Sustainable Solutions Report: A Focus on Managing Complex Chronic Diseases

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The Sustainable Solutions Report: A Focus on Managing Complex Chronic Diseases is the first in a series of reports that will be issued by Shoppers Drug Mart exploring different ways pharmacists can contribute to reforming our health care system through cost-cutting, wait times reduction, improving patient care and generally making Canadians healthier. Diseases explored include arthritis and high blood pressure.
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   Sustainable Solutions Report:A Focus on ManagingComplex Chronic Diseases  SHOPPERS DRUG MARTSUSTAINABLE SOLUTIONS REPORT: A FOCUS ON MANAGING COMPLEX CHRONIC DISEASES 01 TABLE OF CONTENTS Foreword 2  About the Shoppers Drug Mart SustainableSolutions Report 4   General Practitioners’ Perceptions:Key Findings 5  Canadian Public Perceptions: Key Findings 8 Canadian Public Perceptions: Other Research Highlights 9 Recommendations 10 About Shoppers Drug Mart Corporation 13 About Arthritis Consumer Experts 13  About Arthritis Research Centre o Canada 13 Reerences 14  SHOPPERS DRUG MARTSUSTAINABLE SOLUTIONS REPORT: A FOCUS ON MANAGING COMPLEX CHRONIC DISEASES 02 Foreword The increasing prevalence o complex chronic diseases is becoming one o the most important health issuesin the 21st century. These diseases have a signifcant impact on Canadians’ ability to work and lead activelives. For that reason, the ederal government has identifed chronic disease prevention and management asa key priority. Chronic diseases include arthritis (aecting 4.4 million Canadians in 2012), hypertension(5.1 million), diabetes (1.9 million), asthma (2.4 million), and chronic obstructive pulmonary disease(806,592). i Overall, chronic conditions aect 37% o Canadians, and cause 70% o mortalities. ii Risk actorsinclude some that can’t be helped, like age and genetics, and others that are more controllable, like diet,exercise, and tobacco or excessive alcohol use.Not only are chronic diseases a concern or their impact on the health o Canadians, but they are also asubstantial fnancial burden on the health care system. In 2011, the medical costs associated with chronicdiseases were estimated at $42 billion, or 21% o total health care spending. iii What’s worse is that fgure isexpected to climb to $53 billion by 2015. iv These rising costs are unsustainable and solutions are needed now.Pharmacists are uniquely positioned to help government achieve their goals and be part o the solution byreducing health care expenses, while also improving patient care. This is true or the health care system asa whole, but particularly in the area o chronic disease management. For example, due to the complexityo some drug therapies or chronic care, many patients do not take their medication as prescribed. Inact, medication non-adherence results in 5% o hospital admissions, 5% o physician visits annually, andcontributes $4 billion to health care costs each year. v I pharmacists were permitted to use their judgement inadjusting dosages and writing prescription renewals or specifc drug classes, they could help ensure patientsstay on track with their medication regimes.Important measures like this were outlined in a plan entitled, 9,000 Points of Care: Improving Access to Affordable Healthcare  , released by Canada’s broader pharmacy community. That plan estimated between$1.4 and $1.9 billion would be saved over three years by expanding the role o pharmacists in managingchronic diseases. vi It is also estimated that 1.3 million emergency room visits and 500,000 hospitalizationscould be avoided, reeing up to 6.3 million hours o physician time. vii  The ollowing Sustainable Solutions Report outlines the results o a study o Canadian general practitioners(GPs) and their views on expanding the role o pharmacists in relation to chronic diseases and overall. Itdemonstrates the wider health care community supports pharmacists playing a more active role in primarycare. For example, 88% o physicians say they would be open to having more support rom other health careproessionals to help manage care or their patients with chronic conditions. Four in fve physicians (80%)agree pharmacists can play an important role in helping patients with chronic conditions manage their health.The Report also shows Canadians as a whole are open to using pharmacists’ expertise in an expanded way.  SHOPPERS DRUG MARTSUSTAINABLE SOLUTIONS REPORT: A FOCUS ON MANAGING COMPLEX CHRONIC DISEASES 0303 1. Enable pharmacists to develop and manage patient care plans.  This would involve one-on-one annual or semi-annual meetings with pharmacists who can proactivelyollow up to monitor health conditions and remind patients to adhere to and refll their prescriptions.An example o this type o program is the Shoppers Drug Mart Arthritis Screening, developed in partnershipwith Arthritis Consumer Experts (ACE) and the Arthritis Research Centre o Canada (ARC).The screening includes a joint exam and questionnaire which can help detect the disease early.It also helps Canadians with arthritis work with a pharmacistto monitor their symptoms and medication over time to prevent the disease rom worsening. 2. Where appropriate, allow pharmacists to make prescription renewals and adaptations. This would help ensure patients stay on track with their medication regimens. 3. Consult the pharmacy community now to improve electronic inrastructure and inormation-sharingbetween pharmacists and physicians. An electronic inrastructure is already being developed, but the pharmacy community canprovide valuable insights on what is needed and what improvements can be made.These recommendations include:Change needs to happen now in order or our health care system to remain sustainable or generations tocome. Pharmacists want to be part o the solution. The report concludes with a set o recommended practicalsolutions that will not only save the health care system billions o dollars, but most importantly improve the careor the millions o Canadians managing complex chronic conditions like arthritis, diabetes and hypertension. We hope these recommendations incite discussion and action among key stakeholders and government ofcials. Domenic Pilla Cheryl L. Koehn Dr. John Esdaile President and CEO, Founder and President, Scientifc Director,Shoppers Drug Mart Arthritis Consumer Experts Arthritis Research Centre o Canada Foreword The vast majority o Canadians (94%) agree pharmacistscan play an important role in helping people with chronicconditions manage their health. Four in fve Canadians(80%) agree they would speak with a pharmacist to helpthem manage their chronic condition i they had one.
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