Integral medicine

Integral medicine /AQAL- All Quadrants All Levels/ observes medicine from four different dimensions: intentional, behavioral, social, and cultural. The integral medicine that is rapidly developing today is more than ”holistic” medicine. It integrates both ”conventional” medicine and ”alternative” medicine. Conventional medicine treats the illness and alternative medicine treats the person; but integral medicine goes one step further: it treats the illness, the person, and the physician. Integral medicine is a way to help patients more effectively and efficiently; but it is first a way to help the health-care professional handle pressing problems, such as compliance.

„An integrally informed medical practice changes the practitioner first; he or she can then decide which of the treatments-conventional, alternative, complementary, and/or holistic-that he or she wishes to utilize when practicing medicine with integrity. It may include adding new treatments, conventional and alternative; or more conscientiously referring patients to otherquadrant practitioners when an integral diagnosis so indicates. The only item that is constant in all of those is the transformed practitioner. It is the physician who is healed and wholed first, not merely by learning new and complementary techniques, but by inhabiting a new consciousness that makes room for new techniques; and how that integrity then expresses itself in an integrally informed medical practice might vary considerably.” Ken Wilber /developer of the AQAL approach/.

Compliance-enhancing interventions

Many studies have been published about strategies to improve compliance. Seventy-six compliance interventions were evaluated in the systematic review by Petrilla and Benner.

They divided the compliance-enhancing interventions in the following categories:

·         coordination of healthcare: improved linkages between primary care physicians, clinicians and other health professionals;

·         live consultation and education;

·         the changes of the therapy dose, dosage and packaging for the convenient drug taking;

·         patient education materials;

·         disease management programs by clinicians;

·         reminders: medication refill reminders delivered by mail or telephone;

·         self-monitoring;

·         social support programs;

·         and the combination of these interventions.

Common attributes of successful programs included simplified treatment regimens, facilitation of doctor-patient relationships, and patient education methods, clear up from their review.

Effective treatment need a good clinician-patient relationship. Spending time on patient education and answering patient's questions is worth the time. Patients should be educated about the most important features and complications of their disease. Compliance may be enhanced, if the medical check-up and the therapy is known by the patient.



Reference:

Petrilla, A.A., Benner, J.S.: Critical evaluation of interventions to enhance patient compliance with chronic medications. Value in Health, 2003, 6, 200.

Electronic pillbox for the Baby Boomer Generation

MedFolio developed a new innovative pillbox.

The features of the MedFolio device address the needs of patients, caregivers, and their healthcare providers. The unique built-in pill identification system is a portfolio of every medication stored in the device, thereby giving the patient/caregiver the confidence to engage in medication discussions with their healthcare providers.  In order to help patients in remembering to take the “right dose at the right time”, advanced medication reminder systems have been incorporated into the device. The device connects to a personal computer by USB and installed software allows the patient/caregiver to easily customize the device to their specific medication regimens and dosing times. The medication information stored into the memory of the device will initiate audio alert and visual lighting reminders from the device. Additionally, the software program will communicate with a secure website to offer the option of receiving electronic messaging reminders (e-mail and text message) for each scheduled medication dosing time.

Gaps between patients and physicians understanding of osteoporosis

The survey findings ‘The gaps between patient and physician understanding of the emotional and physical impact of osteoporosis’ have been published in Archives of Osteoporosis.

This multinational survey conducted on behalf of the International Osteoporosis Foundation (IOF) show clear disparities between patients’ and doctors’ perceptions of osteoporosis and its management.

The 13-country survey of 844 postmenopausal patients over 55 years of age and 837 doctors investigated gaps between patient and doctor understanding of the emotional and physical impact of osteoporosis; identified barriers to patient adherence; and sought to understand the ways in which osteoporotic patients can better share and obtain information about the management of the disease.

Key findings showed:

• Patients are not as well informed as they believe themselves to be
• Patients fear fractures and worry about their quality of life, but do not always adhere to treatment
• Doctors consistently underestimate their patients adherence to treatment
• Doctors underestimate patients’ concerns about fracture, the impact of osteoporosis on their quality of life and fear of dependency. 

Adherence and persistence to osteoporosis therapy is a serious problem, with studies showing that fewer than 50% of patients still take their prescribed medication after 1 year. This can be attributed to underestimation of personal risk, uncertainty of benefits versus risks of treatment, side-effects, and a belief in the efficacy of lifestyle measures alone. Patients who drop their prescribed treatment unknowingly leave themselves at high risk of fracture.

The survey also showed the willingness of doctors to support initiatives that would improve patient adherence to treatment: 80% of doctors surveyed would be willing to hand out educational materials to increase adherence and 76% would recommend patient programmes that encourage better communication on osteoporosis management.

"As this survey revealed, patient and doctor misconceptions exist on a number of levels," noted IOF CEO Patrice McKenney. "Community-based online support programmes have a great potential to fill these information gaps. They can help patients share their concerns, improve patient-doctor dialogue, allow patient-to-patient contact, encourage long-term adherence to prescribed treatment and help patients to maintain or improve quality of life."

The International Osteoporosis Foundation, in cooperation with national osteoporosis societies in four pilot countries (Austria, Germany, Sweden and Switzerland), is currently developing a novel community-based platform called 'OsteoLink'. 'OsteoLink' aims to improve communications and facilitate dialogue among patients and between patients and doctors, providing personal networking opportunities and new tools that respond to current unmet needs.

The above story is reprinted from materials provided by International Osteoporosis Foundation (http://www.iofbonehealth.org/news/news-detail.html?newsID=394).