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Patient Advocacy Group Shares Solutions to Fuel Greater Participation in Workplace Wellness Programs

Workplace wellness is not a new concept, but it is definitely one that is recently gaining more importance.

With non-communicable diseases on the rise, many people are becoming more concerned about what lifestyle choices can be made to avoid them and stay healthy. Furthermore, businesses recognize the cost of stressed, out of shape, non-productive employees: increased health insurance costs,absenteeism, retention problems, and loss in productivity. Trying to take a more active role in the health of their employees, employers are creating and implementing wellness programs that encourage healthy behavior. Through incentives and rewards, companies are encouraging their employees to make healthy lifestyle choices like eating well and exercising regularly.

Melissa Kostinas

Melissa Kostinas

Despite the benefits of these programs, their success and sustainability can only be achieved through employee participation – which has been a challenging feat for many employers.  Without high participation, programs will result in limited return on investments for employers and might discourage them from implementing other programs in the future.  Because of this risk and the tug of war between cost and benefits, some companies find it too difficult and futile to implement workplace wellness programs.

Fortunately, there are solutions that help employers increase participation. First and foremost, companies should be focusing on the employees themselves – their needs, schedules, and interests – and design programs tailored to these considerations.

Employers should ask their employees: What gets you healthy? What motivates you to do what everyone knows is healthy behavior? We all have reasons for not doing what we know we should – time, access, knowledge, and cost. All these factors contribute to our denial.

Employees are busy, so the more a company can incorporate healthy eating and activity into existing schedules the more likely they are to embrace them. Easy access to workplace wellness programs makes a big difference. Onsite, or nearby programs offered during breaks or outside work hours also are great ways to tackle the time and access excuses.

Information and knowledge, while seemingly obvious, helps to motivate employees too. Of course we know we should exercise, but do your employees know that physical activity helps to prevent back pain?  It increases muscle strength and endurance, and improves flexibility and posture. With this knowledge, maybe the next time they get that twinge in their lower back they might think about exercise instead of painkillers. Providing reduced or no-cost programs will also boost participation rates. Coupled with incentives, like bonuses or rewards (e.g. allowing employees to trade in some of their unused sick days at the end of a year for an extra vacation day), rates of participation are likely to increase.

There are also management steps that can be taken to increase and maintain participation.

Unless employers are committed to employee wellness, the workplace wellness program becomes another ineffective plan that sounded good on paper but never achieved the anticipated results. The executives at Valley Health System understood the importance of managerial commitment. When they created Valley Health Workplace Connection the program managers worked closely with the health system’s managers to make sure all higher-level staff understood the importance of their involvement. Today, Valley Health Workplace Connection is a very successful workplace wellness program with high participation and employee satisfaction.

To ensure such success, workers from all levels should be actively engaged in programs. Planning should include processes to maintain communication with staff and the creation of program committees to guide intervention, observe participation, and adjust programs accordingly.

Additionally, program designers should consider all the major health risks in their targeted population as well as their business’ needs. Different programs should be offered at different levels, depending on characteristics of the recipients. The key is integrating health into the business. Policies governing the workplace wellness program should align with the organization’s mission, vision and values. They must affirm and communicate the value of good health and show commitment to engage workers in health enhancement. Again, a program is only effective if it reaches the intended audience and motivates them.

Pfizer recognized this and found that using programs like Keas got their employees more involved because it was engaging but less invasive. By making wellness a challenge and incorporating games and goals into the plan, Pfizer overcame the primary challenge in any wellness program — participation.

The bottom line is that wellness programs are gaining steam, but there are challenges. Having the support of management and creating a program that meets your employees’ needs will allow your program to overcome those challenges.  Be creative and remember: Wellness can be fun.

Personal Connections with Pharmacists Drive Medication Adherence Outcomes

With nearly half of all patients in the US not taking their medications as prescribed, medication non-adherence remains a dangerous and expensive problem that costs the health care system $329 billion annually (Express Scripts Drug Trend Report), meaning more hospitalizations and visits to the emergency room (ER).

Paul DeMiglio

Paul DeMiglio

So what’s the good news? Effective, comprehensive solutions are emerging to reverse this trend by involving the pharmacist to improve medication adherence rates through a personal connection with patients.

Recent stories underscore how pharmacists are uniquely positioned to engage patients in conversations that help them understand why treatments are prescribed and why meds should be taken as directed.

A report released on June 25 by the National Community Pharmacists Association (NCPA), for example, illustrates how interpersonal relationships between pharmacists and patients boost adherence. Authors of the report found that a patient’s sense of connectedness with one’s pharmacist or pharmacy staff was the survey’s “single strongest individual predictor of medication adherence.”

