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Medication abstracts – Leigh Vaughan Automated Digital Intervention Drives Medication Adherence Abstract: According to studies done by the Center for Medicare and Medicaid Services (CMS), 130 million Americans currently suffer from comorbidity (more than one disease) and are prescribed multiple medications. Links: Get it at Duke Full Text: ALISO VIEJO, Calif., Aug. 1, 2012 /PRNewswire/ -Bi-Rite Quality Pharmacy in La Habra, Calif., has piloted a new patient engagement solution to educate, motivate and remind their patients with chronic diseases to take their medication as prescribed. The results after the first six months of the program show dramatically improved medication adherence. The solution, developed by PrescribeWellness, and called Automated Digital Intervention (ADI), leverages automated voice, text, e-mail and push notification to better engage the patient and improve patient behavior. "Over 700,000 people are admitted to emergency rooms in the United States every year because of nonadherence to prescribed medications," said I.R. Patel, R.Ph., of Bi-Rite Quality Pharmacy. "The problem is growing, and until now, there has been no cost-effective solution to confront the unique and individual causes of non-adherence. My pharmacy has the added complexity of serving patients with more than 10 native languages and corresponding cultural differences. The ADI solution from PrescribeWellness is the first service that allows us to automate communications in our patients' channel of choice and language of choice. It is also the first to address the cognitive, motivational and cultural differences in behavioral change." According to studies done by the Center for Medicare and Medicaid Services (CMS), 130 million Americans currently suffer from comorbidity (more than one disease) and are prescribed multiple medications. Nonadherence to these medications results in hospitalizations and costs totaling $300 billion annually. By moving patients from 50 percent compliant in their medication to adherent (at least 80 percent compliant), insurance companies and healthcare providers can annually save between $4,000 and $8,000 per patient in hospital and emergency room visitations. "Most adherence solutions on the market today are designed to address the cognitive challenges of medication non-adherence, but ignore the other factors. Cost, lack of motivation, fear of side effects, denial and health literacy are equally important," said Dr. Terry Olson, VP of Behavioral Solutions at PrescribeWellness. "We have designed our ADI service to address all of these factors." In the pilot program, Dr. Olson designed a scale that allowed pharmacists to categorize patients based on their past behavior and observed challenges. This check box selection process, administered either at the time of the prescription delivery or during a one-hour Medication Therapy Management (MTM) session between patient and pharmacist, automatically enrolled patients in a unique series of communications designed for each individual's needs. "The frequency and intensity of messages for a patient taking two medications a day is completely different from a patient taking 20 medications a day who is also suffering from dementia," said Dr. Olson. Through the first six months of the program, Bi-Rite Quality Pharmacy was able to increase medication refills in patients with high cholesterol from 60 percent to 93 percent and from 76 percent to 91 percent in patients with hypertension. As a result, patients in these two categories rose from 77 percent to 93 percent adherent. By moving the vast majority of patients to adherent, PrescribeWellness has helped Bi-Rite Quality Pharmacy improve customer loyalty, but more importantly, improved the health of their patients, keeping healthy people out of the hospital and shining a light on the promise of reducing national health care costs. About PrescribeWellnessPrescribeWellness was founded in 2010 with a mission of reducing health care costs and improving health in America. The company delivers cloud-based communications and facilitates collaboration of health care providers, family and other stakeholders to improve care and outcomes. Their services include population health, medication adherence, chronic disease management, behavioral change programs and transitional care. For more information, please visit www.prescribewellness.com. SOURCE PrescribeWellness Credit: PrescribeWellness 1. Shellpak(R) Demonstrates Statistically Significant Improvement in Patient Medication Adherence Bibliography Document 1 of 1 Shellpak(R) Demonstrates Statistically Significant Improvement in Patient Medication Adherence Author: Anonymous. Publication info: PR Newswire [New York] 16 June 2011. ProQuest document link Abstract: According to the researchers, a Shellpakbased adherence strategy could provide a substantial cumulative public health benefit when broadly implemented over a large population. Links: Get it at Duke Full Text: RICHMOND, Va., June 16, 2011 /PRNewswire/ -According to new data published in Clinical Therapeutics, the way a medication is packaged can have a significant impact on whether patients take it as prescribed. The study showed that Shellpak(R) calendar blister packaging from MeadWestvaco Corp. (NYSE: MWV), a provider of pharmaceutical packaging