AlignMap

AlignMap In Cites, the tumblelog companion to this blog, offers succinctly annotated links to web sites and online material pertinent to treatment adherence.

Typically, these are brief news stories, videos of compliance enhancement devices, and summaries of treatment studies that require little explication.  In addition, AlignMap In Cites posts frequently include information sources from outside the healthcare sciences mainstream.

Some of the most recent AlignMap In Cites posts follow:

• Poison information specialists concerned about callers who don’t adhere to their advice
• A new Research Chair in Patient Adherence to Drug Therapy at the University of Saskatchewan
• A discussion of the legal and ethical aspects of withholding state of the art AIDS drugs from non-compliant patients
• An educational and behavioral change focused game promoting Adherence

Excerpts from and links to the most recent AlignMap In Cites posts are listed in the right sidebar.

Some of the recent entries at AlignMap In Cites warrant special attention.

• Always vigilant for any glimmer of humor associated with patient compliance, I was delighted to discover this short, funny video promoting adherence to ARVs as essential regardless of whatever else may be going on – including a gunfight. The scenario shown may not pass muster as politically correct, but I have showcased it here in the belief that this kind of public service announcement is more likely than the typical ponderous didactic presentation or scared-straight derivatives to attract an audience and have an impact on the the treatment adherence of those viewers.
• “Cancer-Related Fatigue Awareness Month” is not a name that flows trippingly from the tongue but the concept behind it is profoundly pertinent to compliance. “Between 70 and 100 percent of cancer patients receiving treatment have fatigue … . Up to one-half of all survivors have reported fatigue lasting months or even years after treatment.”  (From personal experience and my own reading, I would add that the fatigue factor is likely as high for the caretakers as well.)
• Etiquette-based medicine is a supplement to rather than a substitute for evidence-based medicine and could well enhance compliance with the latter.
• The flip side to etiquette-based medicine is the subject of the New York Times article, Arrogant, Abusive and Disruptive — and a Doctor.
• A new study pushes personalizing the often detached, dehumanized  exercise of reading x-rays by routinely adding patient photographs to the digital file of all radiographic examinations.
• A monograph on smart pillboxes and gizmos to magnify the fine print on pill bottles¹ contain photos of the latest compliance-enhancing devices on the market.
• The results of a national survey of compliance among Canadian women under treatment for osteoporosis demonstrate the usual surprising severity and pervasiveness of nonadherence,² even among patients who have experienced first hand the consequences of the unchecked disease. For example, “Only 56% of those who have fractured a bone are more careful about taking their osteoporosis medication as prescribed since their fracture.”
• A study backing the clinical wisdom that alcohol misuse predicts poor medication adherence, another study examining the relationship between blood pressure levels and adherence to medication in patients with chronic heart failure, and an advance look at a study that will systematically explore  medication compliance by children.

As always, the 10 most recent posts at AlignMap In Cites are listed at the bottom of the right sidebar of this page under the clever title, AlignMap In Cites Recent Posts.

1. See Check The Fine Print For Noncompliance, Part 1 and Part 2.↩
2. I will be starting a pool to allow wagers on how many of these studies will be necessary before the same dreadful results are described as surprising. The smart money – trust me on this one – will be on the high numbers.↩

Alignmap In Cites Goes Video

A plethora of compliance-pertinent videos are now available online.  I’ve begun posting some of these flicks on this blog’s tumblelog counterpart, AlignMap In Cites.

Videos selected for the AlignMap In Cites Patient Compliance Theater meet one or more of the following inclusion criteria:

1. Presentations of patient compliance research that briefly and clearly present highlights of findings
2. Tips targeted to patients or clinicians that may improve adherence
3. Demonstrations of and infomercials about devices that ostensibly enhance adherence – or at least amuse me.
4. Testimonials from patients and pontifications from clinicians that provide useful information, reveal pertinent attitudes that could have a positive or negative impact on patient compliance, or surpass a difficult to articulate but easy to recognize threshold of – oh, let’s call it eccentricity.
5. Anything else that strikes my fancy.

