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5 posts from March 2013

03/28/2013

Medication Adherence: Would You Accept the Challenge?

Adherence and compliance are commonly used terms when referring to patients taking their medications as prescribed. While both of these words have their own connotation, one term suggests a more collaborative effort. Concordance implies that patients and doctors have an interactive dialogue, which produces a mutual understanding of treatment regimens thereby increasing the likelihood of adherence. While prescribers and pharmacists would be ideal advocates of medication concordance, they are often unable to provide the necessary dialogue because of time constraints. Observant of this lapse in care, initiatives around the nation have begun to embark on improving adherence.

One initiative is the Script Your Future campaign launched by the National Consumers League, which aims to spread awareness about medication non-adherence. Script Your Future shapes an integrated approach by incorporating various health care providers with a number of public and private partners to address the issue comprehensively. The campaign also provides adherence tools, action plans and other resources to both the patient and the provider to improve adherence. Aside from initiatives like Script Your Future, medication adherence has become integral component in many national efforts, including Million HeartsTM and the National Council on Patient Information and Education. Such programs recognize that the success of patients adhering to medications is based on interaction and patient empowerment.

What is especially encouraging about campaigns like these is that they provide a great opportunity for student pharmacists to get involved and expand their knowledge about medication adherence.  Employing pharmacy students in this effort sheds light on a viable solution to address the issue that many clinicians simply do not have the time for. Pharmacy schools around the nation have even teamed up with other health care disciplines to take on the challenge of creating innovative methods to promote adherence. Recently, a research study found that pharmacy students are not always getting enough education on adherence while in school. By engaging and motivating students to come up with new ideas to tackle medication non-adherence, students are able to develop their own understanding while helping patients at the same time.   

As initiatives around the nation continue to deploy this reserve of medication adherence activists, we see a new way to achieve clinician-patient relationships that will be increasingly concordant without
increasing the burden on the provider. What can we take away from all of this? The tools are there; the people are there; the interest in patient care is there. It is now up to the current clinicians to amalgamate these forces to produce a harmonious solution to medication non-adherence.

Anita A. Pothen, PharmD ‘14

03/23/2013

Pharmacy Students Have Plenty of Opportunities for Leadership and Networking

By Grace Earl, PharmD, APhA-ASP faculty advisor

Picture1There are many opportunities for students in the College of Pharmacy to participate in activities on campus as well as network with other students on a regional or national level.  Many students become members of the American Pharmacists Association-Academy of Student Pharmacists. This important organization gives students a chance for developing leadership skills. Student leaders work with their team on campus to develop an agenda of activities that include health screenings, health promotion events, and educational events.

Left to right: Faculty Advisor Dr. Grace Earl, Ashley Krumenacker PharmD'15 (Member-at-Large), Faculty Advisor Dr. Samantha Decker, Robert Bond PharmD'18 (PCP chapter representative for advocacy), Faculty Advisor Dr. Anisha Grover, Annette Lista PharmD'14 (Region 2 Operation Heart Award and “Make your Mark” recognition), Faculty Advisor Dr. Karleen Melody, and Faculty Advisor Dr. Hank Schwartz.

For the 2012-2013 year, students at the Philadelphia College of Pharmacy (PCP) attended the Mid-Year Region II Meeting in Morgantown, Va., from Nov. 9 to 11, 2012. Two individuals assumed a leadership role at the regional level and one student was recognized for their leadership on campus.

Ashley Krumenacker PharmD’15 was Member-at Large. "I was elected to be the Region 2 Member-at-large, in which I am responsible for communication across the region with chapter leaders regarding a wide variety of APhA-ASP activities, including membership, patient care projects, and APhA/ASP International Pharmaceutical Students’ Federation (IPSF). In January, I along with the other Regional Officers reported to APhA Headquarters in Washington, DC for our Business Meeting. At Annual2013 I served as a member of the Reference Committee for APhA-ASP and an Alternate Delegate for the APhA House of Delegates."

Robert Bond PharmD’18 represented the PCP chapter for advocacy. This role is an excellent choice for someone who is interesting in presenting and defending their ideas. Students come together at the regional meeting to develop and vote on a slate of advocacy positions. Students have supported steps to enhance patient access to care. In one example, students supported changing legislation so pharmacists could administer epinephrine injections in the event a patient had an anaphylactic reaction. This would like be a life-saving intervention that would save precious time by administering the antidote in a setting that is close to the patient’s own home.  These positions are forwarded to the the APHA organization which uses them to develop their national policies.

Annette Lista PharmD’14 was recognized with the Region 2 Operation Heart Award and the “Make Your Mark” Recognition. She received a certificate for this honor. Annette was instrumental in promoting heart health at several events including the American Heart Association’s Home Runs for Hearts and the Heart Walk. The Home Run for Hearts event involved a blood pressure screening event held at Citizens Bank Park Baseball Stadium in Philadelphia.

Annette feels that pharmacists are the public’s most accessible health care provider. “Pharmacists can play a significant role in the prevention and management of cardiovascular disease. As future health care professionals and patient advocates, student pharmacists can support these efforts and address an unmet need in public health. Through public awareness, community outreach, and patient-specific education on cardiovascular risk factors, student pharmacists can empower patients to take control of their health. However, the first step is taking the initiative to reach out to the public, encourage fellow student pharmacists to take action, and spread the wealth of knowledge we have with others!”

