May 2010
2 posts
“In the case of prescription drugs, we know that 20%-30% of patients report...”
– G. Caleb Alexander, MD, bioethicist at the University of Chicago’s MacLean Center for Clinical Medical Ethics. From The One Subject That Doctors and Patients Still Avoid: Introduction
On Skin Cancer, it’s Clueless in Cleveland (and... →
This is another massive case of healthcare noncompliance (in this instance, the advice not being followed is that of dermatologists on preventing and detecting skin cancer), which can be summed up in the words of Dr Darrell Rigel, a professor of Dermatology at New York University Medical Center, “Over the years we’ve been somewhat successful with that message, but some people won’t change their...
April 2010
4 posts
“Holly Kennedy: Did you take your medication today?
Daniel Connelly: No, I...”
– From P.S. I Love You (2007)
September 2009
1 post
August 2009
5 posts
And You Thought a Prescription Was Private →
What Does Health Care Reform Really Mean to... →
“The Smart Patient will: (1) Know their medical history and is able to share it....”
– From keynote speech by Mamet Oz at Aspen Health Forum. Good, Bad & the Ugly at the Aspen Health Forum
“So, while the rest of the country is debating the cost of health care, those of...”
– The local MD: Cost or compliance?
“Informed consent is an opportunity to invite patients to participate in the...”
– Doctor and Patient - Treating Patients as Partners, by Way of Informed Consent
July 2009
15 posts
“Findings from the evaluation of this program suggest the potential value …...”
– Prenatal Payments Could Improve Birth Outcomes
Precursors to Corneal Transplant Failure; Patients... →
Excerpt: To learn more about adherence, a team of researchers from Johns Hopkins and University of Pennsylvania Schools of Medicine gave glaucoma patients a prostaglandin eyedrop medication at no cost and monitored use with an electronic device. “Eighty-six of our 196 study patients (44 percent) took their medication less than 75 percent of the time. A combined analysis found the most...
Lower Copay and Oral Administration: Predictors of... →
Excerpt:
Key Points
Little is known about first-fill adherence patterns of patients receiving first prescription for asthma medications; adherence is necessary to improveoutcomes in this patient population.
This is the largest study of its kind to analyze characteristics of first-fill or no-fill for asthmamedications. Of the 2023 patients with asthma in this study, 78% filled their first-time...
3 HIV Treatment Adherence Articles →
Antiretroviral Therapy Adherence, Virologic and Immunologic Outcomes in Adolescents Compared With Adults in Southern Africa. Nachega JB, Hislop M, Nguyen H, Dowdy DW, Chaisson RE, Regensberg L, Cotton M, Maartens G. J Acquir Immune Defic Syndr. 2009 Mar 11.
Transportation Costs Impede Sustained Adherence and Access to HAART in a Clinic Population in Southwestern Uganda: A Qualitative Study....
Best Ways to Deal With No-Shows →
Excerpt:According to a recent University of Missouri survey that looked at 11,000 scheduled patient visits, patients who suggested the most convenient time for an appointment were more likely to show up than when the scheduler suggested the appointment time. Usually the scheduler was trying to book patients in the way that was most organized for the practice. For example, they’d schedule the...
“I readily admit that over the years I did not comply with my blood pressure...”
– Don’t ignore dangers of silent killer
Reminder Program Boosts Mammography Rates →
Except: In the postreminder implementation phase, women who received the intervention were 1.51 times more likely to undergo mammography than those in the comparison group (95% confidence interval [CI],1.40 – 1.62), after controlling for demographics and clinic visits.
New Horizons in Patient Compliance : Canine... →
Latest Compliance Enhancement Device: Zen the Border Collie
Excerpt: Every clinically study has to address the issue of patient compliance but sheep can be particularly difficult to keep on a program. Leaping out of stalls, running through fences and the desire to stay with the flock at all costs can make maintaining compliance hard work!
… Patient compliance can be a real struggle but...
Use predictive modeling in Medicare populations →
Predictive modeling has many implications for compliance enhancment.
Excerpts:
Most predictive modelers are heavily dependent on medical and pharmacy claims data. It is well known that not all claims are created equal; for example incomplete or inaccurate coding, bundling or up-coding, and lags in submission may occur. Relying on information from claims data alone for validation of risk can lead...
What Impact Will The ARRA Have On Pharma?... →
Excerpt: The [Obama] stimulus also targets programs with the greatest potential to improve the quality of primary care and extend it to a greater number of people. One such program is the Patient Centered Medical Home (PCMH), a work-in-progress since the late 1960s. Stated simply, PCMH is about forging tight partnerships between primary physicians, patients, and when desirable, family members....
Intensifying Therapy for Hypertension Despite... →
Abstract—More intensive management can improve controlblood pressure (BP) in hypertensive patients. However, manywould posit that treatment intensification (TI) is not beneficialin the face of suboptimal adherence. We investigated whetherthe effect of TI on BP varies by adherence. We enrolled 819patients with hypertension, managed in primary care at an academically-affiliatedinner-city hospital....
How One Company Pushed Workers Into Preventive... →
Excerpt: Last year, AmeriGas Propane Inc. gave its employees an ultimatum: get their medical checkups, or lose their health insurance. The nationwide propane distributor took the unusual step after facing years of steep increases in the cost of health coverage for its roughly 6,000 workers. The company’s work force was aging, and many employees had unhealthy habits—the average worker is 46, and...
[Compliance] Technology and aging by category -... →
From the post:
Medication compliance technologies These technologies have monitoring, reminding, dispensing features and combinations thereof. Most of these technologies are stand-alone and are targeted at the seniors or the caregiver. Simple monitoring is offered by QuietCare. Intel and Oregon Health and Sciences University (OHSU) (www.orcatech.org/index.php) have prototypes of monitoring and...
