Recording medicine usage
cicero
19 Jul 2006 23:28
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Recording medicine usage
In Denmark the amount of factor concentrates has been growing steadily over the past 10 years. The public health care system is receiving a lot of attention and faces continuing demands to make the most of the budget. Under such circumstances, it may be tempting to take away free treatment for bleeding disorders, since is has low prevalence but extremely high cost per patient. To counter such plans, it is important to be able to document the effect of treatment, both in terms of quality of life for the patient and in preservation of mobility and avoiding joint surgery in the long term. The key to documenting the treatment is for patients to record their usage of medicine.
In Denmark it has been very much up to the individual patient whether or not he would keep a record. Now, however, patients are strongly urged to note down every treatment, to allow the doctors to more closely monitor the health of the patient and to be able to correct unfortunate habits and adjust the dosage for optimum efficiency. At the moment, paper forms are filled in by the patient and handed over to the doctor at the annual check-ups. Experiments have been conducted with electronic treatment registration, but it is not in widespread use.
It would be interesting to hear how other countries go about documenting the medicine consumption. Do you use electronic registration, or paper forms. How much do you record: amount of product, location of bleed, time between noticing bleed and treatment, batch number of product, etc.?
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cosmosVIII
23 Jul 2006 07:05
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At first, well when I started to infuse myself (that`s approximately twelve years ago), the recording of consumed factors was an obligation for all hemophiliacs. Six years ago, I signed up to use the first versions of an electronic treatments registration with Bayer`s system. Nowadays, most of the people use the electronic registration with a handheld computer (like Palm Pilots) including a barcode scanner, but the system they use varies from treatments centres. I know that Baxter is another one who offers the electronic system.
One question that aroused to me while answering you: is every major pharmaceutical is offering an electronic treatment registration and are they compatible with products that come from another company?
That I don`t know because the system I use is from Bayer and the products that I take are also from them.
In the paper form, we don’t inscribe much information, only the lot number, the date of the infusion, the number of units, and the cause of the infusion. On the other hand, on the electronic form, we can write a lot of things! Beside everything that we write in the paper form, we can write in which part of the body we did the infusion, where was the infusion made, the time of the day, the after-effects and many other things. It’s really great for the amount of information we can add. For that reason I think that the electronic system is far better that the papers and I can also find two other advantages: it safes a lot of paper (?) and the medical staff can have access to the information about our infusions way more quickly.
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cosmosVIII
23 Jul 2006 07:09
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mhhh, the question mark in parentheses in the last paragraph was supposed to be a smiley instead... I don`t have any doubt that the electronic form safes paper, but of course it surely participates to another form of pollution, but that`s not the subject here. Sorry!
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cicero
23 Jul 2006 08:59
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It is very interesting to hear that you have been using electronic registration for so long. I can see that we are way behind.
The Danish Haemophilia Society did a survey of electronic registration a few years ago, and they concluded that the systems were not yet ready for widespread use - I think the lack of compatibility between different systems was one of the major issues.
You say that medical staff have access to your data quicker - does that mean you send the registrations over the internet to your treatment centre?
With paper forms, which I hand in at the check-ups, the doctor does not have much time to look at them while I am there. If the doctors had access to that information before I came, like if I sent registrations via the internet, I suppose they could prepare better and look for patterns etc.
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cosmosVIII
23 Jul 2006 18:42
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About the compatibility issue, I don`t know very much since I am "Bayer only" I could say.
But about sending our data, we do it after every infusion or once a week. We plug the handheld computer via the telephone line and with a simple click the rest is done automatically. That is why the medical staff is more aware of what`s happening and, like you said, it`s better for the annual check-up.
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wayne
25 Jul 2006 22:44
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In Durban South Africa, we are on the paper system as there is no infrastructure to support an electronic form and a large percentage of our patents don’t have computer let alone hand helds.
The items that we fill in on our forms are...Date, Area of Bleeding (e.g. left or right knee), No. Units, Batch No., Expiry Date and Administrated By:
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cosmosVIII
26 Jul 2006 15:13
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Wayne, your message reminded me of something, the handheld computer is provided by the pharmaceuticals.
The electronic registration is a good thing, but as we know, it`s not upon the first priorities of a good "comprehensive care" strategy. And the way that I understand it: if the pharmaceuticals don`t get involved, switching from papers form to electronic form is too costly for the hospital alone.
In Canada for instance, a few hospitals with major treatment centre did employed a new person to be in charge of overseeing the electronic system, but the servers, the handhelds and many other things were provided by Bayer for our case.
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cicero
26 Jul 2006 17:41
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Just an idea - electronic registration does not require a handheld computer. It should be possible to do it with a mobile phone, and I think a lot more people have a phone than a handheld. With one of the newer phones you could use the built-in camera to scan the barcode and they can also run small programs, which could ask about the area of bleeding etc. before sending an SMS or MMS message to the hospital.
@wayne: what percentage of patients would have a (not too old) mobile phone in your area?
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wayne
31 Jul 2006 18:25
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@cicero
The number of people that have Cell phones in this country is unbelievable. So a Cell phone system would be the way to go.
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