Category: Latest News

16^th September, 2024

When it comes to healthcare communication between doctors and patients in a digitally saturated world, phone calls continue to play a critical role and offer that very special touch. Despite advancements in telemedicine and digital health platforms, the healthcare industry and healthcare providers are the last to adopt the technological advancements of digitalization. Hence, in urgent cases, direct phone communication is still the preferred method for doctors when contacting patients. This preference is rooted in several practical, cultural, and logistical factors, making phone calls indispensable to patient care despite the digital surge that offers 24/7 connectivity.   

Phone calls in healthcare settings offer practical advantages over many forms of communication we now take for granted. They provide immediacy and directness, which can be crucial in medical situations. For example, post-discharge, personalized follow-up calls help ensure that patients and caregivers understand their care instructions and medication regimens and, in the process, reduce the risk of complications and readmissions. 

Preference for phone could be based on regional preferences too. For example, the Middle East caters to more than 100 languages and cultures in a smaller area due to migration and expatriate working populations, sometimes making it difficult for relevant communications to reach all. In such cases, direct phone calls facilitate clearer communication and understanding as compared to written messages which may not be able to convey the emotion or the personal touch that a phone conversation does. Doctors speaking in a way that the patient understands provides two-way communication, allowing for a personal check-in and a more personalized approach. Phone calls provide a personal touch that can help build trust and rapport between doctors and patients, especially for managing chronic conditions and ensuring compliance with treatment plans. For example, doctors and healthcare staff regularly use phone calls to follow up with patients, especially those in remote areas. This practice helps monitor the patient’s health status and address any immediate concerns without the need for a physical visit​​. That said, being digitally connected in healthcare is of paramount importance as the world moves on to Artificial Intelligence and beyond. 

How Axios International provides the human touch

Axios International believes in redefining healthcare by striking the perfect balance between cutting-edge digital access and the warmth of human interaction. While Axios’ digital health ecosystem, Axios+ enables patients to connect to the healthcare and treatment they need at every step of their treatment journey, where patients enrolled in the Axios-managed Patient Support Programs (PSPs), prefer us getting in touch with them on a personalized phone call via Axios CareLine, or through our home care visits, our commitment to providing healthcare with warmth and familiarity sets us apart in the industry.    

A study by Axios International and published in the Journal of Comparative Effectiveness Research shows that the potential benefit of phone-based programs to support patients with chronic disease treatments should be explored in less developed countries. Titled “Phone contacts and treatment discontinuation predict survival cancer patients in a subsidized drug access program,” the study includes 460 patients from Egypt, Malaysia, Mexico, Peru, Philippines, Thailand and Ukraine. The study shows that patients who were contacted by telephone as compared to email, during their treatment were more likely to stay alive at the end of the study. Results also show that of the total patients included in the study, phone-based patient support had a protective effect and lowered the mortality risk by 11 percent as compared to other messaging methods and emails. According to the study, reaching out to patients by phone helped them stay on their cancer medication by making sure they were supported in managing side effects or scheduling appointments which helped them live longer as compared to those who were contacted via emails.  

While digital solutions play a vital role in improving healthcare outcomes, Axios recognizes that the essence of healthcare lies in the human touch, compassion, and empathy that define the patient-caregiver relationship.

Logistical convenience

The logistical convenience of phone calls cannot be overstated. The calls are immediate and do not require the same level of technological infrastructure as video calls or digital consultations. Almost everyone has access to a telecommunication device with a personal number. This is particularly relevant in areas with limited internet connectivity or populations less comfortable with digital technology, including the more medically vulnerable, such as the elderly and special needs population.  

Modern technological advancements are now integrated

While phone calls remain a traditional method of communication, they are increasingly being integrated with modern technology to enhance their effectiveness. Many healthcare providers now use apps that provide a secondary phone line for patient interactions, maintaining boundaries, and managing calls efficiently without compromising personal privacy. These tools support text messaging and voicemail, making communication more convenient and streamlined​. An upcoming trend is that, if not most, major healthcare organizations now integrate their direct dialing within Google search results, instantly connecting with the hospital, clinic, or doctor instead.   