solutions, was associated with improvement in prescription adherence behavior in patients when compared with traditional pill vials. According to the researchers, a Shellpak-based adherence strategy could provide a substantial cumulative public health benefit when broadly implemented over a large population. Poor adherence to medication is a growing issue across the country. The New England Healthcare Institute estimates the current cost of drug-related morbidity, including poor adherence, to be as much as $290 billion annually in avoidable medical spending, 13% of total U.S. healthcare spending. Research also shows that half of all patients in the U.S. do not take their medicines as prescribed, a dismal level of adherence which has held steady over the past three decades. Poor adherence leads to worsening of disease, serious and avoidable health risks, increased hospitalizations and even death. Within the study, the use of Shellpak, a proprietary calendarized 30-day, unit-of-use medication package, demonstrated improvement in the adjusted estimates of refill persistence and adherence as measured by length of therapy and proportion of days covered with medication. "We know there are many factors affecting medication adherence, and we know that the most successful solutions will involve multiple components," said study co-author Lenn Murrelle, MSPH, PhD, and principal founder of Venebio, a life sciences research consultancy. "What's exciting about this study is that medication packaging alone was found to have a positive effect on medication refill behavior. This says to us that packaging without any additional communications or instructions to either pharmacists or patients can play an important role in helping patients take their medication as directed." The retrospective analysis used pharmacy dispensing data from Walmart for 3.1 million individuals filling prescriptions for the generic cardiovascular medications lisinopril or enalapril, either alone or in combination with hydrochlorothiazide. Results revealed the Shellpak refill persistence benefit was especially pronounced among certain subgroups. New medication users had an average length of therapy increase of 9 days over a year. Ongoing medication users had an average length of therapy increase of 5 days over a year. Persons taking fixed-dose combination formulations, or 2 medications in a single tablet experienced an average 17-day increase in length of therapy for new users and 12 days for ongoing medication users. In addition, the study revealed that Shellpak users overall were more likely to reach "full refill adherence" - at least 80% of days covered with medication in a year - than vial users, with the greatest effect observed in new medication users. However, full refill adherence (PDC greater than or equal to 80%) was more likely in Shellpak users regardless of their baseline level of adherence. PDC greater than or equal to 80% was more likely reached by using Shellpak in those with the lowest level of baseline adherence, by 20% in new medication users and 23% in ongoing users. Individuals with a middle level of adherence at baseline had a 15% greater likelihood of reaching full adherence with Shellpak for new users and 8% for ongoing users. In the group with the highest level of baseline adherence, Shellpak users were 11% more likely to reach full adherence for new medication users and 5% for ongoing users. "This publication is the first, large-scale pharmacoepidemiologic analysis of medication packaging, and the results are exciting and significant," said Ted Lithgow, PhD, president and chief science officer, MWV Healthcare. "We believe smarter packaging serves a purpose beyond simply containing and protecting the physical integrity of a pharmaceutical, and this robust data provides compelling scientific evidence for Shellpak as a now-proven solution to help drive better patient adherence. We will continue to work with the medical, pharmacy and pharmaceutical communities, and regulators to consider these data and to further investigate the effects of packaging on medication adherence." About the Study This was a two-year, retrospective cohort study of 325,361 new and ongoing users of the oral angiotensin converting enzyme inhibitors (ACEI) lisinopril or enalapril - commonly prescribed for the treatment of hypertension and congestive heart failure - designed to assess the real world effectiveness of a new calendar packaging technology on prescription refill adherence and persistence for daily, self-administered, long-term medication use. Eligible users comprised two packaging cohorts, Shellpak (282,605 lisinopril users (86.9%)) and vial (42,756 enalapril users (13.1%)), and ACEI user groups: 76.321 new users (23.5%) and 249,040 prevalent ongoing ACEI users (75.5%). To assess the impact of Shellpak on refill behavior, measures of refill adherence and persistence in the baseline year before and follow-up year after the packaging switch were compared in the 325,361 adults aged 18-75 years who filled 30- or 90-day prescriptions in both the baseline and follow-up years. These individuals had adherence and persistence data available both before and after the packaging switch to Shellpak. Researchers used linear and logistic regression and propensity score matching to assess the impact of calendar blister packaging on refill adherence, using