HEALTH

‘Multifaceted strategies’ can improve medication adherence among patients

BY Alaric DeArment

SAN DIEGO Improving medication adherence will require bringing multiple methods together in order to be successful, Pharmacy Quality Alliance senior director for research and performance measurement David Nau said Tuesday in an education session at the National Association of Chain Drug Stores’ Pharmacy and Technology Conference in San Diego.

 

“You need to have a multifaceted strategy around adherence if you want to have an impact on adherence,” Nau said.

 

 

According to last year’s study by the New England Healthcare Institute, poor medication adherence increases medical costs by up to $290 billion. The estimated one-third of patients who do not take their medications properly fail to do so for a number of reasons, which Nau boiled down to five social-economic, patient-related, therapy-related, condition-related and healthcare system-related factors, including costs of medications, fear of side effects and dependence, complexity of regimens, comorbidities and lack of incentives.

 

 

Complexity of medication regimens can be a particular problem for patients with chronic conditions. According to a study of patients using statins for cardiovascular disease, the average user studied took 11 medications, including nine maintenance medications, and often had to visit multiple pharmacies and had multiple prescribers; 10% of statin users studied took 23 or more medications. But according to another study, conducted by Harvard University and CVS Caremark, patients demonstrated greater adherence when they synchronized their refills and were able to fill all their prescriptions at one pharmacy.

 

 

All these factors mean that combating nonadherence requires a number of different approaches rather than simple interventions, Nau said. “It’s not just about counseling; it’s not just about slashing co-pays — it’s about having a multifaceted strategy,” he said.

 

 

Future trends that could affect adherence include deals between drug companies and pharmacy benefit managers, integration of medication reminders into social networking sites and medication-delivery technologies allowing delivery of multiple drugs in one pill, or implants that automatically administer doses. The last trend already is under way, to an extent, with the introduction of combination drugs for hypertension, such as Novartis’ Tekamlo (aliskiren and amlodipine besylate), which the Food and Drug Administration approved in late August.

 

 

Following Nau’s presentation, Rite Aid director of clinical services Rick Mohall took the stage to show some of the retail pharmacy chain’s adherence programs, such as automatic refills, reminder calls, medication therapy management and the Wellness+ rewards card. “Generally, what’s good for the patient is good for the pharmacy as a business,” Mohall said.

 

 

Both presenters emphasized the role of pharmacists in solving the nonadherence problem, with Nau citing a study from this year showing that physicians are “rather ineffective” in promoting medication adherence. “The greatest intervention tool, the thing that all these things need to point to, is the pharmacist,” Nau said.

 

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PacificHealth names Duffner CEO

BY Michael Johnsen

MATAWAN, N.J. PacificHealth Labs on Tuesday announced that Fred Duffner has been promoted to CEO and president reporting directly to the board. Duffner previously had been named president in January 2010.

“We have made great progress this year refocusing the company on its core brands in sports nutrition, reducing expenses and in building our cash position,” Duffner stated. “I believe [PacificHealth] is now in a position to take back its leadership position in the category and begin to lead with new innovation and consumer messaging.”

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Study: SAMe may benefit patients taking antidepressants

BY Michael Johnsen

BOSTON A new study conducted by investigators at Harvard Medical School and Massachusetts General Hospital suggested that the dietary supplement S-adenosylmethionine (SAMe) can be an effective, relatively well-tolerated, adjunctive treatment for adults with major depressive disorders who do not respond to their treatment with antidepressant medication, Pharmavite announced Tuesday.

BOSTON A new study conducted by investigators at Harvard Medical School and Massachusetts General Hospital suggested that the dietary supplement S-adenosylmethionine (SAMe) can be an effective, relatively well-tolerated, adjunctive treatment for adults with major depressive disorders who do not respond to their treatment with antidepressant medication, Pharmavite announced Tuesday.

“With each study, we continue to gain a better understanding of SAMe’s role in treating depression,” stated George Papakostas, associate professor of psychiatry at Harvard Medical School and lead author of the study. “This new finding, albeit preliminary and in urgent need of replication, suggests significant, clinically meaningful differences in outcome among patients who had SAMe added to their antidepressant medication treatment compared to those taking a placebo with their medication,” he said. “Continued research, however, is urgently needed to more definitively further our understanding of the role of SAMe in the treatment of adults diagnosed with depression. Adjunctive SAMe therapy is promising, but cannot yet be recommended for widespread clinical use.”

The first-of-its-kind study was published in the August 2010 American Journal of Psychiatry. According to the National Institute of Mental Health, there are approximately 14.8 million people with major depressive disorders in the United States.

 

The National Institute of Mental Health funded the study.

 

 

Pharmavite, manufacturer of Nature Made SAM-e Complete, provided the SAMe supplements and placebo pills used in the study.

 

 

The study, "S-adenosylmethionine (SAMe) Augmentation of Serotonin Reuptake Inhibitors for Antidepressant Nonresponders With Major Depressive Disorder: A Double-Blind, Randomized Clinical Trial," is the first randomized, placebo-controlled clinical trial conducted on SAMe in a population of patients with major depressive disorders. A total of 73 adults were enrolled in this six -week study and randomly assigned to the placebo control group or the SAMe treatment group. SAMe, in combination with standard depression treatment, was more effective than antidepressant treatment alone in improving measures of depression and remission rates of patients with significant clinical depression. SAMe-treated subjects had a greater response and remission rate to treatment than the placebo-treated group. SAMe was well-tolerated with no reported adverse reactions.

 

 

To date, at least 40 clinical trials have been conducted on SAMe directly and in combination with traditional antidepressant medications. Studies have evaluated SAMe’s use in naturally restoring a healthy mood to the most recent research for treating major depressive disorders. This current study follows a pilot study published in 2004 in the Journal of Clinical Psychopharmacology, which concluded that antidepressants used in combination with SAMe were significantly more effective in relieving depression than medication alone.

 

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