ActualMeds provides web-based solutions to facilitate patient data collection and automate coordination of care for Medication Management in patients with chronic diseases such as hypertension, congestive heart failure, diabetes, etc. . The solution is optimized for older adult patients who typically have multiple chronic conditions and the most complex therapeutic regimens.
This program, developed in part with funding from the National Institutes of Health (NIH) , captures patient self-reported information about Observations of Daily Living (ODL), medications ( including Rx, OTC and supplements) and symptoms and conditions, as structured data. It also receives biometric data such as blood pressure, weight or blood glucose from devices. All of these data are reduced by a rules-based framework to generate a SmartList™ of medications and potential risks for the patient that can be shared with healthcare provider, family or a trusted caregiver. The solution also provides content and coaching that adapts to the patient’s conditions.
The rules engine also supports a solution for healthcare providers that combines the structured, patient self-reported data with that available in the patient’s EHR (electronic health record ) or PHR (personal health record). This gives the provider unprecedented visibility into the patient’s functional status and the ability to optimize and coordinate care plans that have been demonstrated to improve the response to therapy in clinical trials. In aggregate, patient data can be used to segment patients according to medication risk, and to manage populations more cost-effectively.
Professor Patricia J. Neafsey, RD, PhD and collaborators with expertise in visual communication design, software usability testing, gerontology, and psychometrics set out in 1991 to design and test an interactive learning software program to enable older adults to avoid adverse self-medication behaviors. With funding from the University of Connecticut Research Foundation and the Donaghue Medical Foundation, the research team developed Preventing Medicine Conflicts, an interactive learning software program to enable older adults with hypertension to avoid drug-interactions. Older adults accessed Preventing Medicine Conflicts on IBM Thinkpad laptops (retrofitted with touchscreens) in a rigorous clinical trial. Users of Preventing Medicine Conflicts demonstrated increased knowledge and self-efficacy concerning potential adverse self-medication practices and reported fewer adverse medication behaviors compared to older adults receiving conventional care. The International Medical Informatics Society gave the research team a “Best of Medical Informatics” citation in 2003.
In 2005, The NIH National Heart Lung and Blood Institute (NHLBI) funded a 5-year Health Literacy study to develop and test a web-based intervention to improve patient adherence to antihypertensive regimens and reduce adverse self-medication behaviors. The next-generation Personal Education Program (PEP-NG) captures patient self-medication behaviors on a touch-sensitive tablet PC. The rules engine analyzes patient-entered information, prioritizes the adverse behaviors found, and delivers interactive educational content tailored to the reported behaviors. Summaries of self-reported symptoms, medication use (including frequency/time), drug interactions, and corrective strategies with an illustration of the drug interaction are printed to inform the provider prior to the primary care visit and for the patient to take home for self-study.
The PEP-NG was subjected to formal usability testing and two separate beta trials with adults with hypertension aged 45-60 and aged 60 and over. The PEP-NG clinical efficacy trial was conducted in 10 primary care practices in CT. Taken together, results suggest that, in addition to increasing knowledge and self-efficacy for avoiding adverse self-medication behaviors and high user satisfaction, the solution is associated with improved self-reported antihypertensive adherence and a two-fold greater reduction in blood pressure (BP) among participants not at BP goal upon study entry compared to participants receiving usual care. Research is continuing to determine the long-term cost-benefit of the PEP-NG in terms of reduced healthcare costs.
To date, the PEP-NG has 32 peer reviewed publications and 22 research presentations. The solution is the first “bottom-up” approach (i.e. getting information from the patient, rather than from prescribing information) to address the patient’s “shadow regimen” arising from self-medication. The PEP-NG is the first of its kind to prioritize the relative risk of the potential drug interactions identified and offer a targeted and tailored education program addressing adverse self-medication behaviors.
In February of 2009, ActualMeds Corporation was formed to bring this technology to the market for medication management in older adults with complex therapeutic regimens. Today the Company markets applications that are interoperable with electronic medical records (EMR) and personal health records (PHR) for patients/caregivers to manage medications under the ActualMeds™ brand It also provides tools to healthcare professionals to manage patient populations according to risk, as well as to accomplish medication reconciliation for patients at transition of care points.