Biological treatments represent promising advances for individuals with rheumatoid arthritis (RA), and have been associated with significant improvement in outcomes including reduction in pain, joint swelling, serologic inflammatory indices, and rates of radiologic damage. Few studies have examined adherence to and/or persistence on biologics in RA patients in the U.S., especially among Medicaid enrollees. Since the Medicaid population comprises a large part of our public payer health system as well as tends to be underrepresented in clinical trials, it is important to examine adherence to and discontinuation of RA biologics in such patients. A recent study, "Adherence, Discontinuation, and Switching of Biologic Therapies in Medicaid Enrollees with Rheumatoid Arthritis" published in Value in Health, examined adherence, discontinuation, and switching of RA biologics (etanercept, anakinra, or infliximab) over a one year period following initiation of the biologic treatment in Medicaid patients with RA in California, Florida and New York.
Hospital Healthcare Leaders Call For System-Wide Programs For Medication Reconciliation, A Key Factor For Improving Patient Safety
The American Association of Critical-Care Nurses (AACN) added its bold voice to hospital healthcare leaders by endorsing a white paper that calls for system-wide programs for medication reconciliation the process of verifying that current patient medications are correct, medically safe and necessary. "Making Inpatient Medication Reconciliation Patient Centered, Clinically Relevant and Implementable: A Consensus Statement on Key Principles and Necessary First Steps" appears in October's Journal of Hospital Medicine. It outlines 10 key areas to progress medication reconciliation, including: -- Uniformly accepted definitions of medication and reconciliation -- Clearly defined roles of multidisciplinary participants in reconciliation -- Clinically meaningful reconciliation processes -- Comprehensive reconciliation across the continuum of care -- Mechanisms to prospectively and proactively identify patients -- Research to identify effective processes -- Dissemination of medication reconciliation strategies -- Integrated personal health records that transfer easily between care sites -- Healthcare and community-based partnerships -- Healthcare payment structures that align with medication safety goals Among the organizations that endorsed the pivotal white paper: the American Academy of Pediatrics, Consumers Advancing Patient Safety, Institute for Healthcare Improvement, Institute for Safe Medication Practices and The Joint Commission.
Researchers at the University of Cincinnati (UC) and the Cincinnati Veterans Affairs (VA) Medical Center have found that about one-third of chronic kidney disease patients who are prescribed therapies for high blood pressure do not often adhere to treatments. This report was published in the Nov. 2 online edition of the American Journal of Nephrology. The study, led by researchers at UC and the Cincinnati VA, showed that treatment of hypertension in patients with chronic kidney disease continues to be a challenge in their care and that by simply improving medication adherence, outcomes would improve greatly. Chronic kidney disease is the slow loss of kidney function over time. The main function of the kidneys is to remove wastes and excess water from the body. Ongoing hypertension is often associated with kidney disease.
People with rheumatic diseases don't take their medication on a regular basis, and this leads to poor outcomes in their disease treatment, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Atlanta. Treatment adherence (consistently and correctly following the treatment plan outlined by a health care professional) is a crucial part of successfully managing rheumatic diseases such as rheumatoid arthritis and lupus. Although there are multiple ways health care professionals can monitor if their patients are taking medications as prescribed, electronic monitoring is considered one of the most accurate. Recently researchers conducted two studies to look at adherence rates among people with RA and lupus to determine how well they follow their prescribed treatment plans.
A trial in Kenya has shown that using text messages to help patients adhere to their treatment improves absolute adherence rates by 12% and numbers achieving viral load suppression by 9%. The results of the WelTel Kenya1 study are reported in an Article Online First and in an upcoming Lancet, written by Dr Richard Lester, University of British Columbia, Vancouver, BC, Canada, and colleagues. The study is being presented at the 2010 'm Health' Summit in Washington, DC, USA. The number of cell phone users is rapidly expanding (4â 5 billion cell phone subscribers are expected worldwide by 2012), mainly because of free market forces (ie, capitalism) and the demand for rapid wireless communications for personal use and to aid multisector economic development (eg, trade, tourism, and infrastructure);