In a place where direct communication is highly valued, phone calls offer a personal and reliable way to connect doctors and patients. Harmonizing two crucial elements – digital and the human touch – is the way forward to reshaping the future of healthcare.  

9^th September, 2024

There was a time when access to healthcare was not a priority on the global public health agenda. In fact, until the late 20^th century, the idea of “access” was historically understood as a strictly physical issue – like the access you need to get into a special exhibit at your local museum. What changed and what does it mean for the future of patient health? 

The HIV/AIDS epidemic opened the world’s eyes to the consequences of access inequities. 

In the 1980s and 1990s, the HIV/AIDS epidemic devastated communities worldwide, with sub-Saharan Africa bearing the brunt. The epidemic exposed severe inadequacies in healthcare systems, particularly in resource-limited settings. Life-saving antiretroviral treatments (ART) were available, but only to a privileged few in more developed countries. For millions in Africa and other developing regions, these treatments were out of reach due to high costs, limited distribution networks, and at times, a lack of political will to address the crisis comprehensively.  

No previous health crises highlighted the disparities in healthcare access more starkly than the HIV/AIDS epidemic. The HIV/AIDS crisis underscored the devastating impact of inadequate access to healthcare, sparking a global awakening that forever changed public health. 

Early pilot access programs showed that treatment access was feasible around the world. 

At a time when the healthcare access debate was in its infancy, Axios International recognized that equitable access to quality medicines and services was crucial for combating the HIV/AIDS epidemic, and future health crises to come. For that reason, Axios was founded in 1997 with a mission to improve access to healthcare for underserved populations. That same year, in collaboration with UNAIDS, we designed what would become the first access to treatment program for low- and middle-income countries (LMICs) called the Drug Access Initiative (DAI). Working in close collaboration with pharmaceutical companies, DAI offered ARTs at discounted prices and facilitated their distribution in regions hardest hit by HIV/AIDS, enabling both treatment availability and accessibility. 

The DAI pilots weren’t just small-scale studies of ARV introductions in LMICs. They were proof-of-concept for an idea that had never been tried before. DAI increased access to treatment at a critical time. Importantly, it also showed the world that it was possible to make quality medications accessible in LMICs. DAI was the first time access was used in the context of medicine.  

These early efforts were instrumental in shifting the public health agenda towards a focus on healthcare access. The success of these initiatives demonstrated that with the right strategies, it was possible to deliver life-saving treatments to even the most marginalized populations. This paradigm shift laid the groundwork for subsequent global health campaigns and policies, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and many other public and private initiatives for HIV/AIDS and other diseases.

Skyrocketing chronic disease rates put a significant burden on existing healthcare delivery mechanisms, growing the need for access to healthcare solutions. 

Fast forward to the 21^st century, chronic and non-communicable diseases have surpassed infectious diseases as a leading cause of death around the world. As rates of these diseases increase quickly, the burden on the healthcare system is significant. Whether it’s governments struggling to cover the cost of new specialty medications for chronic disease patients, overworked healthcare providers, or overcrowded hospitals, the chronic disease epidemic is resurfacing many of the same issues first faced during the HIV/AIDS epidemic.  

As a result, healthcare stakeholders are being forced to prioritize alternative mechanisms to improve access to quality care and treatment, such as innovative treatment financing models and adherence support models to address affordability issues and minimize the burden on providers and health facilities.

Why It Matters  

As we reflect on the journey from a time when healthcare access was not on the public health agenda to today’s more holistic approach, it is clear that the work initiated during the height of the HIV/AIDS epidemic was transformative. The evolution of healthcare access from a neglected issue to a central tenet of the global health agenda showed us: 

1. The importance of thinking outside the box. When DAI first launched, few thought it was possible – but today, that one program inspired a much bigger access to healthcare movement.  

2. The need to think ahead. When it comes to healthcare, we can’t afford to act only once the issue is already out of control (as was done during the HIV/AIDS epidemic). We need to look around corners and be proactive with our solutions.  