medication possession ratio (MPR) and proportion of days covered (PDC), and persistence using length of therapy (LOT). The study was designed, conducted, analyzed and reported in accordance with the Good Research Comparative Effectiveness (GRACE) principles and Guidelines for Good Pharmacoepidemiology Practice. The Walmart pharmacy dispensing data were deidentified in accordance with HIPAA guidelines. About Shellpak(R) MeadWestvaco Healthcare's Shellpak(R) is an innovative, award-winning package designed to improve medication adherence alone or in combination with other adherence strategies. Shellpak features a childresistant and senior-friendly outer plastic shell that protects medication tablets packaged in a 30-day calendar blister card similar to packaging long used for birth control pills. The calendar feature helps patients track medication usage, helping reduce dosing errors such as overdosage and missed doses, and refill timing. The large, flat blistercard and package surface allows for dosing instructions and patient education to be printed in large, readable font. Shellpak can also be customized to reflect a brand image and provide differentiation for each medication enclosed. About MWV MeadWestvaco Corporation (NYSE: MWV), provides packaging solutions to many of the world's mostadmired brands in the healthcare, beauty and personal care, food, beverage, home and garden, and tobacco industries. The company's businesses also include Consumer & Office Products, Specialty Chemicals, and the Community Development and Land Management Group, which sustainably manages the company's land holdings to support its operations, and to provide for conservation, recreation and development opportunities. With 19,000 employees worldwide, MWV operates in 30 countries and serves customers in more than 100 nations. MWV manages all of its forestlands in accordance with internationally recognized forest certification standards, and has been named to the Dow Jones Sustainability World Index for seven consecutive years. For more information, please visit www.mwv.com. 1. InnovationRx Unveils Patient-Centric Medication Adherence Service Bibliography Document 1 of 1 InnovationRx Unveils Patient-Centric Medication Adherence Service Author: Anonymous. Publication info: Wireless News (Jul 18, 2008). ProQuest document link Abstract: "InnovationRx fills a gap in a circle of care by offering resources and behavioral intervention that increase adherence and improve patient outcomes," said Dr. Nathaniel Rickles, chief clinical officer. "InnovationRx challenges patients beyond the act of taking medication simply because it was prescribed and helps them to goal set and identify positive outcomes that will improve their quality of life." Links: Get it at Duke Full Text: WIRELESS NEWS-July 18, 2008-InnovationRx Unveils Patient-Centric Medication Adherence Service (C)2008 10Meters - http://www.10meters.com InnovationRx, a division of Innovation Group, has launched a comprehensive medication adherence service that educates and enables patients to take more control over their medications and health. The patient-centric service, jointly developed through a research grant with Northeastern University School of Pharmacy, targets all demographics, age groups, disease states and includes a combination of education, self assessments, customized intervention plans, reminders and private, convenient access to live pharmacists. The service is available immediately. Patients can select one of several monthly subscription plans available online at innovationrx.com. Fifty percent of people do not take their medications as prescribed, and up to a third of patients receiving prescriptions never even fill them. Moreover, it's estimated that 125,000 yearly deaths in the U.S. are caused by medication non-adherence. Typical reasons for non-adherence include a fear of side effects, cost, or not understanding the importance of taking the medication. "Non-adherence leads to health problems, emergency room visits and hospitalizations, and causes an economic ripple effect that leads to $300 billion in related healthcare costs," said Sean D. Teare, president of InnovationRx. "InnovationRx addresses nonadherence head-on with a customized intervention plan and live support from pharmacists. We not only expect to help wring out costs that are a major drain on the healthcare system, but also to dramatically improve the quality of life for patients." Key elements of the InnovationRx service include: - Adherence Assessment - This proprietary assessment survey targets the underlying issues causing nonadherence. The assessment produces a non-adherence risk score that enables triage and intervention. - Pharmacist-Staffed Call Center - Staffed with licensed pharmacists trained in motivational interviewing and adherence intervention, the call center provides patients with personalized, one-to-one support and consultation. Pharmacists are trained to help patients overcome behavioral, motivational, cognitive and another adherence obstacles. - Medication Reminders - Patients receive automated reminders to take their medication via e-mail, text message or automated phone call based upon their preferences. - Case Management - Dedicated clinical liaisons work with organizations to ensure that clinical goals and standards are met. They can create and define