An Overview of Patient Adherence

Today millions of Americans are dependent on the daily use of a prescribed treatment regimen.  Whether prescription drugs, or daily-use medical equipment, these therapies are only beneficial when properly followed.  The question remains, though: how to ensure patient adherence? Adherence, or compliance, is defined as the degree to which a patient follows medical advice (such as with lifestyle or behavioral management), and follows prescribed therapies (medications, or the use of ambulatory oxygen, for example) as directed.

Adherence varies with the type of treatment prescribed. For medications, adherence rates are about 50 per cent; the rate is much lower when patients are asked to make significant lifestyle and behavioral adjustments.  For durable medical equipment, or DME, adherence rates vary.  Studies show that for patients using constant positive airway pressure (CPAP), between 29 to 83 percent of patients do not meet compliance standards.  Adherence to oxygen therapy is low, averaging between 55 and 40 per cent.

What factors into adherence?
There are many factors involved in patient adherence.  Recent studies corroborate that effective communication greatly – and positively – affects patient satisfaction, health status, and recall of information and adherence.  In analyzing 106 physician-patient communication studies, more than 98% of patients demonstrated a positive relationship between physician communication and patient adherence.  Patients whose physician was a good communicator were 2.1 times more likely to adhere to their prescribed regimen.

What are the barriers to patient adherence?
Non-adherence can result for a number of reasons, though in an informal poll of diabetics, the top four deterrents were directly linked to inadequate information or training, and difficulties in integrating prescribed regimens into their everyday routine.  Reported deterrents included:

1. Time management: Depending on time constraints, patients may have to choose between treatment and other daily activities like sleeping, or exercising. 


2. Scheduling and maintenance: Long-term treatment requires not only a daily discipline, but also ensuring timely medications refills and, in the case of DME, equipment maintenance and upkeep. 


3. Comprehension: Medical professionals may not have time to adequately instruct patients in the specifics of their treatment regimen; additionally, patients and caregivers may take away only a portion of the instructions given, or may misunderstand them. 


4. Lack of Information: Generally, patients are unaware of treatment options available to them.  They may also be confused about how medications are administered, and how to maintain durable medical equipment, when necessary.

How to bolster patient adherence:
Adherence is necessary for a patient’s health to improve. The medical industry has moved away from placing full responsibility with patients to understand and follow prescribed treatments, and more emphasis on improving physician communication styles. In a study of oxygen users, “[most] respondents described a single conversation with their doctors about oxygen that occurred at the time of their initial prescription.” Integrating prescribed treatments into a patient’s life can entirely alter their routine, making adequate training a must – not only at the initial prescribing appointment, but on an ongoing basis.

Other medical professionals can also be effective in conveying information to the patient.  Nurses, pharmacists, technicians, and home health care providers may have more time to interact with the patient, and more information to disseminate due to familiarity with products or medications.  In recent years, physicians have begun to trust DME companies, and value the DME provider’s input for appropriate equipment selection. Instructing patients in the use of durable medical equipment requires additional training, both for the patient and for the delivery technician. Because training is ongoing for their employees, DME companies can offer current reference materials, and industry-certified customer service support and technicians to address questions and concerns.  DME providers may also follow up with patients to ensure adherence and proper use of equipment.

While current adherence rates are low, medical professionals and medical suppliers are working to increase the number of patients who not only follow their prescribed treatment, but understand it as well.  Communication is the key to improving adherence – both in and out of the doctor’s office.

Source: www.symbiusmedical.com

Tips on Managing Diabetes During the Holidays

While holiday eating is something we enjoy year-round with Fourth of July picnics, and Easter dinners, the trinity of winter holidays – Thanksgiving, Christmas, and welcoming the New Year – are the ones we lament most when hitting the scales in their wake.  The average American will consume 4,500 calories on Thanksgiving dinner alone, not factoring in other meals, or late-night leftover snacks.  And while you may think those extra calories can be worked off by aggressive Black-Friday shopping, most Americans will hold on to an extra 1 to 2 pounds each year.

For the 24 million diabetics living in the US, the holiday season adds additional concerns for both nutrition, and testing regimens. With travel and daily routines interrupted, maintaining healthy habits can be difficult.  Whether living with diabetes, or hosting someone with diabetes during the holiday season, there are many ways to enjoy the season healthfully.

There are 2 major types of the diabetes, Type 1 and Type 2.  In Type 1 diabetes, the body’s own immune system destroys the insulin-producing cells of the pancreas. Type 2 is the most common form of diabetes, affecting 90-95% of those living with the disease in the US. Type 2 diabetes results from either the pancreas not producing enough insulin, or the body’s inability to use insulin, also known as insulin resistance.

Diabetes is directly related to the way the body processes food, and is therefore considered a metabolic disease. When digested, most food is broken down into glucose, which is the type of sugar found in the blood, and the body’s main source of fuel. When glucose passes into the bloodstream, it is used by cells for growth and energy and, with the aid of insulin, enters into the cells.

