Patient Education Goes Bollywood
Today’s post at AlignMap, the blog and web site where I write about treatment adherence, takes patient education and medication compliance from the sad and drab ghetto of mainstream materials such as posters, pamphlets, and sideshows, to the fab world of entertainment.
Check out Tracey Ullman’s conceptualization of patient counseling performed by Padma Perkish, an Indian pharmacist in Oak Ridge, Tennessee, who provides more than full service.
The videos of Tracey Ullman as Padma Perkish, the pharmacist with the unique take on patient education, can be found at The Tracey Ullman Patient Compliance Videos.
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Slate Story On Patient Compliance May Sound Familiar
Returning Heck of a Guy readers will, I suspect, find little new in “Doctors Without Orders,” an article about medication noncompliance by Jessica Wagner in today’s Slate.
The material may seem, in fact, distinctly familiar to those readers I’ve successfully harangued into reading posts at AlignMap, the blog and web site where I write about treatment adherence.
Yep, the article is based, in large part, on an interview with me and data drawn from the AlignMap site.
But, while the material may have be old hat to some viewers, it is, I must admit, altogether more impressive when Ms Wagner writes it under the Slate aegis.
Jessica Wagner’s Slate.com essay on medication noncompliance can be found at
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What’s New In Patient Compliance
AlignMap, EnrichMap, and The Scourge of Treatment Noncompliance
Many returning readers know I maintain another blog and web site, AlignMap.com, which focuses on patient compliance and adherence to treatment.
For those who are unaware of the significance of patient compliance, I’ve included the following excerpts from AlignMap.com:
Noncompliance with treatment is a healthcare catastrophe.
Because many otherwise effective treatment plans are inadequately implemented or are not implemented at all,1
- Millions of unnecessary hospital admissions and thousands of preventable deaths (in the US alone) take place every year
- Innumerable patients suffer needlessly prolonged, severe, or relapsed diseases
- Healthcare dollars go to waste at an annual rate of $100 - $300 billion (in the US), losses in workplace productivity take an even higher toll, and patients, their families, and their communities endure profound financial, social, and psychological damage
- Cascading misinformation, mistrust, and inefficiencies impair medical research, corrode the morale of clinicians, and imperil the healthcare system itself
Some readers may also know that, in my pre-AlignMap, pre-Heck of a Guy life, three colleagues and I formed a group called EnrichMap to develop a system for grouping patients according to their behavioral patterns pertinent to compliance. That information would allow customized, group-specific strategies to minimize unnecessary treatment failures caused by noncompliance. That decrease in treatment failures would, in turn, reduce the consequent morbidity and mortality, research confoundments, delays, and financial waste.
Humanity in general and healthcare in particular would be enhanced, the American economy would be saved, and apropos of this new Age of Aquarius, peace will guide the planets and love will steer the stars. Oh, and the four of us would be rewarded with appreciation, a sense of accomplishment, and vast sums of money.
And, indeed, we were able to construct what has become the Emap Profile, a model that, based on an individual’s responses to a brief (20-25 items) questionnaire, divides the adult, cognitively-intact population into six segments, each with different implications for patient compliance:
- Sage and Satisfied
- Security Seeking
- Self Starting
- Uncertain and Concerned
- Spontaneous and Impulsive
- Vigilant and Suspicious
The problem was that we were unable to find a practical means of testing the tool.2 Consequently, we set the project aside. I began the AlignMap web site and blog, in fact, to provide an outlet for my continuing interest in treatment adherence.3
It now appears likely that my partners and I will be able to work with one of the companies involved in clinical trials to find out if the Emap Profile does what we think it does - make meaningful distinctions between how patients respond to treatment proposals.
And thus is reincarnation accomplished in the business world.
One manifestation of EnrichMap’s revitalization is the EnrichMap.com web site, which just came online. EnrichMap.com offers, naturally, more information about the Emap Profile, including the opportunity for a visitor to determine which of the six groups best describes his or her pattern of responses to healthcare instructions.
So, if you are interested in the impact of healthcare noncompliance, if you want to take the survey to find out where you fit in the Emap Profile, or if you’re just curious about how I’ve spent my so-called free time lately, check out the ~ EnrichMap web site ~
Footnotes
- The scope & effect of noncompliance is elaborated at
~Noncompliance Fact & Fiction~ ~back~ - ”Practical means of testing the tool” translates into “a clinically and statistically valid method for testing our hypothesis that we could afford out of pocket.” ~back~
- Yes, if I had known we would be resuscitating EnrichMap, I might have chosen a name for that site other than “AlignMap,” which will inevitably be confused with “EnrichMap.” If it helps, AlignMap covers patient compliance in general; EnrichMap deals with a specific solution, identifying subtypes of patients with respect to adherence and customizing enhancements for those groups ~back~
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The High Cost, Thank Goodness, Of Placebo R&D
From Research To Retail In 24 Hours
Tonight’s AlignMap1 post, Breakthrough In Placebo Science - High End Retail, is my response to the news of a study published this week in The Journal of the American Medical Association indicating that expensive placebos are more effective than cheaper placebos.
Immediately recognizing the opportunity this insight afforded me, I have established a new AlignMap-Heck of a Guy enterprise, the placeboutique, to produce and, more to the point, to sell what our slogan describes as High Priced & Highly Effective Placebos
the placeboutique
The Sign Of High Priced & Highly Effective Placebos
Check out the business strategy and offerings of the placeboutique at
Footnotes
- AlignMap is my professional web site and blog that focus on patient compliance, also known as adherence to treatment ~back~
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Mystery Of Medication Noncompliance Solved
Meet Marshall Molar, Medication Modulator
Little did I suspect when I began my routine daily scan of scientific, news, and commercial reports pertinent to patient compliance that I would be reading about the imminent demise of healthcare noncompliance, my central professional interest for the past several years and the focus of AlignMap, my healthcare blog.
