Experts | University of the Sciences

Forecasting Medication Non-Adherence: A Profitable Approach That Helps Patients

$290 billion a year—a study by the New England Healthcare Institute found this to be the amount spent in the United States as a result of medication non-adherence and other avoidable issues. An analysis by Capgemini Consulting estimated that $188 billion account for pharmaceutical industry losses in the United States for the same reason. With such considerable monetary losses in addition to the health risks associated with non-adherence, the profitable future for health information technology (health IT) is becoming increasingly apparent.

After recognizing the significant financial costs associated with non-adherence, many insurance providers are utilizing new initiatives based on health IT that aim to predict non-adherence in an effort to proactively address the issue. In early 2011, CVS Caremark introduced its Pharmacy Advisor™ Program, which pays special attention to patients with chronic conditions like diabetes, who are likely to be non-adherent.  In April of 2012, Express Scripts^® launched a similar predictive tool called ScreenRx, which detects risk for medication non-adherence and then subsequently provides personalized interventions for those patients. Additionally, companies like RxAnte^© and Allazo Health^© apply behavioral science, predictive analytics and claims data to formulate algorithms that will allow them to determine which patients would be at an increased risk for non-adherence. They then take it a step further by tailoring interventions according to patient characteristics.

So since there’s no magic crystal ball one can look into to predict medication non-adherence, how do these companies determine who to monitor and intervene with? The key to the above-mentioned initiatives is the incorporation of patient behavior in forecasting non-adherence.

One commonly used model in analyzing health behavior is the Health Belief Model (HBM). This model explains that a patient’s behavior when it comes to health is motivated and influenced by varying perceptions. In essence, the HBM finds that perceived susceptibility, perceived benefits, perceived barriers and perceived seriousness all contribute to decision making when it comes to health, which in this case, would be in reference to taking their medications.

So how relevant is patient behavior when it comes to medication non-adherence? Express Scripts^® found that 69% of medication non-adherence was attributed to patient behavior factors including simple procrastination and forgetfulness. With even more advancements in health IT, providers will be able to dissect and rationalize reasons for non-adherence and further analyze patient behavior to formulate optimal regimens that will save billions of dollars all while promoting better health outcomes.

 Anita A. Pothen, PharmD’14

Simple Steps to Avoid Trips and Falls

A Health Tip from University of the Sciences in Philadelphia

By:  Frank Kunkle

Falls Prevention Awareness day may have passed, but it is never a bad time to take steps to prevent avoidable trips and falls, particularly for older adults. According to the National Council on Aging, one in three Americans aged 65+ fall each year.

“We know older adults make up the at-risk population when we begin thinking about preventing falls. A few environmental changes prove to be very helpful, but an inter-disciplinary approach is often best,” said Pamalyn Kearney, assistant professor of occupational therapy at USciences.

Kearney and Dr. Carol Maritz, associate professor of physical therapy, urge older adults and those caring for loved ones to make a few changes this season.

Fall Prevention Tips:

• Clean up that clutter—clear pathways are essential for older adults. Think twice before leaving items on stairs and evaluate placement of a pet’s food dish. Also, consider eliminating throw rugs—they can wrinkle easily or slide across the floor.
• The bathroom can be one of the most hazardous rooms in the house. Use rubber mats to keep the tub surface from becoming slippery and install grab bars for stability. The wall soap dish and towel rack are not meant to hold human weight and can be very dangerous to use as support.
• Use a strategically placed nightlight since it takes time for human eyes to adjust at night. Check the lighting on stairs and remember, light that is too bright can cause a glare, making it just as dangerous as poor lighting. 
• Older adults should carry a cellphone or a life support button at all times—even in the house—to summon help quickly.
• Are appliances and dishes frequently used in the kitchen within easy reach? If not, reorganize. Only use a stepstool with a handle, not a dining room chair.
• Many older adults use their cane or walker only when they go out but in reality, they are no steadier in their own home. Unlike your assistive devices, grabbing furniture presents a risk because it can move or break.

Beyond these environmental modifications, Kearney and Dr. Maritz recommend older adults take an inclusive approach to their well-being. They should be doing strength-building exercises and a meeting with doctors to discuss medications. In addition, a physical therapist can help determine a person’s deficits and recommend a variety of resources, while an occupational therapist can evaluate how a person goes about their daily activities and suggest lifestyle changes.

Tips for Good Posture at Work

PT's Dr. Gregory Thielman provides tips for maintaining good posture at work for 6ABC's Health Check: http://abclocal.go.com/wpvi/video?id=7012554

Research Day Showcases Faculty and Student Research

From metabolic engineering to computational chemistry and from structural prediction of proteins to rational design of new therapeutics, University of the Sciences in Philadelphia showcased the diversity and growth of research pursuits on campus during its 7th Annual Research Day starting on Thursday, April 2, 2009. Posters representing approximately 120 topics were on display.

Research Day recognizes undergraduate and graduate student research efforts, and highlights aspects of faculty scholarly activity to encourage and promote communication and collaboration among investigators. The University is distinctive in that most undergraduate students conduct research with faculty early in their academic careers.

The diverse research activity on display spans several aspects of the University’s scholarly pursuits, including:

• Biological Sciences: Dr. Jennifer Anthony’s research involving the metabolic engineering of E. coli for the production of vitamin A.
  • Chemistry: Dr. Randy Zauhar’s use of computer-aided drug design to identify new antimicrobial lead compounds.
• Pharmaceutical Sciences: Dr. Bin Chen’s evaluation of the effects of vascular-targeting photodynamic therapy on prostate cancer metastasis.
• Physical Therapy: Dr. Therese Johnston’s usage of treadmill training for children with cerebral palsy.
• Social Sciences: Psychology major Mark Paullin’s (Philadelphia, Pa.) study of mild cognitive impairment in Alzheimer’s disease.
• Health Policy: Master in public health major Sekinat Kekere-Ekun’s (Deptford, N.J.) work on the descriptive epidemiology of viral hepatitis in methadone maintenance clients.
• Pharmacy Practice: Doctor of pharmacy students Neha Patel (Fairless Hills, Pa.), Puja Patel (Hillsborough, N.J.), and Isha Shah’s (Bensalem, Pa.) analysis of the usage of ondansetron in non-chemotherapy patients at a community teaching hospital.