Treating Chronic Diseases Through Patient Support Program

New technologies have made remote communication possible between patients and clinics, which has opened up new pathways. Patient Support Program (or PSP) have emerged, allowing for an enhanced treatment program through a series of instruments, methods, and services focused on improving adherence to therapy

The real challenge that Italy and all western countries have been called to win in the field of healthcare is the management of chronic diseases. The dynamics of patient management have radically changed in the last few years, becoming more complex. Coping with a chronic disease means dealing with long-term support, yet it is becoming more and more difficult for healthcare systems to manage these numbers. With the progressive aging of society, the number of chronic patients keeps on rising.  

PSPs – a broader concept of support

The objective of Patient Support Program is to place patients at the center of a support network that leads to improved quality of life and optimizes the effectiveness of treatment and adherence to the treatment plan prescribed. Due to their success in Europe, PSPs have become a consolidated reality in Italy, where they were introduced and developed for the first time in 2005 by Domedica.

Data has shown that the main reason drug therapies fail is due to poor medication adherence. While this aspect may have been overlooked until a few years ago, it can no longer be ignored. Disregard for therapy represents an exponential increase in healthcare interventions and an increase in the total cost of healthcare without any concrete benefits for the patient.

Patient Support Program are designed for patients with chronic diseases that need help self-administering therapy, training or simply managing treatment devices. The idea behind PSPs is that maintaining adherence to therapy through total patient management improves the patient’s quality of life all while increasing the effectiveness of drug therapy. It is a virtuous circle that brings benefits to everyone involved, from patients to doctors.  

How patient support program work

Thanks to increasingly more innovative procedures and medicine, some diseases such as diabetes, hemophilia, multiple sclerosis, and cancer have become chronic diseases, greatly prolonging the lives of those affected. Many patients, however, for different reasons, don’t regularly take their medicine, seriously compromising their state of health. This problem also leads to a considerable increase in costs for the national healthcare system, which must use more expensive treatments, hospitalization, or surgery to deal with consequences and eventual relapses.

The main reason drug therapy is not always effective is due to poor adherence to therapy on behalf of the patient. The percentage of non-adherence to therapy for patients with chronic diseases sometimes exceeds 50%. Consequently, this behavior results in reduced control of the diseases treated and an increase in requests for healthcare and the incidence of mortality. The disadvantages for both patients and the healthcare system are obvious.

The Patient Support Program designed and carried out by Domedica are based on the following fundamental principles:

  • Doctors are involved to define the content and healthcare methods to be used with each patient;
  • Emotional and psychological support is given to patients;
  • Patient care increases awareness about: their disease; the importance of adhering to a treatment plan and indications prescribed by the physician; information for patients to improve the management of their own condition (even 24/7); a lifestyle that positively impacts their own health and lifestyle.

More specifically, the different services offered by Domedica’s PSPs include:

  • Administration of therapy or infusions at the patient’s home or at Domedica’s blood transfusion center.
  • Education and training at clinical centers on practical aspects and topics concerning therapy, as well as an introduction to therapies and devices.
  • Remote support and telehealth for therapy training and education as well as support services for healthcare visit reminders, appointments, and expiration date reminders concerning the patient’s therapy or treatment plan.
  • Support and training on the administration of therapy at the patient’s home, the prevention and management of adverse events and for practical and emotional support.
  • Home-delivery of medicine and assistance in the correct preservation and management of special wastes related to the administration of therapy.

All this results in many benefits for the patient, especially in time saved, which promotes the psychological well-being of both the patient and the caregiver. Quite often PSP services are carried out remotely, avoiding costly home visits. Other visits (medical, nursing, and physiotherapeutic), instead, that are carried out within patient support program (at clinics, home, infusion centers, or specific local facilities), require minimal travel for patients to reach hospitals for healthcare activities necessary to the programs. 

Patient Support Program

Benefits of patient support programs

A fundamental distinction must be made. PSPs do not replace doctors or pharmacists but act as a support network of activities carried out by several professionals. In fact, PSPs are never a part of the plan of treatment. They provide information to patients regarding a more correct lifestyle to follow as well as suggestions and guidelines about their treatment plan. Everything is organized to guide the patient down the best path of living with his or her disease, but never alone.

Many studies have demonstrated that involving patients more actively in their treatment plans is extremely beneficial as it not only improves adherence to therapy but also builds the trust that each patient has in his or her physician or pharmacist. Increased involvement and awareness reinforce a patient’s active participation, which is the key to success.

