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Wiki.eyeforpharma.com: A New Source Of Patient Compliance Information

November 16th, 2006 at 7:29 am · Allan Showalter, MD · Clinical Info · No Comments

Patient compliance From Wiki.eyeforpharma.com



The Eyeforpharma Wiki

Eyeforpharma, which describes itself as “the leading pharmaceutical business strategy information provider” and produces industry conferences as well as supplying news, events, research reports, and interviews with movers and shakers in the field, recently opened the Eyeforpharma Wiki, modeled on the Wikipedia, that focuses on information relevant to the pharmaceutical community.1

As of this posting, the content of this nascent wiki is limited to brief descriptions of pharmaceutical companies (e.g., GSK and Merck) and individuals (most of whom seem to work for Eyeforpharma) and a handful of industry-specific articles that range from two lines on Medicare and Medicaid to three screens on E-detailing.

Most pertinent to the AlignMap blog’s interests, of course, is the significant entry on Patient compliance.

Patient Compliance On Wiki.eyeforpharma.com

The article is divided into eight sections:

  1. Description
  2. Case Studies And Recent Findings
  3. Talking up compliance
  4. Patient non-compliance a “rampant” problem
  5. Latest Thoughts
  6. Ways to improve adherence
  7. A role for the pharma industry
  8. Patient compliance through education and adherence programs

Description
The basic data about treatment adherence found in Description is clearly written, well referenced, and accurate although it offers little that is unique and that couldn’t be found in standard reviews in the literature or other sites such as AlignMap.com.

Case Studies
Similarly, the Diabetes and Osteoporosis Case Studies are interesting and insightful but are, by necessity, arbitrary choices. Heart disease, asthma, or HIV disorders, for example, could have served the purpose equally well. More to the point, there is again little information or analysis here that couldn’t be found in several other sites or articles in print.

Talking up compliance
Talking up compliance, on the other hand, does deal with less common issues — the interface of communication among patients, clinicians, and the pharmaceutical industry, including the impact of explicit points of discussion. This material is not typically featured in the medical literature. Further, my experience has been that such content, when covered in newsletters and web sites within the pharmaceutical industry, seems most often presented to promote or defend a program or strategy rather than to explore and evaluate the issues with an evidence-based approach.

Patient non-compliance a “rampant” problem
Patient non-compliance a “rampant” problem returns to a standard exposition of basic facts about the prevalence and incidence of nonadherence and, in fact, might more logically fit in the initial Description section.

Latest Thoughts
Latest Thoughts is a thoughtful take on the importance of enhancing adherence and the means of achieving this goal.2 The section’s themes can be summarized by these three quotes:

  1. Improving adherence might be the best investment for tackling chronic conditions effectively.
  2. Interventions for removing barriers to adherence must become a central component of efforts to improve population health worldwide.
  3. For outcomes to be improved, changes to health policy and health systems are essential.

Ways to improve adherence
Ways to improve adherence is a reiteration of the empowered patient concept. While this approach has obvious appeal, is politically correct – and may even work, it is disheartening to find it reported here as fact without any references or support.

A role for the pharma industry
A role for the pharma industry begins, “The main role of the pharmaceutical industry is to develop safe and efficacious treatments” although it does go on to advocate the education of patients about those products. While this may be accurate in the most restrictive sense, its tone seems oddly incongruent with the preceding points in this same Patient Compliance entry that emphasize the imperative to enhance adherence by any means possible. For example, “Increasing the effectiveness of adherence interventions might have a far greater impact on the health of the population than any improvement in specific medical treatments” implies, by my reading, that pharma’s responsibility extends beyond providing “safe and efficacious treatments.” An even more directly conflicting declaration is embedded in Latest Thoughts, “Medicines won’t work if you don’t take them. Even the best treatment plan will fail if it isn’t followed.”

Patient compliance through education and adherence programs
Patient compliance through education and adherence programs also promotes specific methodologies. Two excerpts that characterize this section follow:

… Jane Martin, a respiratory therapist and founder of pulmonary patient support programs in Michigan, the most successful patient compliance comes down to “patient education made so simple and convincingly logical, that there is little reason for a patient not follow the prescribed instructions.”
According to Alice Watson, a physician and research fellow at Partners Telemedicine, matching drug reminder technologies to patients’ needs and situations is critical to seeing a positive impact on drug compliance. She also stresses the importance of developing messages and tools to meet the needs of different age groups and disease states.

Mirroring my comments on the Ways to improve adherence section,3 these approaches have obvious appeal, are politically correct – and may even work (although it is far from certain that either patient education or medication reminders is a panacea4 ), but it is, again, disheartening to find such theories reported as self-evident facts without any references or support other than the (hardly surprising) endorsements by those responsible for those programs.


Commentary

The quality of this early offering is uneven but it is apparent that the Wiki.eyeforpharma.com offers a significant opportunity to provide not only worthwhile information but a valuable perspective on patient compliance to clinicians, politicians and bureaucrats, and the lay community as well as those within the pharmaceutical industry. Currently, only a portion of that potential is now being realized. A course correction at this early point could have a significant impact that will be impossible later. I’ll offer specific recommendations for improving the situation5 in a future post (either the 16 November or 19 November entry).

Update
The recommendations and followup can be found at Recommendations For Wiki.eyeforpharma.com


Footnotes


  1. The Eyeforpharma Wiki joins a group of other information sharing sites emulating the Wikipedia, including WikiCPA, “dedicated to all things CPA,” the RHIO Wiki Web site, an online clearinghouse for Regional Health Information Organizations, and MormonWiki, “the free encyclopedia about Mormons from the perspective of faithful members.” [back]
  2. ”Thoughtful take,” of course, means the author agrees with what I’ve been pushing. [back]
  3. It is not clear to me why Ways to improve adherence and Patient compliance through education and adherence programs are separate sections [back]
  4. See Myth #3. Noncompliance Can Be Eliminated By Educating The Patient, Motivating The Patient, Eradicating Or Relieving Side-effects, Simplifying The Treatment Plan, … in Patient Noncompliance Myths [back]
  5. The folks at Eyeforpharma are, no doubt, breathless with anticipation of my oracular pronouncements. [back]

Tags: Clinical Info