From Reuter’s Health, a report on Sex Bias in Control of Cancer Pain:

“How well pain is managed in people with cancer apparently differs between men and women, new research hints. Dr. Kristine A. Donovan, of the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, and colleagues examined pain severity and the adequacy of pain management in 131 cancer patients newly referred to a multidisciplinary cancer pain clinic.” Full Story

From LifeScript, a study that shows 1 in 5 Diabetics do not take their medication as prescribed. “Too many diabetics are neglecting to take life-saving prescription medicines regularly, one study warned. Published in the Archives of Internal Medicine, the study estimated that 21% of diabetics fail to adhere to their prescription schedule.” Full Story

Allan Showalter, MD from AlignMap discusses the Implications Of The Redundant Patient Compliance Review. I like to post abstracts and some compliance reviews, but his blog posts are always more insightful, biting and from an MD’s perspective. Full Story

And lastly, from the International Journal of STD and AIDS: Factors associated with lack of antiretroviral adherence among adolescents in a reference centre in Rio de Janeiro, Brazil. Full Story.

OBJECTIVE: To evaluate the relationship between cognitive functioning and medication adherence in children and adolescents with perinatally acquired HIV infection.

METHODS: Children and adolescents, ages 3-18 (N = 1,429), received a cognitive evaluation and adherence assessment. Multiple logistic regression models were used to identify associations between adherence and cognitive status, adjusting for potential confounding factors.

RESULTS: Children’s average cognitive performance was within the low-average range; 16% of children were cognitively impaired (MDI/FSIQ <70). Cognitive status was not associated with adherence to full medication regimens; however, children with borderline/low average cognitive functioning (IQ 70-84) had increased odds of nonadherence to the protease inhibitor class of antiretroviral therapy. Recent stressful life events and child health characteristics, such as HIV RNA detectability, were significantly associated with nonadherence.

CONCLUSION: Cognitive status plays a limited role in medication adherence. Child and caregiver psychosocial and health characteristics should inform interventions to support adherence.

ROCKVILLE, Md., March 26 /PRNewswire-FirstCall/ — InforMedix Holdings, Inc. (OTC Bulletin Board: IFMX), announced that results presented by Dr. David Bangsberg, an internationally renowned expert on medical adherence, at the Third International Conference on HIV Adherence, showed that HIV+ patients using its Med-eMonitor™ “smart pillbox” that monitors medication and care plan adherence, achieved an average 89.5% medication adherence rate.

The Med- eMonitor “smart pillbox” is linked to the Med-eXpert™ software system that analyzes patient information and provides Web-enabled reports and urgent outbound alerts to caregivers when patients miss medication or suffer declining health.

Approximately 1.2 million people in the US are living with HIV, with an additional 40,000 becoming infected each year, costing the US health care system approximately $50,000-$75,000 per year per patient, or $50 to $75 billion in total annual costs.

Average adherence to HIV antiretroviral therapy is under 70%, and 20-33% of HIV-positive patients will miss at least one of their doses over any given 3-day period. Given that a 10% difference in adherence by individuals is associated with a doubling of viral load, and a 21% increase in the risk of progression to full-blown AIDS; based upon the statistics above Med-eMonitor/Med-eXpert offers the potential for a 40% decrease in the risk of an HIV patient developing full blown AIDS.

The challenging population of 76 patients that were enrolled in the program not only suffered from HIV infection, but frequently were also suffering from drug abuse and severe mental illness, and were near-homeless.

COMMENTS
As I always say, I applaud anything that encourages and enhances medication adherence. It am impressed by these raised adherence rates for HIV patients, but I think regular adherence rates are even lower. Here is my one question though, the sample group of 76 patients were near -homeless, and suffered from drug abuse and severe mental illness. This, to me, does not seem like an accurate test of the efficacy of Med-eMonitor™ – since it is in a controlled environment. I am not knocking the Med-eMonitor, but certain factors have to be in place to use it: #1 being a house to put it in, a fast internet connection, and a patient who waits for the machine to tell them when to take their pills.

With such a structured regimen as HIV medications, sometimes 10 – 20 medications a day, at certain times, one would have to be in front of the Med-eMonitor all day, waiting for the cue to take their meds. So how did the study go? Did the drug addicted, mental unstable near homeless stay in a shelter, rehab facility or mental institution and have their own Med-eMonitor programmed for them? Instead of the nurse coming around with their pills, it was the machine?

I will have to look further into this study to get a real understanding of it all. It just struck me as bizarre. If you are going to announce these results, maybe not mention that the patients were mentally ill, homeless drug addicts.

I still applaud the work and the use of Med-eMonitor and InforMedix for the software they have developed to increase medication adherence. I will have to look at AlignMap to see if Showalter has any comments.