The following videos in the list that follows have been posted to AlignMap In Cites in the past 24 hours. The links below go directly and only to the post indicated. These posts can also be accessed en masse by going to the AlignMap In Cites home page and scrolling back through the chronologically listed posts.

Now Showing
The AlignMap In Cites Patient Compliance Theater

Infomercial about the e-Pill Cube Pill Timer and Pillbox My first impression, based on the rather complex explanation of its operation, is that the device might be better positioned as a test of cognition rather than a convenient medication dose reminder.

Tips to enhance adherence to medication regimen Nothing unusual but potentially helpful ideas about remembering to take ones medications. Targeted to patients.

Medication compliance survey: Moderately self-serving presentation and recommendations from The National Community Pharmacists Association.

Infomercial about the e-Pill MD2 dispenser

Psych Medication Non-compliance: A patient’s own story of medication noncompliance.

Adherence to ARVs — Part 1 and Adherence to ARVs — Part 2: Poignant patient educational video from Baragwanath Hospital, Soweto, South Africa  promoting adherence to anti-HIV ARV drugs.

How to Improve Patient Compliance in Dyslipidemia Diagnosis: Medscape produced video report on study affirming value of electronic patient reminders.

Importance of Patient Compliance in Healing: Presented by a clinician and targeted to patients. Excerpt: So, do what the doctor tells you. Try to be compliant. Try to get better. And if you need our help, we’re Baker Chiropractic. We put patients first.

Michelangelo's Temptation and Fall - from Sistine Chapel Ceiling

Increasing Ones Knowledgebase Is Not Without Risk

Treatment Adherence Data From Fields Beyond Healthcare

While I’ve previously written AlignMap posts about the value of alternative perspectives on patient compliance, most of the entries here focus on pertinent studies and review articles from the familiar genre of medical literature.

Readers interested in extending their thinking beyond the standard party line may find some of the material covered at AlignMap In Cites, the tumblelog companion to this blog, helpful.  The succinctly annotated links comprising AlignMap In Cites tend to be more catholic in content than AlignMap.com and often include information sources from outside the mainstream.

Moreover, thanks to the recent change in the AlignMap.com structure it now  easier for viewers on this site to follow AlignMap In Cites.¹ The section labeled “AlignMap In Cites Recent Posts” at the bottom of the column to the reader’s right is a list of links to the 10 latest posts at AlignMap In Cites.

The two most recent AlignMap In Cites posts  today, in fact, are examples of non-medical resources:² the first links to a review of Buyology By Martin Lindstrom, which examines how marketers, using magnetic resonance imaging scanners, record brain activity in minute detail, measuring how the products they are selling affect the brain’s pleasure centers while the second is a reference to Emerging Lessons, a WSJ article on “understanding the needs of poorer consumers,” which includes, by my reading at least, useful concepts for conveying information to patients with low healthcare literacy. Both of these have obvious implications that could affect how we understand treatment adherence.

Posting at AlignMap In Cites tends to happen in batches separated by fallow periods so I recommend following the titles here and checking out those that look helpful.

I’ll also be listing other nontraditional sources of information about patient compliance here at AlignMap.com in the future.

Bonus #1: Other AlignMap In Cites Posts

I’ll take this opportunity to explain that the content of AlignMap In Cites includes references such as those discussed above, connections to AlignMap.com posts,³ and many entries into what might charitably be called “Miscellaneous.” Among today’s recent posts group, for example, is a quote lifted from a medical student’s publically published blog, which evidences that political correctness has not completely eliminated the blatently obnoxious declaration and which reminds those of us grown perhaps a tad jaded to the basics of patient compliance that teaching the fundamentals to medical students remains an essential task.