“Pharmacists can help patients and caregivers overcome barriers to effectively and consistently follow medication regimens,” NCPA CEO B. Douglas Hoey, RPh, MBA, said in a statement. “Indeed, independent community pharmacists in particular may be well-suited to boost patient adherence given their close connection with patients and their caregivers.”

According to the American Pharmacists Association (APhA), one effective method pharmacists can use to improve adherence is medication therapy management (MTM) services for patients taking more than one drug for multiple chronic medical conditions. In addition to therapy reviews, pharmacotherapy consults, anticoagulation management, immunizations, health and wellness programs and other clinical services, MTM involves the following elements:

  • Comprehensive medication review, including a personal medication report that lists all the medications the patient is taking.
  • Medication action plan.
  • Education and counseling or other resources to enhance understanding about using the medication and to improve adherence.
  • Coordination of care, including documenting MTM services, providing the documentation to other providers, and referring patients to other providers as needed.

Pharmacists can also leverage a variety of practical tips to help patients improve adherence that include:

  • Discussing the appropriateness of each medication and its impact on their multiple medical conditions.
  • Evaluating the effectiveness and safety of each medication.
  • Assessing whether some medications may be unnecessary and should be discontinued.
  • Discussing the need to change medications or doses if problems arise.

The implications of improved adherence will help lower the cost of treating chronic conditions, decrease hospitalizations, reduce ER visits and by extension lower the risk of treatment failures, serious adverse reactions and deaths too.

“Studies have repeatedly recorded the cost-saving effect of MTM,” said Kevin Schweers, Senior Vice President, Public Affairs, NCPA. “One Minnesota study found a 12:1 return-on-investment for MTM.  In North Carolina, Kerr Drug reports that MTM programs for seniors produced a 13:1 return. Improved adherence would likely help reduce hospitalizations as well. So many prescription drugs are intended to treat chronic conditions, such as heart disease, that can result in hospitalization. In addition, hospital re-admissions can result from the failure to stick to a prescribed medication regimen.”

Joel Zive, adjunct clinical faculty, University of Florida College of Pharmacy, underscored the need for patients to cultivate relationships with their pharmacists.

“While MTM services are quite important in helping adherence, getting to know your pharmacist’s name is helpful in establishing a relationship with your pharmacist,” he said. “Pharmacists are trained to pick up clinical clues from patients.  This is why if you are having unusual reactions medications, speaking to your pharmacist is an option.”

Although MTM services are an effective way to increase adherence, greater participation among patients and pharmacists is needed according to the APhA and the National Council on Patient Information and Education (NCPIE).

In addition to leveraging tips and strategies to boost adherence, pharmacists can also draw on a number of resources for patients, referring them to the NCPIE wallet card and to a brochure made available by NCPIE and the Agency for Healthcare Research and Quality (AHRQ), “Your Medicine: Be Smart. Be Safe.”

What else can pharmacists do to engage patients? How can stakeholders in health care, government, academia and the private sector collaborate to improve dialogue among pharmacists and patients around strategies that increase adherence?

Turning DASH Strategy into Reality for Improved Cardio Wellness Outcomes: Part II

As part of their health & wellness program, the largest health insurer sent me a refrigerator magnet highlighting the National Institutes of Health’s (NIH) Dietary Approach to Stop Hypertension Diet (DASH).  In their accompanying letter, the company stated that the refrigerator magnet is a “tool to help you manage your blood pressure.”

Shawn J. Green

Shawn J. Green

The DASH Eating Plan refrigerator magnet was a nice gesture to remind clients to consume less sodium and incorporate more vegetables and fruits into their diet to lower blood pressure.  However, is this the most effective wellness tool to engage and motivate individuals to change their eating habits?

As we learned in last week’s post, plant-based diets – especially those rich in leafy greens, such as spinach and arugula – elevate cardio-protective nitric oxide.  For many pre-hypertensive individuals, staying with a plant-based diet is a critical driver to prevent elevated blood pressure and the diseases associated with hypertension.

Yet many Americans continue to fall far short of eating recommended daily servings of vegetables that elevate natural nitric oxide levels in our body.

A new model is needed to drive behavioral change. So how do we consistently integrate cardio-protective plant-based diets into our daily dietary lifestyle?

Berkeley Test may be a start.

Berkeley Test’s Saliva Nitric Oxide Test Strips and its iPhone Cardio Diet Tracker are designed to break bad habits and empower folks from various walks of life to incorporate plant-based foods into their daily diets.  These engaging tools provide a model to influence dietary change on a personal level that supports lasting compliance with measurable outcomes.