Finally, a Drug Company Embraces Social Media, AEs... →
Open communication, including adverse events, is key to transforming patient compliance to a useful concept.
“Project Connect is based on a program used in AIDS clinics in Zambia. In the...”
– To Fix Health Care, Some Study Developing World - WSJ.com
June 2009
17 posts
Best Ways to Deal With Noncompliant Patients →
The focus of this article is on the legal and practical aspects of noncompliane with only a passing glance at causes clinical management.
“Many times, we can certainly report on the outcomes, but the real issues lie...”
– Seen. Heard. Noticed.: Concept and Usability Testing
“There is a clear consensus in the United States that change is needed in our...”
– MARK ROGERS: Health care plan needs patient accountability - Quincy, MA - The Patriot Ledger
“… there is one part of the healthcare milieu that is not being addressed...”
– Dr. Deborah Honeycutt on the ethics of government intervention in field of patient compliance.Progressive Regressive Health Care Reform
Improving Diet and Physical Activity with ALIVE: A... →
This study has been touted elsewhere (not by the research team itself) as demonstrating that “E-mail reminders to exercise and eat healthy are effective in modifying behavior.” (quote is from E-mail wellness program encourages patient compliance, study finds) The abstract indicates that the program is more than just reminders: “[ALIVE is] a 16-week e-mail program offered...
“The hope is that new gaming psychology and techniques can help improve some of...”
– Are video games the next OTC medical device? | MassDevice.com | MassDevice - Blogs
“Conclusion: Medication diaries did not improve clinical and virologic response...”
– Medication diaries do not improve outcomes with highly active antiretroviral therapy in Kenyan children: a randomized clinical trial - 7thSpace Interactive
Texting Teen Transplant Patients Improves Outcomes... →
” … the transplant recipients receive a text message reminding them to take their anti-rejection medications. If they don’t respond to the text message, their adult caregiver will then receive a text message. Since taking anti-rejection medications at the same time every day is important for preventing rejection, and “I forgot” is the most common reason for missing...
“Dear Mr. and Ms. Patient,
It has come to my attention that in order for you...”
– Satirical letter to patients pointing out weaknesss of a health reform plan that assumes patients and their problems operate by laws of math and logic.Dr. Wes: An Open Letter To Patients Regarding Health Reform
Nurses Frustrated by Lack of Adherence to Poisons... →
Nurses and pharmacists at poison control centers have all the technical information they need to answer callers’ enquiries but need more training in order to improve caller adherence to their recommendations, according to a study published in the May issue of the Journal of Emergency Nursing.
Contributions from 3 pharmaceutical companies and... →
Withholding State of the Art AIDS Drugs From... →
Although 10 years old, this article, originally a CME offering, is still worthwhile reading for its explication of the ethical and medical problems inherent in treating a non-compliant patient when failure to maintain the regimen can result in the emergence of drug-resistant viral strains.
“Adherence: An educational and behavioral change focused game can be part of a...”
– Can Healthcare Games Change the Game of Healthcare?
“Many patients with heart failure, unfortunately, don’t know which medicines to...”
– Survey: More Than Half of People Can’t Find Heart on Body Diagram
“Participatory sensing could also help people monitor their exercise habits and...”
– The Medical Quack: Are Cell Phones Enabling anyone to be a Scientist or Doctor - Participatory Sensing from CENS at UCLA
“In Las Vegas, we ran three campaigns: one, to have more patients adhering to...”
– The Health Care Blog: Data-Driven Health Care: An Interview with Jerry Reeves, MD
January 2009
1 post
Problem Drinkers Respond to Feedback From... →
Riper H, et al. Curbing problem drinking with personalized-feedback interventions: A meta-analysis. Am J Prev Med 36(3), 2009.
Excerpt: In questionnaires delivered via mail or the Internet, 3,682 participants in 14 randomized controlled trials noted how much and how often they drank. They received personalized feedback and advice on whether their drinking patterns were normal for their peer...
December 2008
10 posts
When a Job Disappears, So Does the Health Care →
It’s apparently breaking news at the New York Times that employer-based health insurance is a major funding source for healthcare in the US and, consequently, loss of a job means loss of health insurance, leading to decreased healthcare. Pertinent to compliance is this excerpt: Richard D. Jackson, 53, was an oven operator at the bakery for 30 years. Mr. Jackson and his two daughters often...
More About "Do Patients’ Photos Help Doctors?"
Including Patient Photo With Radiology Images Increases Length, Depth of Radiologist’s Report This Medscape report on the same study described in an earlier post, Do Patients’ Photos Help Doctors?, includes possible negative results, as noted in this except:
“There is a counter argument. Introducing a photo introduces physician bias,” he cautioned. “Without anonymity,...
Relationship between blood pressure levels and... →
Mahsa Mohammadi, Inger Ekman, Maria Schaufelberger Vascular Health and Risk Management 2009:5 13–19
From Abstract: Objective: To investigate whether change in objective signs during up-titration of angiotensin-converting enzyme (ACE)-inhibitors in patients with chronic heart failure affect perception of information about medicines and subjective activities such as self-care.
Methods:...
“We wish to find out why and why not children take their medicine and use this...”
– A spoonful of sugar? The article antipcipates a study looking at medication adhderence by children. From abstract: The 21-month study involving health specialists at The University of Nottingham and The University of Leicester will draw on the experiences of school children with asthma, diabetes,...
Alcohol misuse does seem to predict poor... →
Ann Intern Med 2008; 149: 795-903 Excerpt: Analysis of data from a controlled trial provides objective evidence that alcohol misuse is associated with poor adherence to medications.The authors of this study used data from a pre-existing cohort to examine the hypothesis that alcohol misuse would be associated with a dose-related effect on medication adherence. They used data from large randomised...