Injection Anxiety Soothed by Phone Calls

Could telephone-based therapy management really make a difference in clinical outcomes.

A telephone-based disease therapy management program improved clinical outcomes for rheumatoid arthritis (RA) patients receiving injectable medication therapy.

The program was used in a study that was conducted by Prescription Solutions, a pharmacy benefits management organization and a UnitedHealth Group. The results are published in the Journal of Managed Care Pharmacy.

Patients enrolled in the seven-month-long disease therapy management (DTM) program showed significantly higher adherence to their injectable RA medications compared with a control group of patients who received the same medications through community pharmacies and did not participate in the DTM program.

Adherence was measured as the extent to which a patient continues the mode of treatment recommended by the physician or health care professional. The average adherence rate for patients in the DTM program was 83%, compared with an average adherence rate of 60% for patients in the control group.

The findings may provide insight into the benefits DTM programs provide in helping patients better manage their health.

“This is an important advance in showing how to improve patients' lives further when using injectable, biological drugs, which slow the progression of rheumatoid arthritis,” said Joseph Addiego, M.D., chief medical officer, Prescription Solutions, in a press release. “Higher adherence to this medication encouraged by pharmacist or nurse phone calls translates to better physical health for patients, which is a positive step forward.”

Disease-modifying antirheumatic drugs (DMARDS) have been shown to be most effective for controlling rheumatoid arthritis, but for many patients, adhering to these medications may be challenging. Some patients fear the self-injection required for many of the newer DMARDS and others complain of injection-site reactions or the drugs' high cost. Any or all of these factors can cause some patients to abandon their course of treatment, which may have a significant impact on health outcomes and health costs.

Patients who enrolled in Prescription Solutions' DTM program received telephone consultations with a licensed pharmacist or registered nurse. During each consultation, the pharmacist or nurse educated the patient about his or her medical condition, self-management skills, side-effects management and the importance of medication adherence and persistence. The DTM program was offered in addition to routine specialty pharmacy management services provided by Prescription Solutions, which include medication educational brochures, mail service medication delivery, refill reminders, and access to a pharmacist 24 hours a day, seven days a week.

Patients who completed the seven-month RA DTM program had improvements in physical functioning. However, the study did not demonstrate improvements to mental scores or work productivity.

Source: UnitedHealth Group

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Should more programs involving follow-up phone calls be used to increase adherence?