Managing multiple diseases: Help patients ‘be medicine smart’

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Lately there has been an alarming trend in the number of patients who have multiple chronic conditions. In fact, an estimated one in four Americans has multiple chronic conditions, including 1 in 15 children. According to CDC, the most prevalent combination of two chronic conditions in the United States is hypertension and arthritis. The most prevalent triad of chronic diseases is arthritis, diabetes, and hypertension. As the baby boomer generation continues to age, the problem is expected to get worse.

Adherence agenda

“A growing number of Americans are now taking several prescription medications a day, and they often see more than one health care provider, which means they are at a higher risk for drug interactions, adverse events, and medication errors,” said Ray Bullman, Executive Vice President of the National Council on Patient Information and Education (NCPIE).

NCPIE has released a 10-step adherence action agenda as part of its campaign platform at www.bemedicinesmart.org. Accelerating Progress in Prescription Medicine Adherence: The Adherence Action Agenda lays out 10 policy and programmatic solutions to improve medication adherence. “This report is a wake-up call to action to confront the upsurge of chronic conditions that is threatening to overwhelm our health care system,” said Bullman.

Particularly relevant to pharmacists who manage patients with multiple chronic conditions is a recommendation to expand investment in patient–provider education and engagement tools to help pharmacists and other clinicians implement best practices for medication adherence and counsel patients about the importance of following treatment plans.

The agenda also suggests the implementation of a “pharmacy home” model, which gives patients a single pharmacy point of contact for filling prescriptions and adopting refill synchronization. This will allow patients to fill multiple prescriptions at one time, which reduces the number of visits they must make to the pharmacy.

Patient tools

In addition to counseling patients about their medications and underscoring the importance of medication adherence, pharmacists can direct patients to several freely available tools. NCPIE offers a worksheet, Make Notes & Take Notes, containing questions patients should ask about their medications and blanks where patients can fill in the answers before, during, and after a visit to their physician.

My Medicine List was developed by the American Society of Health-System Pharmacists (ASHP) and the ASHP Foundation through a sponsorship from Sanofi-Aventis to help patients keep track of everything they take, including medications, vitamins, and herbs. Patients can download a free PDF copy and fill out each line electronically, save it to their computer, and print out a copy. The form is also available in Spanish.

In collaboration with the Agency for Healthcare Research and Quality, NCPIE developed Your Medicine: Be Smart. Be Safe. Available in English and Spanish, the guide answers common questions about obtaining and tracking medications and has a wallet card that patients can print and fill out to help them keep track of their medications. The guide suggests questions for patients to ask before they take their medications and tips for sticking with their treatment plans. 

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