The Role of Medication Compliance in Improving Outcomes of Pharmaceutical Care - PowerPoint PPT Presentation

Loading...

PPT – The Role of Medication Compliance in Improving Outcomes of Pharmaceutical Care PowerPoint presentation | free to view - id: 24ef1-Y2VlO



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

The Role of Medication Compliance in Improving Outcomes of Pharmaceutical Care

Description:

The Role of Medication Compliance in Improving Outcomes of Pharmaceutical Care ... Managing medication compliance = improved outcomes ... – PowerPoint PPT presentation

Number of Views:1175
Avg rating:3.0/5.0
Slides: 29
Provided by: matthe83
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: The Role of Medication Compliance in Improving Outcomes of Pharmaceutical Care


1
The Role of Medication Compliance in Improving
Outcomes of Pharmaceutical Care
2
  • Sweeping changes continue to reshape the practice
    of pharmacy. The pharmacy professional needed
    today is a knowledgeable drug expert and skilled,
    persuasive communicator. This pharmacist
    embraces a new practice model - pharmacy care.

3
The Pharmacy Care Process
  • Collect and utilize patient information (build
    rapport)
  • Identify patients drug related problems
  • Develop solutions
  • Select and recommend therapies
  • Follow up to assess outcomes

4
Vision
  • Compliance as a partnership between patients,
    physicians and even managed care to achieve
    desired health outcomes now called
    concordance.
  • Managing medication compliance improved
    outcomes
  • complex, but, interesting implications for health
    practitioners

5
Possible Challenge
  • Improved compliance may also mean more drug
    related problems.
  • over users who take less medication may
    experience increased symptoms
  • under users who take more doses may experience
    more side effects

6
Outcomes
  • Economic
  • increased cost of medications
  • To patients, insurers, government
  • lower total health care costs
  • Clinical
  • better control of disease, symptoms
  • Humanistic
  • patient satisfaction with therapy
  • prescriber satisfaction?

7
When patients do not take their medications
correctly what happens?
8
When patients do not take their medications
correctly what happens?
  • May not get better
  • Can get sicker / worsen disease
  • Can have a relapse

9
The costs of noncompliance
  • 100 billion dollars annually
  • 125,000 unnecessary deaths
  • 10 (more than 1,000,000) of all hospitalizations
    may be due to noncompliance
  • 50 of all medication use

10
Health Effects
  • increased morbidity (sickness)
  • treatment failures
  • exacerbation of disease
  • more frequent physician visits
  • increased hospitalizations
  • death

11
Economic effects
  • increased absenteeism
  • lost productivity at work
  • lost revenues to pharmacies
  • lost revenues to pharmaceutical manufacturers

12
Dimensions of Compliance some things we think we
know….
  • Initial noncompliance or defaulting
  • 2 - 20, possibly as high as 50
  • average 8.7
  • Refill compliance or persistence
  • Decreases over time
  • Not all non-compliance is improper medication use
  • rational noncompliance

13
Benchmark compliance rates
  • Disease
  • Epilepsy
  • Arthritis
  • Hypertension
  • Diabetes
  • Oral contraceptives
  • HRT
  • Asthma
  • Rates of noncompliance
  • 30 to 50
  • 50 to 71
  • 40 (average)
  • 40 to 50
  • 8
  • 57
  • 20

14
Persistence
  • Product persistency curves
  • after 1 year as much as a 50 percent decline
  • after 5 years, compliance as low as 29 to 33
  • greatest declines in first six months

15
Improper medication use
  • Over or under use, wrong time
  • Taking the wrong medicine
  • Not finishing medication
  • Administration errors
  • Using another persons medication
  • Using old, possibly expired medication

16
Patient Considerations
  • Factors believed to affect compliance
  • patient knowledge
  • prior compliance behavior
  • ability to integrate into daily life / complexity
    of the particular drug regimen
  • health beliefs and perceptions of possible
    benefits of treatment (self efficacy)
  • social support (including practitioner
    relationships)

17
Patient Considerations
  • Factors which are NOT believed to be associated
    with compliance
  • age, race, gender, income or education
  • patient intelligence
  • actual seriousness of the disease or the efficacy
    of the treatment

18
Patients at higher risk
  • Asymptomatic conditions
  • hypertension
  • Chronic conditions
  • hypertension, arthritis, diabetes
  • Cognitive impairment
  • dementia, Alzheimers
  • Complex regimens
  • poly pharmacy, QOD

19
Patients at higher risk
  • Multiple daily dosing
  • qd
  • Patient perceptions
  • effectiveness, side effects, cost
  • Poor communication
  • patient practitioner rapport
  • Psychiatric illness
  • less likely to comply

20
Issues
  • Measuring compliance
  • Several methods
  • Non-response v. non-compliance
  • Did the doctor choose the right drug, dose, etc.?
  • Compliance is not easy to pinpoint
  • Compliance problems cuts across drugs, diseases,
    prognosis, and symptoms.

21
Issues
  • Measuring compliance
  • patient reports, clinical outcomes, pill counts,
    refill records, biological and chemical markers,
    monitors
  • MAS, MOS, BMQ
  • Medication Adherence Scale, Medical Outcomes
    Study, Brief Medical Questionnaire
  • Range from complicated to simple, such as
  • How often have you taken your prescribed
    medication in the past four weeks?

22
High Tech Tools To Improve Compliance
23
Strategies to improve compliance
  • personal interaction with your pharmacist,
    through counseling and communication, etc.
  • multimedia educational campaigns
  • patient education, counseling, written
    information, special labels
  • teaching methods for self monitoring
  • new idea….contracts with patients?
  • devices, reminders (mail, telephone), special
    packaging
  • follow-up

24
The RIM Technique
  • Recognize
  • using objective and subjective evidence, the
    pharmacist can determine if the patient may have
    an existing compliance problem
  • Identify
  • determine the causes of noncompliance with
    supportive probing questions, empathic responses,
    and other universal statements
  • Manage
  • develop partnerships with patients

25
Identifying Non Compliance
  • information from the patient
  • patient comments, concerns, questions
  • certain clinical outcomes
  • non response to treatment
  • information from refill records

26
Pharmacy Care Skills Needed
  • Patient skills needed for behavior modification
  • problem solving
  • self monitoring
  • develop systems for reminders
  • enlisting social support get family involved
  • identify positive and negative compliance
    behaviors

27
Actions Needed
  • More fully implement the pharmacy care model
  • Challenges
  • pharmacist commitment to pharmacy care
  • enhance the key skills necessary for patient care
  • develop partnerships with physicians, MCOs and
    patients
  • integrate, coordinate and manage drug use

28
Benefits of improved compliance
  • For
  • Patients - better outcomes and quality of life
  • Practitioners healthier, more loyal patients
  • Managed care - lower total HC expenditures
  • Pharmaceutical Industry - increased sales
About PowerShow.com