NCPIE developed Talk Before You Take in collaboration with the FDA’s Center for Drug Evaluation and Research (CDER) Office of Communications.The campaign was informed by research conducted by the Evidence Generation, Value and Access Center for Excellence within Ipsos Healthcare with input for the Center for Drug Safety and Effectiveness (CDSE), Johns Hopkins Bloomberg School of Public Health.
About the NCPIE A3 Project
The Adherence Action Agenda, or the “A3 Project,” is an initiative of the National Council on Patient Information and Education (NCPIE)bringing together healthcare professional societies, consumer and patient groups, voluntary health organizations, local, state and federal government agencies and industry leaders to identify the major gaps in current adherence improvement efforts and create a collaborative national Adherence Action Agenda at www.BeMedicineSmart.org – the virtual home of the A3 Project to continually offer realistic solutions for improving medication adherence through improved care coordination, harnessing new technology and supportive government policies.
The A3 Project focuses on four key areas: Patient-related factors | Provider-related factors | Influencing macro factors (current drivers for reshaping the design and delivery of medical care and payment reform) | Multiple chronic conditions. This new agenda calls for an increased focus on adherence improvement efforts now underway in medical, pharmacy and nursing practice; technology innovation and adoption; policy arenas; provider and healthcare student education; public awareness; and research.
The Adherence Action Agenda (A3 Project) – helping multiple chronic disease sufferers promote safe & appropriate medicine use.
- The Nation’s leading chronic disease dyad for men and women » High Blood Pressure + Arthritis
- The Nation’s leading chronic disease triad for men and women » Arthritis, Diabetes, High Blood Pressure.
- In 2012, more than half of Medicare beneficiaries with multiple chronic conditions (MCCs) were being treated concurrently for high blood pressure and high cholesterol (52.9 % prevalence).
Learn more and access an A3 program report: Accelerating Progress in Prescription Medicine Adherence: The Adherence Action Agenda – A National Action Plan to Address America’s “Other Drug Problem” »
10 Priorities for Action to Tackle HBP
NCPIE invites fellow AHA HBP Partners to team up with us to tackle each of these 10 Priorities for Action in a meaningful way. Select the particular Priority for Action that aligns with your organizational interests and expertise, and let us hear from you by contacting: Deborah Davidson at email@example.com
1. Establish medicine adherence as a priority goal of all federal and state efforts designed to reduce the burden of multiple chronic conditions.
Because patient adherence is not viewed as an essential element of government initiatives to reduce the burden of multiple chronic conditions, the Adherence Action Agenda calls for adherence to be integrated throughout the range of efforts now underway through the HHS Multiple Conditions Strategic Framework to improve health systems change and facilitate new research efforts, as well as similar state-wide efforts.
2. Establish the role of the patient navigator within the care team to help patients with multiple chronic conditions navigate the health care system and take their prescription medicines as prescribed.
Building on the patient navigator model now used in hospitals and cancer clinics nationwide, the action plan advocates for pairing patients with multiple chronic conditions with specially trained adherence navigators who will, in collaboration with patients and caregivers, obtain the patient’s medical records, create an accurate medication list, set up medication counseling as needed, schedule timely follow-up physician visits, and facilitate communication between the patient and his or her different physicians.
3. Promote clinical management approaches that are tailored to the specific needs and circumstances of individuals with multiple chronic conditions.
Since patients with multiple chronic conditions differ in the severity of their illnesses, prognosis, and functional status, the report encourages health professionals to adopt the American Geriatric Society’s guiding principles for treating older adults with three or more diseases, which calls for eliciting and incorporating patient preferences and choosing therapies that optimize benefits and minimize the harm for older patients.
4. Incentivize the entire healthcare system to incorporate adherence education and medication support as part of routine care for MCC patients.
With research showing that the interactions between patients and their health care providers affects how well patients manage their chronic conditions, the report advocates for an expanded investment in patient/provider education and engagement tools so clinicians can implement best practices for medication adherence and counsel their patients on the importance of following treatment plans.
5. Eliminate the barriers that impede the ability of patients with multiple chronic conditions to refill their prescription medicines.
One of the reasons patients fail to refill their prescriptions is the need to pick up prescriptions at different times and sometimes at different pharmacies, requiring numerous trips to the pharmacy. To reduce these obstacles, stakeholders support implementing the “pharmacy home” model, which gives patients a single pharmacy point of contact for filling prescriptions, and adopting refill synchronization, which allows patients to fill different prescriptions at one time and therefore, reduce the number of visits they must make to the pharmacy.
6. Reduce the cost-sharing barriers for patients by lowering or eliminating patient copayments for prescription medicines used to treat the most common chronic diseases.
NCPIE’s report, Accelerating Progress in Prescription Medicine Adherence: The Adherence Action Agenda makes clear that the cost of medications for some patients is a barrier to filling their prescriptions and taking their medicines as prescribed and advocates adopting policies that will reduce the out-of-pocket costs for medications, especially for patients on multiple prescriptions for chronic condition.
7. Accelerate the adoption of new health information technologies that promote medication adherence.
Because significant innovations in health technology have the potential to improve the flow of timely and complete information on medicine use between patients and providers, the report calls for the swift adoption of new standards for using electronic health records, incentivizing providers to use health information technology to identify patients at risk for medication misuse, and the expanded use of electronic reminders and personal health records to improve medication adherence.
8. Establish medication adherence as a measure for the accreditation of healthcare professional educational programs.
Currently, the nation’s medical residency programs are moving towards an outcomes-based accreditation system, where all medical residents will be evaluated on the basis of required core competencies, including interpersonal skills and communication. From the standpoint of medication adherence, this represents an important opportunity to integrate medication management and e-prescribing into the curriculum of medical residency programs and paves the way for establishing medicine adherence skills as core competencies within the curricula of schools of pharmacy, nursing, and other allied health professions and as a measure for accreditation.
9. Address multiple chronic conditions and optimal medication management approaches in treatment guidelines.
Clinical practice guidelines typically focus on managing a specific chronic condition and do not take into account the presence of multiple chronic conditions. The report advocates the accelerated development of updated treatment guidelines where information on the most common comorbidities clustering with the incident chronic condition is included, starting with the most common combinations of multiple chronic conditions, called dyads and triads, which have already been identified by the Centers for Medicare and Medicaid Services (CMS).
10. Stimulate rigorous research on treating people with multiple chronic conditions, including focused research on medication adherence to promote the safe and appropriate use of different medicines in this patient population.
There is a paucity of evidence-based data on how to treat patients with two or more concurrent diseases who are taking drugs developed and tested in people who have a single condition. According, the NCPIE report, Accelerating Progress in Prescription Medicine Adherence: The Adherence Action Agenda, supports incorporating medicine adherence throughout the research agenda for multiple chronic conditions and advocates for increasing the budget for HHS research efforts on the best ways to treat the most prevalent clusters of concurrent diseases.
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