In a world of rising costs for healthcare services, healthcare reform programs enacted in both developed and developing countries to increase access, reduce costs and focus more on preventative care, and patient-focused interactions from health care professionals and the healthcare system, medication adherence is rising to the forefront of programs that can help us deliver on the promise of improving quality of care, increasing access, and reducing system costs.

Outlined here are seven shifts Frost & Sullvan sees in the way healthcare systems are organized, and the approach to treating and managing healthcare. Each of these trends has an impact on individuals and organizations in the healthcare system.

First is the shift from a system that in the past was very provider centric, with the hospital and physician the locus of control. In addition, the focus is on a more patien-centric system, with more information and responsibility flowing to the patient, both through their own actions and the systematic structure - including adherence programs - that recognize the patient as the ultimate decision maker responsible for much of the success in preventing and treating many chronic diseases. Additionally, patients are seeking more information and interaction, to a large degree via the Internet, in understanding and managing their response to their condition.

The push toward more decentralized monitoring of conditions, even to the home via remote monitoring, is in a way part of this patient-centric shift. Adherence programs have in some ways been on the forefront of this shift by widening the net of caregivers interacting to support adherence, through the use of nurse outreach programs, and pharmacists interacting with patients around adherence in a local setting.

Personalized medicine is part of the shift that involves individualizing treatment in a scalable approach, and requires pharmaceutical companies to change their business models to adapt to a world where the "one size fits all" blockbuster drug will be a smaller part of their strategy. The same driving factors are affecting adherence programs - using technology to create more personalized approaches, with a higher success rate by focusing on individual characteristics, but carried out in a scalable fashion - individualization in a cost-effective manner, leveraging technology.

Finally, the wellness movement puts more emphasis on health literacy and individual patient adjustments and motivations as the keys to success in reducing costs to the system through upfront investments, which is exactly the same goal and output of adherence programs, when viewed from a systematic point of view, as opposed to an individual brand focus.

The upcoming Patient Adherence & Engagement 2010 conference in Philadelphia will bring together leaders from the healthcare industry, healthcare providers, thought leaders, and government and consumer organizations to discuss new and successful programs to address improving adherence at the individual level.

The program will be launched with an introductory discussion of the changed world after healthcare reform has been enacted in the U.S. This section of the program takes a multi-stakeholder (industry, patient, and practitioner) view of how reform can be implemented as a driver to medication adherence, and gives real world examples of "how real change agents are doing it," as John Miall, co-founder of the Asheville project, puts it.

With a focus on preventative care and cost reduction, improving adherence is often cited as the easiest way we can quickly address both of these goals of healthcare reform within the current structure of the system. One difference in the post healthcare reform world is the increased need for collaborative strategies and communication approaches among stakeholders. A need to document outcomes - or, as one speaker says, "Measure, measure, measure" - is another area of focus on the agenda.

Another interesting perspective that is a focus of the first day of the eyeforpharma event in Philadelphia is the view of the provider. Physicians are on the front line of understanding the complexity of patient adherence at the individual patient level, and understanding the physician's viewpoint to successes and hurdles in dealing with adherence issues is key to successful adherence strategies. In a more patient-centric approach, one key to success in communicating with patients is bringing the physician's perspective into alignment with the patient's in terms of shared values, shared language, and mutual respect. Gina Ford from Ipsen will also provide an example of the successful use of nurses in developing patient relationship plans that are executable and deliver lasting results.

Of course, adherence ultimately relies on understanding and addressing patient perspectives. Patients bring to their interactions with the healthcare system their own perspectives, based on their experiences with other industries they interact with, and we in healthcare often fail to measure up to these expectations of interaction. Consumers who are used to being in control of information flows, having on-demand support and control over the timing of interactions and access to information find a world in healthcare where this control and these expectations are met only in interactions with healthcare information presented in "unofficial" settings, such as online patient communities, support groups, and health information websites. While approaches like online consultations are growing, patients generally see their physician interactions as one-way, "talk to" not "talk with" sessions.

At the upcoming conference, many approaches to improve patient communication regarding adherence issues will be discussed - from the perspectives of technology solutions, caregiver interactions, the role of pharmacists, and perhaps most interesting, learning from online patient communities.

Despite concerns that have limited involvement in social media by many on the professional side of our healthcare system, pharmaceutical companies and healthcare providers are involved and engaged in patient online communities, with the goal of improving patients' knowledge of their disease state and treatment programs that can be successful. The goal of these sessions at this conference is to bring forward "how we can" ideas and initiatives, and describe how to get around hurdles to gain success, as opposed to the "wait and see" approach more often seen in pharmaceutical companies' discussion of social media activities.

The conference will close the loop in Day 2 with several sessions focused on the motivation and behavioral influences on medication adherence. As depicted below, the complexity of understanding individual patient reasons for non-adherence, and designing scalable adherence systems to address these individual causes and motivations is a difficult process.

Again, the conference program will take an integrated approach to addressing this issue, with multiple perspectives and real-world solutions presented by patient groups, pharmaceutical companies, healthcare providers, and industry support solution providers. This 360 degree perspective will provide a good closure to two days of interaction and solution exchange by what has always been a high-level group of thought leaders on medication adherence at this annual event.

Eyeforpharma's 7th Annual Patient Adherence & Engagement 2010 conference will be held in Philadelphia on October 19-20. For more information on the conference, visit http://www.eyeforpharma.com/pcusa/. We look forward to a productive two days of discussing successful solutions to improve medication adherence and moving the needle on the goals of improving quality, access and cost within our healthcare system.

Source:
Eyeforpharma