Medication Management
I've been thinking about personal health records (PHRs) lately (probably because of my article on PHRs going live tomorrow), and it somehow brings me to "Rent." I got on a big Broadway musical kick in junior high, and "Rent" started it all. I saw the show twice, listened to the soundtrack and even watched the movie, which--big surprise here--didn't hold a candle to the live show.
So why the health connection? There's a point during the song "La Vie Boheme" when an alarm beeps and Mimi says, "AZT break." (It's an anti-HIV drug.) The nonconformists pop their pills, pause to reflect and then delve right back into their ode to life, love and hedonism.
I always found that moment an interesting juxtaposition. I couldn't even remember to take my daily vitamin, but these individuals, who didn't give a darn whether they went to bed at 4 a.m. and woke at 3 p.m., managed to keep their medications in check--at least for the time being.
As musical memories danced in my head, I learned that today, Dec. 1, is World AIDS Day--a reminder that while "Rent" is just a story, in reality those living with HIV/AIDS face the daily challenge of taking the right medication at the right time. They seem like ideal candidates for personal health records (PHRs); the system would make it easier to keep track of when they took what and which prescriptions are due for a refill. But, as my PHR sources told me, many patients lack the tools or drive to do all that logging on and off to update their accounts [for more, read "PHRs: Perfect Timing or Premature Push" at www.advanceweb.com/him, starting tomorrow].
Now, researchers want to change that.
A new study at University of California, San Francisco will determine if text messages linked to PHRs can improve HIV-positive patients' adherence to medication. It's the 2009 version of that "Rent" scene; instead of a watch alarm, the reminder arrives via cell phone. Participants check the message, take the dose and get on with their lives. Adherence will be measured according to self reports and hair samples, which indicate levels of antiviral drugs in the body.
It sounds like a simple concept--and one that could work. Sure, patients will need to have their meds on hand, and even with the text it's easy to get distracted and forget to pop a pill, but I expect researchers will see an improvement. The actual PHR those texts are linked to may be another story. I just don't see patients, especially those who are more transient, getting pumped up about tracking their health any more than they already do.
If HIV-positive patients do get on board with PHRs, it could improve surveillance and probably unlock some things we have yet to learn about the disease. But for now, making sure patients stay healthy and get the meds they need is the goal.
For more information on World AIDS Day, visit aids.gov.