incentives for pharmacists to use techniques like MTM and MI.

Nevertheless, this article stimulates companies like us to keep on supporting pharmacists with tools so they can further improve patient’s medication adherence!

Author: Rene Stenvert @ Vitaphone Netherlands

Source: Individualizing therapy for the patient with type 2 diabetes, US Pharmacist, September 2013

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INFOGRAPHIC: Factors related to adherence

It’s good to have a clear view of all factors that influence medication adherence! A qualitative review of 102 studies resulted in very comprehensive Infographic. Let us have a further look at the demographic factors:

  • Age: most of the studies (14) show an increased compliance, some (3) a decreased and some (4) show no effect on compliance at elderly patients. With middle-aged or young patients, all (7) examined studies show a decreased compliance!
  • Ethnicity
    • Caucasian: All (4) studies show an increased compliance
    • Minorities: All (10) examined studies show no effect on compliance
  • Gender: Most studies (11) show an increased compliance, some (4) a decreased compliance and some(6) show no effect at female patients
  • Education level: only 2 studies show an decreased adherence, a few more (4) show an increase but the most (6) show no effect
  • Marital status: five studies show an increased adherence and the same amount of studies show no effect on adherence on married status

Possible conclusion: although medication adherence support systems like to focus on the elderly, this doesn’t seem to be the most important target! It’s much more appropriate to look at other factors.

Infographic-Adherence-Factors

Infographic-Adherence-Factors

Author: Indy Kavelaars @ Vitaphone Netherlands
Source: PMC, US national library of medicine

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ECRI & medication adherence

Early January is a great moment for our fortune tellers to predict the future of healthcare. Although we are more eager to understand how long the polar winds will continue to blow in North America and spring finally will end in Western Europe, these professionals tell us that we can expect in 2014 of healthcare improvements. Most of the time, the suggestions have a question mark at the end: “Roboman, Arise: Should You Offer Wearable Powered Exoskeleton Rehabilitation for Individuals with Paraplegia? The Pressure Is On: Is Catheter-based Renal Denervation for Treatment-resistant Hypertension a New Cash Cow or More Fuel for the Fire?”1. Well: I don’t have the answers.
Another question from the fortune tellers: “Will Intelligent Pills Magically Improve Medication Adherence and Prevent Readmissions?”1 . The answer is easy: no, they won’t. Because it’s not about ‘Intelligent Pills’ or ‘Prepacked Medication’ alone. It’s about the way you deal with the information. Did the patient take the pills: great news, no action is needed just sometimes a small tap on the shoulder so that the patients also know they are doing great. But if the Medication Adherence Support System registers that the pills haven’t been taken, action is needed. That can be a call, a sms or even a one-on-one meeting with the user. And the presentation of his/her results of the level of adherence. Plus personal attention. Only that way we can improve the 50% medication adherence that we experience today, according to WHO.

 
Author: Rene Stenvert @ Vitaphone Netherlands

Source: 1 ECRI

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Benchmark medication adherence

HIN (Healthcare Intelligence Network) has published a report of their benchmark which compares 104 healthcare organizations on how they are improving medication adherence in their populations. Complex patients are the most common targets of medication adherence programs (75 percent of the responds). The use of multi-dose blister packs has more than quadrupled in the last 12 months, from 7 to 29 percent. Hypertension has now replaced diabetes as the condition where healthcare organizations think medication adherence programs have the greatest effect, according to 61% of the respondents.

The figure below shows that most respondents think telephonic follow-up will work to improve Medication Adherence (MA). We, at Vitaphone, think a combination of different tactics is the best approach, with a medication adherence support system as basic tool.

When do efforts to improve medication adherence occur

When do efforts to improve medication adherence occur

Author: Indy Kavelaars @ Vitaphone Netherlands

Source: HIN Healthcare Benchmarks Medication Adherence

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Video: Striking back at the drug abuse epidemic

There is an ongoing drug abuse epidemic. Watch the video to get an overview of the problem in Oklahoma, USA.

PDMP, a prescription monitoring program, is one of the most promising resources to help clinicians identify, intervene and curb drug prescription abuse. PDMPs are state-run electronic databases – functioning in 47 U.S. states and territories – that track the prescription and dispense of drugs to patients. Pharmacists report to a PDMP each time a prescription is filled for a controlled substance medication.

When this information is available at the point of care, it can help clinicians to distinguish between patients who legitimately need opioid medications and those who may be seeking to misuse these drugs. While PDMPs can serve as a valuable tool, most clinicians typically don’t use them. This is largely because they have been devious or time consuming to access (especially when outside of a clinician’s normal prescribing workflow).

We see the need to automate this. But what we also see, is the need to support patients that take these medications. Our solution is a real-time monitoring of the intake moments. We think this could be integrated with the health IT systems used by these physicians. Interoperability is essential in this. And last but not least: implement the solution within the physician’s workflow!

Author: Indy Kavelaars @ Vitaphone Netherlands

Source: Health IT

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