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The Intervention Program

THE MISSING LINK IN BIOPHARMACEUTICAL SCIENCES TM. The Intervention Program. A basic principle. “Help your doctor help you”. medAmigo intervention program. medAmigo med=medicine, Amigo=Friend. Screening vs. Algorithms & Interventions Plans. Monitoring & Data Collection.

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The Intervention Program

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  1. THE MISSING LINK IN BIOPHARMACEUTICAL SCIENCESTM The Intervention Program

  2. A basic principle “Help your doctor help you”

  3. medAmigo intervention program medAmigo med=medicine, Amigo=Friend

  4. Screening vs. Algorithms & Interventions Plans Monitoring & Data Collection Intervention Plan Selected Physician & Patient Feedback Physician & Patient Feedback Intervention medAmigo patient management model Patient Starts

  5. Measurement-Guided Medication Management (MGMM) based intervention Successful techniques for improving compliance require two key elements: • Realistic measurement • the objective, continuous electronic recording of day by day dosing times, which can be easily interpreted by most patients • Scheduled appointments with feedback • continuing periodic review with the patient, by the prescribing physician, pharmacist, or nurse of the patient’s ongoing dosing history.

  6. Days on treatment Illustrative results of a medAmigo intervention Treatment of osteoporosis Before intervention After intervention Dosing Time V= a missed dose, 0= Sunday; 1= Monday; 2= Tuesday; 3= Wednesday;…

  7. MGMM tested successfully in Hypertension 12 weeks data No Intervention (N = 34) Mean compliance = 78% Intervention (N = 36) Mean compliance = 95% Difference = 17% McKenney et al., 1992 J Clin Pharmacol

  8. MGMM tested successfully in Hypertension McKenney et al., 1992 J Clin Pharmacol

  9. MGMM tested successfully in Serious Mental Illness Cramer and Rosenheck, 1999 J of Nervous & Mental Diseases

  10. MGMM tested successfully in Resistant Hypertension Burnier et al., 2001 J of Hypertension

  11. Dose compliance ** * * ** Week MGMM tested successfully in Smoking Cessation InterventionN = 51 Difference of ± 30% No Intervention N = 46 * p<0.05 ** p<0.001 Schmitz et al., 2005, Journal of Behavioral Medicine

  12. MGMM tested successfully in HIV • N=26 experienced patients (>6 months on treatment) 2 months 3 months Intervention 82% 93% Difference = 11%, p<0.05 Larger confirmatory trial is ongoing De Bruin et al., 2005 Aids Patient Care

  13. Intervention No Intervention MGMM tested successfully in Lipid Lowering Daily Percentage of adherers 100 90 ~86% % 80 Difference of 15% ~71% 70 P<0.01 60 0 50 100 150 200 250 300 Days since inclusion Vrijens, et al., Pharmacoepidemiology and Drug Safety, 2006

  14. Industry WINS Timely detection, focused Intervention Patients LOSE Late dropouts; retained sales Payors WIN Decreased care costs Payors LOSE Patients WIN Industry LOSES Increased drug efficacy Robust adherence/long persistence Breaking the downward spiral Poor adherence/short persistence Decreased drug efficacy Increased care costs Early dropouts; lost sales

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