a customized adherence program to ensure that outcomes assessment is completed in a timely and accurate manner. Periodic scientific evaluations will be conducted to determine the return on investment (ROI) and continuous quality improvement (CQI) of the program. - Extensive Reporting Capabilities - InnovationRx provides a data-mining tool to analyze and dissect the outcomes data. These tools feature a robust analytics engine fueled by configurable business rules and leading practice performance indicators to empower organizations with a highly customizable data analysis process. Furthermore, patients receive a personal account at the InnovationRx website. Through their homepage, they can access a full line of interactive medication management tools as well as access information about the drugs they are taking and learn about side effects or reactions with other medications or food. "InnovationRx fills a gap in a circle of care by offering resources and behavioral intervention that increase adherence and improve patient outcomes," said Dr. Nathaniel Rickles, chief clinical officer. "InnovationRx challenges patients beyond the act of taking medication simply because it was prescribed and helps them to goal set and identify positive outcomes that will improve their quality of life." ((Comments on this story may be sent to [email protected])) 1. Changing the Face of Healthcare: Community Pharmacists Nationwide Embrace MTM Patient Care Opportunity; Medicare Part D Patients Across U.S. Receive Medication Therapy Management Services Bibliography Document 1 of 1 Changing the Face of Healthcare: Community Pharmacists Nationwide Embrace MTM Patient Care Opportunity; Medicare Part D Patients Across U.S. Receive Medication Therapy Management Services Publication info: PR Newswire [New York] 22 Jan 2007: n/a. ProQuest document link Abstract: CCRx is one of the first Part D plans offering face-to-face MTM services by community pharmacists to fulfill its CMS-mandated MTM obligation. During an MTM visit, pharmacists review patients' medications (including prescription and over-the-counter drugs), counsel patients on proper medication use, pinpoint potential medication interactions and safety issues, identify cost-saving opportunities, provide diseaserelated patient education and coordinate with physicians regarding any recommended changes to the patient's medication regimen. Community MTM Services, Inc. (CMTM) delivers innovative patient care solutions. Our Software-as-aService platform streamlines the delivery of highly targeted medication management programs and speeds patient recruitment campaigns. The broad-based CMTM pharmacy network serves as centerpiece of our nationwide, multi-channel program delivery capability. Working with CMTM, program sponsors can harness the high trust pharmacist-patient relationship to achieve superior business and clinical results. Links: Get it at Duke Full Text: ALEXANDRIA, Va., Jan. 22 /PRNewswire/ -- The Community MTM Services, Inc.(CMTM) pharmacist network delivered targeted patient care services to morethan 44,000 patients during the last six months of 2006. Pharmacists acrossthe United States continue to embrace the opportunity of expanding theirbusiness models to include targeted patient care services, delivering MedicarePart D Medication Therapy Management (MTM) services to thousands of qualifiedCommunity Care Rx(sm) *(CCRx) Medicare patients. "We believe MTM services are best delivered by community pharmacists," said Charles Hallberg, chief executive officer of MemberHealth, plan sponsor for CCRx, the nation's fourth largest Part D plan. "We are thrilled with the results for our members -- medication cost savings, better self-care and disease management, and safer use of medications -- all from private consultations with their pharmacists. Our MTM reach with members in 2006 was phenomenal for a new program, and we look forward to even better results in 2007." CCRx is one of the first Part D plans offering face-toface MTM services by community pharmacists to fulfill its CMS-mandated MTM obligation. During an MTM visit, pharmacists review patients' medications (including prescription and over-the-counter drugs), counsel patients on proper medication use, pinpoint potential medication interactions and safety issues, identify cost-saving opportunities, provide diseaserelated patient education and coordinate with physicians regarding any recommended changes to the patient's medication regimen. "The delivery of MTM face-to-face has enabled our pharmacists to help improve the health of their patients and enhance customer loyalty," said Tony Civello, president and chief executive officer of Kerr Drug, Inc. "Our stores are embracing the CMTM platform because it gives our pharmacists an organized, efficient method for incorporating patient care services into their daily routines. It's easy to learn and use, and delivers targeted patient intervention cases to the pharmacist. We look forward to expanding our services to even more patients in 2007 and beyond." Mr. Civello is the recipient of Chain Drug Review's 2006 Retailer of the Year Award. "In the last six months of 2006, community pharmacy made a significant contribution toward advancing consumer health by stepping up to the plate and delivering MTM and related patient care services," said Kurt Proctor, R.Ph., Ph.D., CMTM