Pictured below is the IntelliDrug device.
Consider it well, because, according to Science sinks its teeth into 2500 year-old drug problem, a story in the 15 January 2008 online edition of Science Centric, “it will mean, finally, an end to the 2500 year-old patient compliance conundrum.” [emphasis mine]
Well, after 2500 years, it’s about time.
There might, however, be one or two teeny-tiny problems with the notion that this is the ultimate solution to patient noncompliance. Or maybe that contention is just sour grapes on my part.
The entire story is available at
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The Adornment and Usage Of Pillboxes and Medication Organizers
Now At AlignMap:1 Introduction To Pillboxes and Medication Organizers
Why Publish A Post On Medication Organizers?
Pillboxes or, more precisely, pill organizers are certainly the most common device recommended (especially to the elderly) and used to improve adherence to a prescribed medication regimen. Yet, until recently, there was little formal research that focused on the effectiveness of this methodology.
It now seems that medication organizers do have, as was assumed, a potential for significantly enhancing medication adherence.
It also appears that medication organizers have their own set of characteristic problems that can not only decrease their effectiveness but even make health problems worse or cause treatment failures or additional disorders.
This is hardly unexpected - most useful tools, from hammers to jet engines to computer chips to international monetary exchange rate systems, carry risks as well as benefits. More surprising is that clinicians and pharmacists have typically done little beyond suggest to clients that they use employ these gadgets. Most patients, other than those using exotic equipment complex enough to require an operating manual, are left, literally, to their own devices.
That’s probably a mistake.
How To Use Medication Organizes: An AlignMap Tutorial
In upcoming AlignMap posts, I’ll be reviewing the sparse literature about simple, non-electronic medication organizers and adding my own observations to formulate concrete protocols to enhance their efficacy and, perhaps more importantly, protect against systemic errors in their use.
If I do my job correctly, this should be immediately useful to anyone who already uses these devices.
Today’s AlignMap blot entry is simply an introduction to medicine organizers, featuring David Letterman, the Bang & Olufsen updated version of the plastic pill organizer, the electronic progeny of the pillbox, and a reference to a clinical study showing the benefits of using a pill organizer in the treatment of AIDS.
That post also has more graphics of the sort seen at the top and bottom of this Heck of a Guy entry, displaying a small fraction of the universe of pillboxes and medication organizers - the practical, the decorative, the emblematic, the luxurious, the cheap, and much, much more. In these two collections of images on this posts are items labeled “Vatican pillboxes,” medication organizers for pets, sterling silver pillboxes, bejeweled and electronic dispensers, pillboxes bedecked with Christian and Jewish symbols, and round, curved, and square models. There are even more variations at AlignMap. Also included are various medication-associated accoutrements, such as pill splitters, reminders, medication logs, etc.) that are often marketed as part of a set, the centerpiece of which is the medication organizer.
And Just In Time For Christmas
Pillboxes and medication organizers make wonderful gifts as well as festive ornaments this 2007 holiday season - or as we like to say at the Heck of a Guy Mercantile & Schwag Emporium, exclusive distributer of the AlignMap Patient Compliance Commemorative Plaques, Make this a Christmas of Compliance - Give the gift of medication adherence.
The AlignMap Post
This AlignMap post can be found at
Footnotes
- AlignMap is my professional web site and blog that focus on patient compliance, also known as adherence to treatment ~back~
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Wall Street Journal On Medication Reminders and Dealing With Your Doctor’s Potential Conflicts of Interest
Two Issues With Immediate Impact On Your Day-To-Day Healthcare
Two topics that could significantly affect the healthcare of anyone taking medication or anyone under a doctor’s care, providing medication reminders and medical information via cell phones and devising the best plan for handling a doctor’s potential conflict of interest,1 are each the focus of separate Wall Street Journal articles featured in today’s AlignMap2 post, Medication Adherence Reminders and Doctor-Patient Communication In The Wall Street Journal.3
Spoiler: I agree with the WSJ assessment that text messaging by cell phone holds special advantages for the enhancement of medication adherence, but believe their take on dealing with the doctor’s conflict of interest is impractical and over-simplistic.
The link to the AlignMap post is
Footnotes
- E.g., a physician with a financial interest in an orthopedic device he developed might be tempted to prescribe it unnecessarily or a doctor might advise patients to undergo a CT scan at a given facility which he owns ~back~
- AlignMap is my professional web site and blog that focus on patient compliance, also known as adherence to treatment ~back~
- The Wall Street Journal articles were originally published 20 November 2007, during the AlignMap blog’s holiday hiatus, which accounts for the delay in their appearance in the AlignMap blog. ~back~
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Test-Driving The Personal Medication Record
An earlier post, How To Create and Use A Personal Medication Record, noted that (1) everybody, regardless of age and health, needs an individual Personal Medication Record that includes at least basic information about current medications and is always available to that person and those treating him or her and (2) several choices of Personal Medication Records (PMR) are available. Today, the focus is on the means by which you can audition the formats for their utility to you.
In my research for these posts on the PMR, I discovered far too many offerings to provide viewers with even a representative sampling, let alone an exhaustive review. I also discovered, however, that there are a few telltale signals that provide valuable insight into the design of the PMR and its potential fit with the user.
To maintain accessibility to this essay, it occupies its own page within the AlignMap web site,1 where it can now be read at
Footnotes