3. The importance of collaboration. Much of what we were able to accomplish during the HIV/AIDS pandemic resulted from a shared sense of urgency, and a willingness to collaborate to find solutions fast. No one person or group can overcome today’s access challenges alone. We must be willing to collaborate cross-sector and cross-industries to achieve real change.   

The fight for healthcare equity is far from over, and it’s important that we keep these reflections in mind as we continue to innovate and advocate for equitable healthcare, and move closer to a world where access to quality healthcare is a reality for all. 

6^th September, 2024

According to the World Health Organization (WHO), adherence is ‘the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes – corresponds with agreed recommendations from a healthcare provider.’

Patients’ adherence to prescribed treatments can positively influence their illness’ long-term outcomes and prognosis. Conversely, non-adherence can lead to repeated hospitalization incidents or physician consultations, lower quality of life, medication waste, and increased healthcare costs. In most cases, non-adherence may lead to disease progression.

Low adherence is a leading problem worldwide, especially in patients with chronic diseases that require long-term management, such as diabetes mellitus, hypertension, cardiovascular disease, and cancer in low-and middle-income countries (LMICs), adherence among patients suffering from chronic diseases averages about 50 percent, with even lower numbers reported in developing countries.

Barriers to adherence to treatment

Various factors contribute to non-adherence, broadly divided into five domains or dimensions, as defined by WHO: socio-economic, health system or systemic, therapy-related, condition—or illness-related, and patient-related. “Socio-economic factors, such as the high cost of medications, lack of social support, and living far away from hospitals are some of the key challenges patients face, which can contribute to low adherence in patients. These are further compounded by other factors that may be unique to specific illnesses or individual circumstances in different regions,” says Dr Joseph Saba, the Chief Executive Officer and Co-Founder of Axios International.

Let’s look at cardiovascular disease (CVD) as an example. The leading cause of morbidity and mortality globally, CVD accounts for about 17 million (30 percent) deaths annually and is expected to increase to over 23.3 million by 2030. Although the CVD epidemic has begun to recede in some high-income countries (HICs), CVD mortality rates in LMICs continue to rise to about 300 to 600 CVD deaths per 100,000 population every year. A key factor driving these rates is sub-optimal adherence to medications for the prevention and treatment of CVD. Adherence to CVD medications in emerging economies is challenged primarily by limited health resources, socioeconomic barriers, and inequities in access to healthcare.

Dr Navin Sukilan, consultant cardiologist from Subang Jaya Medical Centre (SJMC) in Malaysia, says, “Adherence is a big issue in hypertensive patients. In younger patients who are pre-hypertensive or in Stage 1 of hypertension, we usually prescribe lifestyle modifications and regular monitoring of blood pressure. However, patients who present with Stage 3 hypertension or blood pressure reading of more than 160, have a higher risk of organ damage and complications such as heart attack or stroke, where we prescribe medications immediately.”

“To control their blood pressure effectively, hypertensive patients must take a few different medicines over a prolonged period. The increased pill burden is a significant challenge in medicine adherence. Other factors include low tolerance to side effects of the medicines and misinformation. They often obtain false information regarding the adverse effects of taking certain medicines for the long term through social media and chat apps such as WhatsApp, despite scientific data proving otherwise. Even highly educated working professionals believe these messages make adherence to medication even more challenging,” adds Dr Navin.

Improving medication adherence

One American study found that if patients took their drugs as directed, it could avoid up to 23 percent of nursing home admissions, 10 percent of hospital admissions, physician visits, diagnostic tests, and unnecessary treatments.

Although interventions to improve medication adherence have been introduced in high-income countries for patients with CVD, a 2021 study found that they are still at a nascent stage in LMICs. Strategies such as patient education, medication regimen management, fixed-dose combination medications, consultation with clinical pharmacists, and team-based care have been shown to have some success, but due to their cost, may be unsuitable for the health systems of many LMICs.

“Fixed-dose combinations have recently become available to hypertensive patients in Malaysia. These medicines consolidate two or three drugs into just one pill, which reduces the number of medicines patients must consume and improves adherence. However, the drug is available only in limited supplies outside of private hospitals here and is quite expensive, which impacts the ability of some patients to stay on long-term treatment. When a patient visits a government clinic or hospital for follow-ups and refills, they are usually unable to obtain the fixed-dose combination and have no choice but to revert to their former three-pill treatment regimen,” explains Dr Navin.