The pancreas is a large gland behind the stomach which produces the hormone insulin.  If this hormone is not present, or not present in adequate amounts, the body does not properly utilize glucose. When food is processed In a normal body, the pancreas automatically produces an adequate amount of insulin to move glucose from bloodstream into the cells. For those with diabetes, however, the pancreas does not produce the proper amount of insulin, or the cells don’t respond correctly to the insulin. This causes glucose to accumulate in the blood, overflow into the urine, and exit the body in urine. In this process, then, the body effectively flushes its main source of fuel without having utilized it.

Because holiday meals are often much more decadent than our everyday repast, being aware of caloric intake can be tricky.  These tips can make it a bit easier:

• Travel with pre-portioned snacks, in case you don’t have access to appropriate food while in transit. 


• Even if you’re just traveling across town, bring more testing supplies than you’ll need. 


• For meals away from home, ask your host what’s on the menu, and plan accordingly. 


• Fill up on healthy snacks before a meal, so you’re not as tempted by appetizers, which tend to calorie- and fat-heavy. 


• Exercise portion control.  If you simply can’t resist sweet potatoes and pumpkin pie, have smaller portions of each. 


• During the meal, focus on fruits and vegetables, and choose lean cuts of meat, such as turkey breast, avoiding the skin. 


• Avoid “food amnesia.” If you have a smart phone, use an app to keep track of what you’ve eaten. 


• When the meal is finished, leave the table as soon as possible, to avoid grazing on leftovers.

While it can be challenging to enjoy holiday meals when living with diabetes, it becomes easier with knowledge and support.  Being proactive by communicating concerns to friends and family, and asking for help when necessary will keep stress to a minimum, allowing you to focus on what’s important during the holidays – spending time with loved ones.

Source: www.symbiusmedical.com

Why Accreditation

At Symbius Medical, the patient experience tops our list of priorities. By taking a clinical approach to home health care, we have established a reputation for quality – not only in the eyes of our clients, but industry-wide, through accreditation from the highly-regarded Accreditation Commission for Health Care, Inc. (ACHC).

Similar to the standard for universities and training programs, health care accreditation is regarded as a yardstick to measure the quality of an organization.  The accrediting body periodically reviews the prospective health care organization’s ability to standards established by the accrediting body. 

Gaining accreditation indicates the health care organization is reputable, and dedicated to “ongoing and continuous compliance with the highest standard of quality.” By collaborating with industry experts to create these standards, the ACHC accreditation process ensures quality is maintained throughout all aspects of the health care organization.

To become ACHC-accredited, an organization must comply with their stringent criteria. To name a few, ACHC requires:

• On-site surveys to be conducted every three years by industry experts, during which the organization must demonstrate continuous compliance with the ACHC Standards for Accreditation; 


• Comprehensive review of organizational structure, policies & procedures; 


• Compliance with federal/state/local laws; 


• High-level management of fiscal operations, human resource management, infection control, and patient/employee safety.

Well into our scond three-year accreditation cycle, Symbius Medical has been honored with ACHC’s stamp of approval for our rehabilitation technology suppliers services, home/durable medical equipment services, and clinical respiratory care services. We demonstrate the importance of maintaining this accreditation through continued compliance with ACHC’s standards, and an ongoing commitment to policy and procedural education and training for all staff members.

With health care policies constantly in flux, Symbius Medical strives to maintain the highest level of compliance with national standards, to provide you with the best home health care experience possible.

Source: www.symbiusmedical.com

Increasing Patient Compliance of Prescribed CPAP Therapy

Sleep apnea is a fairly common problem in adults, estimated to affect about four percent of men and two percent of women.  Yet of this number, only about ten percent receive treatment, with many cases remaining undiagnosed. Unfortunately, sleep apnea can negatively affect one’s health by contributing to daytime sleepiness, and difficulty concentrating, thinking and remembering.  More serious concerns include high blood pressure, increased incidence of stroke and risk of heart disease, and automobile accidents. Sleep apnea may be characterized by loud snoring, episodes of breathing cessation, abrupt awakenings accompanied by shortness of breath, morning headache, and insomnia.   

Sleep apnea is generally diagnosed after participating in a sleep study.  Once diagnosed, your physician or a sleep specialist may recommend that you be fitted with a continuous positive airway pressure (CPAP) or bi-level mask as part of your treatment. The most widely recommended treatment for moderate to severe obstructive sleep apnea, CPAP entails wearing a mask-like device while you sleep, which provides pressurized air to prevent the airway from collapsing. Unfortunately, without proper coaching and guidance for using these breathing devices, patients may give up on these devices, leaving the disorder untreated.   

There’s a simple solution to this lack of use: education. In a 2005 Veterans Affairs Medical Center study to determine how to improve compliance with CPAP therapy, participants received clinical training in the use of their devices.  Following this simple intervention, twenty-nine percent of patients increased nightly CPAP use.  

At Symbius Medical, we take a clinical approach to care.  To ensure your complete comfort and understanding of your home medical equipment, our highly trained Respiratory Therapists specially fit you with the proper equipment, and instruct you on how to use and care for your device in your home. We follow up ten days later to answer questions, and to ensure you are comfortable operating your new sleep therapy equipment. This follow-up not only guarantees your satisfaction, but also allows us to assess your level of compliance with the prescribed therapy.   

To learn more about our CPAP therapy options, call us today at (800) 948-1868, or email us at cpapsupplies@symbiusmedical.com.