Transcript Educate Before You Medicate: A Big Picture Look at

Educate Before You Medicate:
A Big Picture Look at
Adherence Improvement
Ray Bullman
Executive Vice President
National Council on Patient Information and Education
7th Annual Patient Adherence & Engagement Summit
Philadelphia, PA
About NCPIE
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Multi-stakeholder membership organization -formed 1982 -- healthcare professionals,
consumer & patient groups, industry, govt.
agencies. One of the original patient safety
coalitions.
Mission: Stimulate / improve communication of
information on safe/appropriate medicine use to
consumers &healthcare professionals
Convener, Catalyst, Clearinghouse of ideas &
information to advance members’ shared mission.
“Medicine Education Team” – Patient is key
player
Educate Before You Medicate:
A Big Picture Look at
Adherence Improvement
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Develop an adherence game plan:
Recommendations for action at the local, regional,
and national level;
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Take a multi-stakeholder approach:
The value of a collaborative national medication
adherence awareness campaign;
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Advance adherence at the point of
prescribing and along the patient
pathway: What’s new? What’s driving change?
Develop an adherence game plan
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Planets aligned; adherence is in the middle of
the radar - The Age of Adherence
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Big Picture approach  1 x 1 x 1 challenge
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Systemic problem / systems-wide solutions
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Everyone into the pool – Part D and Health
Care Reform as drivers
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Role for all / Responsibilities for all
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Impacts are order of magnitude
(Diabetes, Asthma,
COPD, CVD, Cancer........) for pts., providers, pharma, payors
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Prove It --
The Age of Evidence
Develop an adherence game plan
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Enhancing Prescription Medicine Adherence:
A National Action Plan (2007)
 National awareness required (HBP model)
 Increased emphasis on provider and student
education & training
 Multidisciplinary approach to adherence
education and management
 Address the barriers for patients with low
health literacy
 Increase funding / rigorous research agenda
Develop an adherence game plan
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Enhancing Prescription Medicine
Adherence: A National Action Plan
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Create the means to share information
about best practices in adherence
education and management
Remove roadblocks for adherence
assistance programs
Develop an adherence game plan
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Other Action Plans / Other Action Pathways
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NCL Collaborative National Awareness Campaign
NEHI Action Series
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Call for care team demo projects
System-wide approach to improving medication
adherence for chronic disease
Roundtable /Roundtable Highlights
Similar Commitments
Similar Goals
Similar Requirements (resources, research,
evidence, systems-wide, patient inclusive)
Take a multi-stakeholder approach
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Medicine Education Team – Patient is a key
player (NCPIE approach);
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Patient-Centered Primary Care Collaborative
(PCPCC):
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The Pt. Centered Medical Home: Integrating
Comprehensive Medication Management to Optimize
Patient Outcomes (Center believes that the ability to
maximize the appropriate use of medications to prevent
and control disease is critical to the success of the PCMH)
Take a multi-stakeholder approach
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THE PATIENT AS A KEY PLAYER
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Initiator (or not)
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As different as night and day
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What motivates you doesn’t motivate me (visa
versa)
Lots of “stuff” going on; making medicine use
relevant / important;
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Reaching you (Blackberry/ Apps) may not work for
your mom
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Advance adherence @ the point of
prescribing & along the patient pathway
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“Reintroducing the Oldest Advance in
Medicine – TALKING” (NCPIE, 1989)
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An assessment of the patient’s medication-related
needs
Identification of the patient’s medication-related
problems
Development of a care plan with individualized
therapy goals and personalized interventions
Follow-up evaluation to determine actual patient
outcomes
(2010, PCPCC, The Pt. Centered Medical Home: Integrating Comprehensive Medication
Management to Optimize Patient Outcomes
Advance adherence @ the point of
prescribing & along the patient pathway
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As in football, handoffs (care transitions) are
important (Pre-prescribing; prescribing;
post prescribing)
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Empowerment begins /ends @t home; make
notes/take notes before, during, after; other ears &
eyes
Let’s Talk (Ask/Tell); motivational interviewing;
putting adherence assessment tools/techniques to
work; if you don’t know what to ask, you can’t ask;
medicine list as a trigger;
Care teams -- comprised of both physicians and nonphysician caregivers, including professionals such as
community pharmacists who operate outside the
physician practice (NEHI)
Advance adherence @ the point of
prescribing & along the patient pathway
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As in football, handoffs are important (Preprescribing; prescribing; post-prescribing)
Medication reconciliation – going in/inside/ going out
(home); what about other team members (primary
provider; neurologist, gastroenterologist,
ophthalmologist, psychiatrist)
Home supports – written medicine information is
undergoing a make-over (in quest for a single
document solution); adherence packaging; refill
reminders / alerts; help lines
Hi Tech – e-prescribing, PMR/EMR; online tools /
supports; unlimited potentials / evidence?
Advance adherence @ the point of
prescribing & along the patient pathway
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As in football, handoffs are important (Pre-prescribing;
prescribing; post-prescribing)
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Prescriber / Patient Interface – (Adherence Red Zone)
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Pharmacist / Patient Interface - (Adherence Red Zone)
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Optimizing Healthcare Provider Supports
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Optimizing Patient Supports – family members, other
caregivers; aids, devices (all the Xs & Os on the board)
Educate Before You Medicate:
A Big Picture Look at
Adherence Improvement
The Age
of
Adherence Opportunity
October 19, 2010 -
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Contact Information
Ray Bullman, Executive Vice President
[email protected]
National Council on Patient
Information and Education (NCPIE)
200-A Monroe Street, Suite 212
Rockville, MD 20850
(301) 340-3940 - phone (301) 340-3944 - fax
www.talkaboutrx.org
www.bemedwise.org
www.mustforseniors.org
www.learnaboutrxsafety.org