The impact of a more authentic relationship between the physician and patient can have on therapy is an aspect that is often underestimated. Dealing with another person instead of just interfacing with mere pharmaceuticals or supplements greatly helps in the management of the problems that patients have to face.

The key does not lie in therapy nor in the disease, but in putting the patient at the center. The patient is embraced by a network of relationships that become fundamentally important to their treatment. The support network built around each patient is made up of both healthcare workers and non and is able to take care of the patient from every standpoint. Patient also has another reference point that is always available to them. The Patient Support Center, made up of trained and competent professionals, for example, responds in real-time to help guide the patient in accordance with the specialist’s instructions.

The patient, thus, receives support not only in the practical management of the disease but also emotional and psychological care as well as support in every aspect of daily life that continues despite the disease.

Patients are not the only ones to benefit. Patient support program also support doctors, who know their patients have services and information available to them that they have personally reviewed and assessed, allowing PSPs to manage phone calls only made by patients to request information. This allows doctors to dedicate more time to important activities, such as research and more. During check-ups, doctors can focus more on the patient’s clinical situation. Patients in support programs are already informed about many aspects of treatment and do not need to ask their physician. Doctors have access to the technological platform used by Domedica that gathers data and can check the patient’s journey throughout the program and monitor the data that interests the doctor the most.

Continuity of care and adherence have positive impacts even on the national healthcare system, which also benefits from patient support program.  As previously mentioned, fewer patients turn to more expensive treatments due to worsening health conditions caused by a lack of adherence to therapy, there are fewer visits to the emergency room, fewer visits with specialists, and fewer hospitalizations.

Another advantage, the effectiveness of drug therapy is optimized when taken correctly. In addition, a considerable amount of real data, fundamental to confirming and verifying the effectiveness of pharmaceuticals, can be gathered through the technological platform used by Domedica.

Towards digitalization in healthcare

We live in an era in which the research of health information is the third most common online activity and more than one out of two people look to the web to find the answers to questions about specific pathologies. It goes without saying that digital channels appear to be the most effective means of beginning active participation. This is why Domedica has undertaken the path towards digitalization, creating even more personalized care pathways with more efficient processes. In this scenario, the revolution brought about by digitalization offers possibilities in healthcare that until recently were only marginally taken advantage of, but today are the foundations of future healthcare.

Healthcare programs can come in various forms depending on the target audience involved. Domedica, for example, reached important results with the implementation of Health Cloud and Community Cloud, which allow a greater amount of data to be traced and analyzed in a much shorter amount of time.

Domedica currently provides constant support to more than 10,000 patients affected by chronic diseases with personalized and resourceful care pathways achieved using Health cloud, a platform that collects and manages enormous amounts of data and guarantees the security of sensitive data. The platform is cloud-based, ensuring continuous innovation and the quick development of new specialized apps, specifically designed for each PSP.

Health Cloud is used by a team of about fifty Domedica professionals that carry out patient care activities at company headquarters, including remote support activities and the collection and tracing of all data related to the circa 10,000 patients currently being managed. The data on each patient includes information about treatment centers, caregivers, remote support requests, and much more. Health Cloud also allows the effective management of all pharmacovigilance procedures requested by pharmaceutical companies.

Community Cloud, instead, is used by Domedica’s healthcare professionals, a team of more than 160 people including nurses, physicians, psychologists, and physical therapists who provide home care services. The platform allows professionals to access lists of visits to perform, reports of what needs to be done for each patient, corresponding deadlines and to collect all useful data for care pathways in real-time.

The future of PSPs

PSPs are now a consolidated reality and have in fact redefined and broadened the concept of healthcare, working to improve patient involvement. The key role of the patient is the leitmotif that will guide healthcare policies in the future. It is a known fact that patients who are not actively involved risk relapses or deteriorating health conditions, leading to a vicious circle that reduces the effectiveness of public healthcare to the detriment of all. Personal healthcare expenses double when patients do not play the leading role in their own treatment journey, and at the same time, the national healthcare system loses as well. 

Even though this revolution appears to be a necessity, clear guidelines are still lacking at the national level. A lot of work must still be done and the time needed to bring about these changes is unknown, yet Covid-19 has clearly demonstrated the shortcomings of our national healthcare system. Now that the peak of the emergency has been overcome, discussions have begun on how to re-organize the system. This is an unprecedented situation that could potentially bring about structural reforms. It is a one and only opportunity, yet possible reforms can only be assessed in the upcoming months.

© Domedica s.r.l. 

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