Educate Before You Medicate: A Big Picture Look at Adherence Improvement Ray Bullman Executive Vice President National Council on Patient Information and

Educate Before You Medicate: A Big Picture Look at

Adherence Improvement

Ray BullmanExecutive Vice President

National Council on Patient Information and Education

7th Annual Patient Adherence & Engagement SummitPhiladelphia, PA

About NCPIE

Multi-stakeholder membership organization -- formed 1982 -- healthcare professionals, consumer & patient groups, industry, govt. agencies. One of the original patient safety coalitions.

Mission: Stimulate / improve communication of information on safe/appropriate medicine use to consumers &healthcare professionals

Convener, Catalyst, Clearinghouse of ideas & information to advance members’ shared mission.

“Medicine Education Team” – Patient is key player



Develop an adherence game plan: Recommendations for action at the local, regional, and national level;

Take a multi-stakeholder approach: The value of a collaborative national medication adherence awareness campaign;

Advance adherence at the point of prescribing and along the patient pathway: What’s new? What’s driving change?

Develop an adherence game plan

Planets aligned; adherence is in the middle of the radar - The Age of Adherence

Big Picture approach 1 x 1 x 1 challenge

Systemic problem / systems-wide solutions

Everyone into the pool – Part D and Health Care Reform as drivers

Role for all / Responsibilities for all Impacts are order of magnitude (Diabetes, Asthma,

COPD, CVD, Cancer........) for pts., providers, pharma, payors

Prove It -- The Age of Evidence


Enhancing Prescription Medicine Adherence:

A National Action Plan (2007)

National awareness required (HBP model) Increased emphasis on provider and student

education & training Multidisciplinary approach to adherence

education and management Address the barriers for patients with low

health literacy Increase funding / rigorous research agenda


Enhancing Prescription Medicine Adherence: A National Action Plan Create the means to share information

about best practices in adherence education and management

Remove roadblocks for adherence assistance programs


Other Action Plans / Other Action Pathways NCL Collaborative National Awareness Campaign NEHI Action Series

Call for care team demo projects System-wide approach to improving medication

adherence for chronic disease Roundtable /Roundtable Highlights

Similar Commitments Similar Goals Similar Requirements (resources, research,

evidence, systems-wide, patient inclusive)

Take a multi-stakeholder approach

Medicine Education Team – Patient is a key player (NCPIE approach);

Patient-Centered Primary Care Collaborative (PCPCC): The Pt. Centered Medical Home: Integrating

Comprehensive Medication Management to Optimize Patient Outcomes (Center believes that the ability to maximize the appropriate use of medications to prevent and control disease is critical to the success of the PCMH)

Take a multi-stakeholder approach

THE PATIENT AS A KEY PLAYER Initiator (or not) As different as night and day What motivates you doesn’t motivate me (visa

versa) Lots of “stuff” going on; making medicine use

relevant / important;

Reaching you (Blackberry/ Apps) may not work for

your mom

Advance adherence @ the point of prescribing & along the patient pathway

“Reintroducing the Oldest Advance in Medicine – TALKING” (NCPIE, 1989)

An assessment of the patient’s medication-related needs

Identification of the patient’s medication-related problems

Development of a care plan with individualized therapy goals and personalized interventions

Follow-up evaluation to determine actual patient outcomes

(2010, PCPCC, The Pt. Centered Medical Home: Integrating Comprehensive Medication Management to Optimize Patient Outcomes


As in football, handoffs (care transitions) are important (Pre-prescribing; prescribing; post prescribing)

Empowerment begins /ends @t home; make notes/take notes before, during, after; other ears & eyes

Let’s Talk (Ask/Tell); motivational interviewing; putting adherence assessment tools/techniques to work; if you don’t know what to ask, you can’t ask; medicine list as a trigger;

Care teams -- comprised of both physicians and non-physician caregivers, including professionals such as community pharmacists who operate outside the physician practice (NEHI)


As in football, handoffs are important (Pre-prescribing; prescribing; post-prescribing)

Medication reconciliation – going in/inside/ going out (home); what about other team members (primary provider; neurologist, gastroenterologist, ophthalmologist, psychiatrist)

Home supports – written medicine information is undergoing a make-over (in quest for a single document solution); adherence packaging; refill reminders / alerts; help lines

Hi Tech – e-prescribing, PMR/EMR; online tools / supports; unlimited potentials / evidence?


As in football, handoffs are important (Pre-prescribing; prescribing; post-prescribing)

Prescriber / Patient Interface – (Adherence Red Zone)

Pharmacist / Patient Interface - (Adherence Red Zone)

Optimizing Healthcare Provider Supports

Optimizing Patient Supports – family members, other caregivers; aids, devices (all the Xs & Os on the board)



The Age of

Adherence Opportunity

October 19, 2010 - ?

Contact Information

Ray Bullman, Executive Vice [email protected]

National Council on Patient Information and Education (NCPIE)

200-A Monroe Street, Suite 212Rockville, MD 20850

(301) 340-3940 - phone (301) 340-3944 - fax

www.talkaboutrx.org www.bemedwise.org

www.mustforseniors.org

www.learnaboutrxsafety.org

Documents

Educate Before You Medicate: A Big Picture Look at Adherence Improvement Ray Bullman Executive Vice President National Council on Patient Information and