The APhA-ASP faculty advisors are faculty members in the Department of Pharmacy Practice and Administration.  They are: Hank Schwartz, PharmD; George Downs, PharmD; Grace Earl, PharmD; Karleen Melody, PharmD; Samantha Decker, PharmD; and Anisha Grover, PharmD.

03/21/2013

Money Makes the World of Big Pharma Go Round

“Money makes the world go round” –whether you first heard the idiom in the 1960’s musical “Cabaret” or as the title of an R&B song by R. Kelly, the popular phrase is highly relevant to the pharmaceutical industry (pharma).   According to the World Health Organization (WHO), the global pharmaceuticals market is worth $300 billion a year. The Centers for Medicare and Medicaid Services found that retail prescription drug spending in the US rose to $263 billion in 2011, and did so at a faster rate compared to previous years. This rise was attributed to increased prices, especially for new and existing brand name medications. Following this trend, pharmaceutical companies are striving to what they do best—increase profits. A key component that has been linked to lead down this route of increased profits is medication adherence.

The logic seems simple enough—if  pharmaceutical companies can entice patients to remain adherent to their drugs, they can maximize profits while the patients attain the clinical benefit. Existing patients may stop taking a certain medication for any number of reasons, including costs.  Having recognized this, companies are attempting to offset the costs of losing customers by investing in incentives to keep them adherent. Pharmaceutical companies like Merck, Astra Zeneca, and GlaxoSmithKline are providing funding to patients in an effort to keep patients taking their medications. Aside from traditional coupons and vouchers, there is an increased effort in tackling the costs with patient assistance programs. For example, if a patient needs a product made by Shire, they can apply to get assistance for that medication that they otherwise would not be able to afford. While there are many groups like the Partnership for Prescription Assistance, which help patients identify companies and other affiliates that are willing to contribute to costs, one may wonder what incentive the companies who make these drugs have to give them out for free. A look at the 2011 report from the Capgemini Consulting group could explain. This report found that on average, it costs pharma 62% more to market to new patients versus the costs of keeping existing ones.

While it would be comforting to know that pharmaceutical companies are funding medications for the sole satisfaction of increasing accessibility of costly drugs, it’s not pragmatic. Money does make the world go round—especially if you are talking about the $300 billion pharmaceutical world. While the palms of big pharma continue to itch, we can only hope they keep the importance of adherence on their minds.

Anita A. Pothen, PharmD ‘14

03/16/2013

The Simpsons as an Educational Tool for Math and Science

I recently had the opportunity to speak at the MINTIFF Conference in Berlin, Germany about using television shows such as The Simpsons as an educational tool.  Here is a video of my talk:

 

 

03/13/2013

What’s So Special About Specialty Pharmacy?

Released earlier this month, the 2012 Drug Trend Report by Express Scripts highlights the decrease in spending of traditional drugs by Americans. Notably, this decrease was offset by an 18.4% increase in the total spending for specialty drugs. As it varies based on patient need, specialty drugs can be defined as those that treat a complex disease state or require a more complex route of administration (i.e. intravenous). With specialty drugs making such a profound increase in costs, it is important to understand their special place in the market.

Following the profound importance of specialty drugs, there has been a subsequent increase in specialty pharmacies. Specialty pharmacies such as Burman’s and Walgreens focus on specific disease states like Hepatitis C, HIV, and Cancer and as a result, have specialty medications more readily available than the traditional community pharmacy. Additionally, specialty pharmacies possess the resources to tailor their services as necessitated by the patient’s condition, which can thereby improve medication adherence.

From a clinical standpoint, specialty pharmacy is especially enticing in its capacity to collaborate with other health care professionals to make optimal treatment interventions in addition to facilitating adherence. As evidenced by Fairview Specialty Pharmacy in conjunction with the University of Minnesota Medical Center, a multi-disciplinary team approach coupled with effective communication can synergistically improve adherence. In this instance, Fairview was able to work with providers to optimize the management of specialty drugs that treat Hepatitis C. According to the Centers for Disease Control, 3.2 million people are chronically infected with the virus. If that wasn’t enough, the drug costs associated with Hepatitis C increased by 33.7% in 2012. With such significant drugs costs on the rise, it is crucial that patients remain adherent to these medications. In a patient with a condition as serious as Hepatitis C, failure to take medications as prescribed puts them at an increased risk of not only costly hospitalizations, but also resistance to future drug therapy regimens which leads to even greater medical costs and potential for treatment failure. By avoiding this, we can see the potential of incorporating a specialty pharmacy. Research has shown that Hepatitis C patients who only used a specialty pharmacy had about an 8.6% increase in adherence as well as a 60% higher likelihood of achieving optimum adherence as opposed to those who used a retail pharmacy.

Thus far, specialty pharmacy has been making its mark. By focusing on conditions with intensive therapy regimens while giving managed care organizations the added benefit of consistent follow-up to ensure better patient adherence, third party providers have been able to cut costs. With its notable benefits from a clinical and financial standpoint, it is expected that specialty pharmacy will further develop as an increasing number of specialty drugs come out of the pipeline.

Anita A. Pothen, PharmD ‘14

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