Designed to detect nitric oxide status in the body throughout the day, Berkeley Test developed the next generation proprietary nitric oxide test strip; for less than 70-cents, an easy-to-use, 1-minute saliva test strip enables consumers to make immediate and real-time dietary lifestyle adjustments.

Once users finish the strip test, they can use Berkeley Test’s Cardio Diet Tracker App to compare their results to a color-coded indicator showing whether nitric oxide levels are on target. After 2-3 hours, the user is alerted to check their nitric oxide status.  Users can leverage the Cardio Diet Tracker App to more effectively adhere to plant-based diets by tracking nitric oxide status in conjunction with the type, frequency, and amount of nitric oxide-potent foods eaten to sustain their levels.

Michael Greger, M.D., of NutritionFacts.org, suggests that Berkeley Test may offer hope by bringing plant-based foods into our dietary lifestyle in an engaging fashion. At the very least, it will remind us to eat our greens on a more frequent basis, he says.

Berkeley’s strip-app bundled technologies demonstrate that self-assessing, analyzing, and fine-tuning wellness outcomes with a shared, open, interactive community can be a catalyst to sustain plant-based cardio-protective diets in our daily lifestyle. The value of Berkeley Test’s model is not only demonstrated in how it equips consumers to make healthier dietary choices, but also in its ability to connect users by allowing them to share dietary successes with their Facebook friends.  In today’s society, wellness outcomes and fitness is highly social and valued.

Individuals – who range from Olympians seeking to boost their physical endurance to baby boomers looking for an easier way to eat healthfully and prevent high blood pressure – are embracing these innovations.  As more people turn to Berkeley’s strip and mobile App to improve adherence to plant-based diets, such as DASH and Ornish, natural communities of mutual support are growing.  These networks offer a unique venue to share experiences, provide strategies for success and a forum to discuss common challenges, refine approaches and achieve desired outcomes.

A dynamically open community to share new knowledge about wellness and create a model for achieving and maintaining healthy living and eating is what we hope Berkeley’s ‘health biomarker’ test strips (such as nitric oxide and mobile App combo) provides.

So, what is your nitric oxide level, today?

Self-Service Kiosks Provide Innovative Path to Testing and Connection to Providers

The recent proliferation of affordable do-it-yourself consumer tools is one way patients are now empowered to take control of their health through prevention and wellness strategies.

One successful example is SoloHealth Station – a free, self-service kiosk offering comprehensive vision, blood pressure, weight and body mass index screenings. Currently located in select Wal-Mart, Safeway, Sam’s Club and Schnucks Markets, more than 10 million people have already used the kiosk in the past two years.

A $1.2 million grant from the National Institutes of Health played a major role in expanding the company’s free medical screening technology, education and wellness programs to a wider audience, including traditionally underserved communities.

“Seventy-one percent of SoloHealth Station users are at medium to high risk of hypertension and 51 percent are overweight or obese,” says Bart Foster, CEO and Founder of SoloHealth. “At the core, we believe that awareness and action can lead to preventative measures that lead to lower costs. So, consumers who realize they are at high risk of BP or BMI would be more propelled to click through to access a doctor or search and scan our database. They are now empowered with knowledge they probably never had before and they want to act on it.”

Foster shares some compelling data that illustrates how SoloHealth links patients to providers:

  • Nearly 40,000 users have clicked through to one or more nearby doctors via the kiosk’s search function.
  • Users with high risk of blood pressure problems are 57 percent more likely to choose a physician.
  • Users with high risk of BMI problems are 97 percent more likely to select a doctor.
  • Users taking the Health Risk Assessment are over seven times more likely to choose a physician.

SoloHealth Station leverages an interactive touch-screen and incorporates videos as part of a 4.5-minute process that guides about 85,000 users each day through its tests. Individuals then receive a comprehensive follow-up health assessment, view their test results, get suggestions for improvement and are given access to a vast network of accredited medical professionals.

Some urge caution about self-service health kiosks, raising concerns about patient privacy, how companies might use personal health data, the quality of their medical information, and whether advertisers and other sponsors might shape their advice and referrals for commercial reasons.

Foster points out that even with the spread of health kiosks, medical professionals remain necessary.

“Technology like the SoloHealth Station can make access to health services and tools easy, free and convenient,” he says. “We believe people will use these accessible tools to take better control of their health care. Once enlightened about a potential health problem, the majority of consumers will act. And knowing is better than not knowing, because prevention leads to better outcomes and lower costs.”

Have you used a SoloHealth Station or other self-help kiosk? Would you do it again? Why or why not? Comment below.

Categories: Access to Care