Bonus #2: Heck Of A Guy Posts

Near the bottom of the column on the left is a list of links to the ten most recent posts at Heck Of A Guy, my personal blog, which has almost nothing to do with patient compliance other than the occasional post alerting readers there to AlignMap posts of general interest. The tag line at Heck Of A Guy is “A pastiche of posts, featuring song, dance, snappy chatter plus notes on prose, poesy, love, lust, life, and beyond,”⁴  which should clue in any blog reader that I have no idea, day to day, about the content of the posts I’ll publish. I recently published my 1000th Heck Of A Guy post, which included a list of random topics covered there:

• Leonard Cohen
• Anjani
• Ketchup decantation
• Recommendations for additional subtypes of quotation marks:Quid Pro Quotation Marks And 2 More Specialty Quotation Marks and Misquotation Marks & Quasi-Quotation Punctuation
• Love story Julie and I shared
• George Washington Carver 6 Posts (Link goes to first in series)
• The reaction of my hometown to the Gay Games Rowing Event being held here 5 Posts (Link goes to first in series)
• Broomcorn 2 Posts (Link goes to first in series)
• The proposed revision of The Seal Of McHenry County Illinois More Than 10 Posts (Link goes to first in series)
• Mom’s inventory  of Ozark tchotchkes Multiple Posts (Link goes to summary)

I know – I don’t understand why it’s popular either.

1. AlignMap In Cites has also transformed its look into one more easily read and one that is, well, way cool.↩
2. Quelle coincidence, eh?↩
3. The graphics featured in Robot Enhancement of Treatment Adherence, for example, were first displayed on AlignMap In Cites,↩
4. Until recently, the tag line was “If this has made just 1 person spew Pinot Noir through his or her nose, then it’s all been worth it … ,” which may be more indicative of the Heck Of A Guy tone.↩

In the preceding post, I mentioned the illness of a loved one; unfortunately, this illness has become severe. Consequently, routine posting on AlignMap.com and AlignMap In Cites, as well as my personal blogs, will continue to be suspended. I will post any changes in this plan, including the resumption of blogging, here.

Given the dearth of recent posts to AlignMap, this is, I suppose, a clarification rather than a notification.

A convergence of family and business responsibilities, the illness of a close friend, and some relatively minor but time-consuming healthcare issues of my own make routine updating of this blog as well as AlignMap In Cites impossible.

The most likely scenario for the immediate future has me sporadically and unpredictably posting items when the opportunity arises.

My hope is to return to my original 3-5 posts per week schedule when the current tempests are quelled.

• Physician Counseling Promotes Healthier Lifestyle in Patients With Type 2 Diabetes
• Understanding Medication Compliance and Persistence from an Economics Perspective
• Written exercise instructions improve patient compliance
• Selling generic drugs via vending machine not only spares patients a trip to the pharmacy, but improves medication compliance
• Adherence to Initial Adjuvant Anastrozole Therapy Among Women With Early-Stage Breast Cancer
• Claimed Benefits of Aerosolized Antibiotics Not Proven
• Depression needs to be discussed during rheumatoid arthritis doctor visits
• Medication adherence and cognition
• HIV/AIDS Advocacy Groups, Scientists React to Swiss Claim About Antiretrovirals, HIV Transmission
• Video: Why many blood pressure patients stop taking their prescription medications
• Handing off teens’ care to the teens
• It costs an average of $6533 to recruit a patient for a trial, and three times that amount to recruit a new patient if one is lost due to noncompliance
• New Developments and Research in Treatment Adherence in Schizophrenia
• Impediments to Prescription Compliance

• Heart Risk Profile: Treatment Motivator

• Is hole in DOTS policy playing a role in the evolution of an XDR-TB strain?

Footnotes

1. AlignMap In Cites is a new tumblelog I’m auditioning as an augmentation to the AlignMap web site and weblog. (See AlignMap In Cites – More Content, Less Delay↩

Favorite AlignMap In Cites Posts

AlignMap In Cites is a new tumblelog I’m auditioning as an augmentation to the AlignMap web site and weblog.¹

Since the last AlignMap post referencing AlignMap In Cites, several items have been posted there. Some of those I consider most interesting are listed below:²

