JustCare

Tag: Medication compliance

  • For people with heart disease, polypills save lives

    For people with heart disease, polypills save lives

    Heart disease is the number one killer. But, people who take their heart medicines are likely to thrive and survive. How to improve medication compliance? The New York Times reports that a polypill for people with heart disease, one pill containing three drugs instead of three separate pills, saves lives.

    Results from a randomized controlled trial of more than 2,000 people reported in the New England Journal of Medicine  found that people with heart disease who were prescribed a polypill were much more likely to take their heart drugs and reduce their likelihood of heart issues than people who were prescribed multiple pills. The polypill makes it easy to comply. One pill, once a day.

    People on the polypill also were significantly less likely to die as a result of their heart disease. In addition, the researchers report that the polypill ensures that physicians prescribe all the appropriate medicines rather than prescribing fewer medicines than appropriate.

    What’s in a polypill for people with heart disease? Blood-pressure medicine, aspirin and a drug that lowers cholesterol, reducing the likelihood of a blood clot.

    Polypills have been around for a long time because they help ensure compliance but also because drug companies can patent the combination drug and charge a fortune for it. Polypills can cost a lot more than the cost of buying the drugs separately. (The heart medicines are all generic and cost very little.) Unfortunately, insurers might not cover polypills when they cost a lot, and it’s hard to argue that they should.

    Does the FDA have to approve polypills? The answer is yes. So, they can be patented, driving up their cost.

    Who were the trial participants? People who had lived through a heart attack in the past six months. They were all 65 or over. The vast majority had high blood pressure, more than half smoked at some point and almost three in five had diabetes.

    The value of the polypill was in adherence to the medication. Though, it’s noteworthy that the difference was 70.6 percent of polypill users adhered compared to 62.7 percent of those taking multiple medicines.

    What was the difference in health outcomes between polypill users and people who took individual drugs? About 3 percent fewer people taking a polypill experience a stroke or heart attack, died of a heart issue or needed care to address a blocked artery over three years than people taking multiple medicines, 9.5 percent v. 12.7. Of note though, death rates were the same for both groups. People in the polypill group had fewer heart deaths but had deaths from other causes.

    Here’s more from Just Care:

  • Why you should ask your doctor if you can review your medical records

    Why you should ask your doctor if you can review your medical records

    If you’re like most of us, you’ve never seen the notes your doctors take during a visit. So, it’s hard to imagine what happens when doctors share their notes. It turns out to be a good idea. Here’s why you should ask your doctor if you can review your medical records if you have not done so.

    Today, 120 health care systems throughout the US use “Open Notes,” an initiative in which doctors open their notes to patients. It’s a new and growing trend in this country but a practice that is common in other parts of the world. Now, patient advisory groups in this country are asking doctors to share their notes.

    As Mara Gordon reports for NPR, for doctors, sharing medical records can be a bit of a challenge. For one, they cannot use acronyms like SOB, shortness of breath, or their patients will not be able to understand the notes. Moreover, their patients may question or object to their entries.

    One patient felt her doctor had betrayed her trust when she read in her doctor’s notes that she and her child were not in a good place. The doctor made the entry to remind himself and other doctors that this patient did not have a health care buddy to join her at her doctors’ appointments. But, the patient felt she had shared the information with her doctor in confidence, not to share it with other doctors.

    A study of 105 doctors with 19,000 patients receiving primary care at Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in rural Pennsylvania, and Harborview Medical Center in Seattle, reveals that information is power for patients in the health care arena. OpenNotes allows patients to partner with doctors in conversations about treatment options. Patients who see their doctors’ notes have a better sense of their health issues, and they report better medication compliance.

    Results from another OpenNotes study, letting patients see their doctors’ notes, also show it can help improve patient “satisfaction, trust and safety.” The majority of patients who read their doctors’ notes felt the same about their doctors after reading them, and almost four in ten, 37 percent, felt better about their doctors. No doctors who shared their notes reported ordering more tests or more referrals. And a slim majority said they believed their patients were more satisfied with their care and trusted them more.

    While it’s still not customary for doctors to share their notes with their patients, it is a growing trend. Doctors and nurses believe patients benefit from seeing these notes. They can be more engaged in decision-making about their care. That can mean better health outcomes. And, if there are mistakes in patients’ records, patients can catch and correct them.

    Major funding is now in place for 50 million more Americans to access OpenNotes. We’ve come a long way since the Seinfeld episode in which Elaine struggles without success to see her doctor’s notes. Check out this short clip below.

    And, if you’re wondering whether it’s time to find a new doctor, here are four questions to ask yourself; there are several reasons you need a good primary care doctor.

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  • FDA approves first digital pill

    FDA approves first digital pill

    The New York Times reports that the FDA has approved the first digital pill, a pill that allows doctors to know whether you took your medicines and when. This latest health technology embeds a sensor in a prescription drug that captures and transmits data. The digital pill is designed to help with ensuring that people comply with their medication regimens.

    Digital pills will be especially helpful to older people and others who might otherwise forget to take their medications. Researchers have found that patients typically take only half of the doses of their prescribed medications. People who do not take their medications as prescribed may jeopardize their health.  They may end up hospitalized and in need of otherwise avoidable health care. The health care spending implications of medication noncompliance in the US is estimated by one population health management company at between $100 billion and $289 billion a year.

    The first digital pill, Abilify MyCite, is a new version of Abilify, an antipsychotic medicine. Patients must sign a written document consenting to give their doctors, and up to four other caregivers, access to the digital data. Abilify MyCite’s sensor is no bigger than a grain of salt. It is made of magnesium, copper and silicon. Once ingested, stomach acid activates the sensor.

    The data from the pill’s sensor is transmitted through a patch that patients wear. It indicates whether they took their medicine and when.  Patients can protect their privacy through a digital app that allows them to control who has access to their data.

    The FDA requires Abilify MyCite to have a warning that older patients with dementia-related psychosis, who are treated with antipsychotic drugs, are at increased risk of death. “Abilify MyCite is not approved to treat patients with dementia-related psychosis.” The drug poses serious risks of harm, including nausea, vomiting, anxiety, and uncontrollable limb and body movements.

    It may not be long before all medicines will be embedded with sensors to allow doctors and caregivers to monitor patients and help ensure medication compliance. At a minimum, sensors will be able to indicate whether a patient has taken a medicine. The public health benefits are significant.

    But, we also need to protect people from the big risks posed by this new health technology. Privacy and security issues abound. The data could be used by insurers against patients who fail to comply with their medication regimens. And, if the data is not stored securely or it is hacked, patients may have no control over the people who can access it.

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  • Smart pills win FDA approval to promote medication compliance

    Smart pills win FDA approval to promote medication compliance

    It is projected that only about half of people today take the medications that they are prescribed. Some people simply can’t afford to comply. But others get confused. The FDA has just approved new technology designed to promote medication compliance. The technology can track which pills you’re taking and whether you’re taking them at the right time.

    It is not yet clear when this new medication compliance device will go to market. When it does, however, it can let your doctors and health care buddies know whether you are taking the right drugs at the right time.

    Here’s how it works. Very small sensors that you can swallow will attach to your pills., a patch you wear with blue tooth technology will then track each pill you take on your smartphone app. You can then share that information with whomever you desire.