Strategies such as cognitive-behavioral therapies and electronic pill monitoring with text messages, automated refill tracking of in-patient electronic records or email alerts to a provider for missed refills, although widely used in HICs, have not been sufficiently adapted for use in LMICs, often due to cost limitations. Reminders to take medication via phone calls, text messages, Short Message Services (SMS), or in-phone calendars were some of the most common adherence interventions in LMICs. The study also found that reminders were more effective when they were personalized or interactive rather than generic.

“Improving adherence is a complex issue that involves different factors and multiple stakeholders. While we, as physicians, should take certain proactive steps to remind patients or reiterate the importance of adhering to their treatments, it is usually factors such as the high cost of medication and limited availability of less costly options that would ultimately determine if the patient continued to adhere to their treatment. This is especially true in managing chronic conditions such as hypertension and cardiovascular disease, which require long-term management,” says Dr Navin.

Importance of personalized adherence solutions

Thanks to decades of work by researchers worldwide, adherence is now understood and addressed as a behavioral issue that requires more than consistent reminders. Much of that research supports the theory that behavior is mediated by cognition, where knowledge of a person’s condition, treatment, and attitude affects their actions. Cognitive-behavioral theories recognize knowledge alone as insufficient to produce behavioral change. A person’s perception, motivation, skills, and social environment influence behavioral change.

As a result, adherence programs and apps must prompt patients to take their medication and promote well-being through goal setting and tracking. Ideally, they should also consider their patients’ needs and barriers to adherence. This allows for more tailored support to meet the needs of individual patients.

Patient Support Programs (PSPs), such as those provided by Axios International, benefit from approaching adherence as a behavioral issue and play a key role in providing 360-degree support to patients to maximize their health outcomes.

“Adherence is rooted in creating an environment where patients can cope with their disease throughout their treatment journey. At Axios International, we believe there is no ‘one size fits all’ when it comes to designing access solutions. Every patient’s journey is unique, so to help patients stay on treatment, we must utilize a multi-layered approach to effectively address the five dimensions of adherence through a versatile approach with a broad range of Maximized Adherence Solutions,” explains Dr. Saba.

“The PSPs we manage are designed to create an integrated ecosystem of care and treatment. Using our proprietary Patient Needs Assessment Tool (PNAT), we identify the risk factors that may lead patients to discontinue their treatment and tailor programs to best meet those unique requirements. By adopting an evidence-based approach, PNAT customizes services for each patient, thereby maximizing adherence to treatment, engagement, and program cost-efficiency,” adds Dr. Saba.

Our partnered-access programs yield improved medical outcomes and reduce the burden on hospitals and healthcare professionals by following through with patients outside the hospital environment. Through the programs we manage, we also foster trust with patients and their caregivers, thus ensuring sustained program outcomes. PNAT is currently used in five countries, including the UAE, Kuwait, Kingdom of Saudi Arabia, Iraq, and Egypt, for disease areas such as Dermatology, Rheumatology, Immunology, Neuroscience, Asthma, Cardiology, and Oncology.

Using digital to support adherence

In recent years, many positive advances have been made in developing digital support programs that facilitate stronger adherence to treatment.

Axios’ digital health ecosystem, Axios+, intuitive tools to enhance the patient experience and medical outcomes while facilitating the delivery of Axios-managed Patient Access Programs (PAPs and PSPs). Axios+ offers intuitive tools to enhance the patient experience and medical outcomes while facilitating the delivery of Axios-managed Patient Access Programs (PAPs and PSPs). The MyPatients app helps physicians stay in touch with their patients, allowing them to check their progress in a personalized way to help them stay on treatment and get the most out of their medication.

To improve patients’ medical outcomes, barriers to treatment adherence must be considered as seriously as patients’ ability to afford treatment. To encourage and sustain behavior that leads to medication adherence, patient’s personal needs and motivations to use digital tools must be considered and incorporated into the design and implementation of healthcare solutions.