1. The Psychotic Dilemma
2. Workplace Wellness Programs: Pro and Con
3. Problems With Compliance Among Australian Aboriginal People For Whom Western Medications Have Little Meaning
4. International Osteoporosis Foundation report outlining fiscal and clinical impact of noncompliance in osteoporosis patients signals the launch of the IOF Staying Power: Closing the Adherence Gap in Osteoporosis campaign
5. 33% of patients admit that they did not fill all their NEW prescriptions in the past year
6. Having to pay as little as $10 of a mammogram’s cost leads many older women to skip the breast cancer exam, a large study of Medicare users finds
7. Medicine is not set up to worry about what happens when people leave the doctor’s office
8. Researchers Propose Consumers Buy Yearly ‘Drug Licenses’ as New Way to Pay for Prescriptions; Compliance Expected To Improve
9. Nobody knows why people lie to their doctors and nurses but we do have an infallible technique for detecting patients who are telling porkies; their lips move
10. The National Audit Office wants to print the cost of drugs on packets to discourage us feckless patients from wasting precious NHS resources by failing to take the medicines we have been prescribed.
11. As far as I an remember, that was the only compliant patient I’ve ever had here.

Search Me

I’ve added a search function to AlignMap In Cites (see area in red box above). Like the tumblelog itself, the search mechanism is on trial. This search is fast and covers all the posts (unlike Google, which covers only those posts indexed by the Googlebot). The limitation of this mechanism is that, as far as I can determine, it can search only for a continuous string; e.g., entering “patient compliance” will find all instances of “patient compliance” as a single term but will not find posts with both “patient” and “compliance” if those words are separated – such as “The patient was in the compliance study.”

Footnotes

1. See AlignMap In Cites – More Content, Less Delay↩
2. These items are listed by time of entry with the most recent first. The links below go directly to the single item described. All entries can be accessed in a single listing at AlignMap In Cites.↩

Most Recent Posts at AlignMap In Cites

AlignMap In Cites is a new tumblelog I’m auditioning as an augmentation to the AlignMap web site and weblog.¹ The items below are listed by time of entry with the most recent first. The links below go directly to the single item described. All entries can be accessed in a single listing at AlignMap In Cites.

1. Explaining Patients’ Beliefs About the Necessity and Harmfulness of Antidepressants by Aikens et al. (Abstract)
2. The Placebo Effect (at Science Based Medicine)
3. Study: Calls help couch potatoes walk
4. Wellness Programs May Face Legal Tests – WSJ.com
5. January/February 2008 Annals of Family Medicine tip sheet
6. The economic consequences of noncompliance in cardiovascular disease and related conditions: a literature review
7. Americans Use Excessive Force, or None at All, Battling Diseases

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Footnotes

1. See AlignMap In Cites – More Content, Less Delay↩

An Introduction To AlignMap In Cites

AlignMap In Cites is a new tumblelog I’m auditioning as an augmentation to the AlignMap web site and weblog.

For readers who are in the adult, non-geek population, the Wikipedia definition of tumblelog is provided below:

It may also be helpful to think of AlignMap In Cites as the quicker, less obsessive, happy go lucky younger sibling of the curmudgeonly, prolix, and sometimes abstruse AlignMap Weblog.

Both the design of tumblelogs described above and Tumblr, the software that powers AlignMap In Cites, make posting a link to a site, such as an online abstract or text, the home page of a compliance-enhancing product, or another blog covering an aspect of adherence, a quick, easy process. Posting a link to web site X can be accomplished without leaving web site X.

The ease and speed of posting makes this process ideal for pointing to items that require little or no explanation beyond, “Hey, look at this.” It’s not unlike mentioning to a colleague over lunch that he might be interested in a study on noncompliance of 50-60 year old males with hip fracture rehabilitation programs in the new issue of the New England Journal.

Although I just began posting to AlignMap In Cites this morning, I’ve been playing with Good Clean Wholesome Fun, the tumblelog sidekick for my personal Heck of a Guy blog, for four or five days and feel as though I’m getting the hang of the thing.

While I’m convinced this format is worth trying, I am not yet convinced of its utility. As I said, it’s a tryout, and you get free tickets to the dress rehearsal.

The first two AlignMap In Cites entries are online at