chief operating officer. "We foresee a major role for the CMTM service in helping pharmacists provide targeted, proactive, quality care to patients from coast to coast." Participating pharmacists used CMTM's secure, Webbased solution to schedule, manage, chart, and bill for MTM and other patient care services. The CMTM service identifies qualified patients and routes them for intervention to the patient's own pharmacy, along with targeted patient education materials to facilitate informed, high quality and evidence-based care. *Operating as Community Pharmacists Care Rx in Oklahoma About Community MTM Services, Inc. Community MTM Services, Inc. (CMTM) delivers innovative patient care solutions. Our Software-as-aService platform streamlines the delivery of highly targeted medication management programs and speeds patient recruitment campaigns. The broad-based CMTM pharmacy network serves as centerpiece of our nationwide, multi-channel program delivery capability. Working with CMTM, program sponsors can harness the high trust pharmacist-patient relationship to achieve superior business and clinical results. FOR MORE INFORMATION: Jeri Kirschner Director, Marketing Community MTM Services, Inc. 100 Daingerfield Rd Alexandria, VA 22314 703-600-1253 [email protected] 1. Consultant helps patients manage multiple medications Bibliography Document 1 of 1 Consultant helps patients manage multiple medications Author: Anonymous. Publication info: The Billings Gazette [Billings, Mont] 16 Oct 2011: C1. ProQuest document link Abstract: How long have you been in business? Since July 2010. Links: Get it at Duke Full Text: More and more older people are seeing more than one doctor and being prescribed more than one medication. Some medications aren't compatible, which can compound existing problems and could even be deadly. Other medications may be redundant, and many prescriptions have less expensive generic alternatives. If you're a patient, trying to sort it all out can be vexing. That's where Carla Cobb comes in. She runs AssessRx in Billings, a consulting business that provides comprehensive medication reviews for people with chronic illnesses. "We meet with individuals in a private office setting to go over all of their medications in detail and provide information and recommendations about how to improve results or decrease costs," Cobb said. "We help people get the most from their medications." Many of her clients are referred by doctors or family members. She sees her service as something like visiting a dentist or an eye doctor for a check-up. "It's just another spoke, and important spoke, in the health care wheel," she said. "The consultations can save a person a lot of money and could save them a trip to the emergency room." AssessRx is at 3936 Ave. B, Suite D, in Billings and Cobb may be reached by phone at 281-8252, by fax at 281-8253 fax, by email [email protected] or through the company's website, www.assessrx.com. Here's what else Cobb had to say about AssessRx: Why start this business? We realized that there is a need in the community for helping people with their medications. If people take several medicines, see more than one doctor, or are having problems with their medications, we can take the time to answer all of their questions. We have a special interest in working with people with mental illnesses as the additional assistance can be especially helpful for them. Where did startup funding come from? Four partners made a personal investment to set up the office space to meet with patients and lease medication management software. How long have you been in business? Since July 2010. Your biggest challenge during the current recession? Educating people about the benefits of a comprehensive medication review and helping them understand what a unique service we provide. What was done to overcome those challenges? We have been meeting with patient organizations and doctors to let them know about this new type of service. Once patients go through a medication review and understand the benefits, word of mouth has been very beneficial for getting the word out. What is being done to expand the business? We are doing market research to help identify our target audience and develop our messaging. Your best business decisions? Applying for a grant to be able to offer this service to people at no cost and be able to prove the benefits. Your worst business mistake? Underestimating the time commitment needed to market a new concept. What advice do you have for someone running a business? A new business can consume your life. Be sure to make time for yourself and your family. Number of workers? Four medication experts and three part-time staff. What's your rive-year plan for the business? Our primary goal is to demonstrate that comprehensive medication reviews can improve access to healthcare, improve patient outcomes, and reduce costs. We want to prove the value to insurance companies so that we can offer the service to even more people. A question you would ask other entrepreneurs? How do you get the word out about a totally new concept? If you weren't doing what you are now, what would be your dream job? I dream of being able to provide comprehensive, stateof-the-art, one-stop care for people with depression and. bipolar disorder, where they could get all of their health care needs met in one place.