Governments
Challenge
Public health and wellness is a growing concern of governments. Given the escalating costs of health care, and in conjunction with a number of disturbing trends in the direction of poorer health, it’s becoming increasingly important for governments and their institutions to deal directly with the issue.
For example, cardiovascular disease kills more Canadians than any other disease. In 2002 it accounted for 34% of all female deaths and 32% of all male deaths. Hypertension, hyperlipidemia and hyperglycemia are other leading causes of death that are largely avoidable. And more than two million Canadians suffer from diabetes. Of these people, 90% have type 2 diabetes, and the condition’s prevalence is increasing. According to a 2005 World Health Organization survey, 5% of North Americans die each year from diabetes-related complications.
Compounding these health concerns are resource constraints. Public funding for prevention and disease management is currently limited to a select few on-site cardiac rehabilitation programs. These programs are often limited in duration (generally under six months) and provided predominantly to patients who have had recent cardiac hospitalizations or cardiac procedures.
Additionally, many physicians don’t have the time or expertise to provide extensive lifestyle counseling. Often, the degree of counseling required for long-term behaviour change is intensive, and it increases among patients with disease complications and co-morbidity. Moreover, physicians are inadequately compensated for treating patients with chronic diseases and, as a result, have targeted hundreds of millions of dollars at disease management.
Solution
Recent evidence suggests that lifestyle programs would be beneficial to as much as 80% of the adult population. Moreover, Canadian guidelines advocate for health risk assessments every one to three years for every male over the age of 40 and every female over the age of 50 (or earlier if post-menopausal). Indeed, over the past few years, Canadian provincial governments have identified prevention as the key to reducing healthcare expenditures for such costly diseases as diabetes.
INTERxVENT Canada addresses all these issues by providing solutions for government that can:
- Improve access to healthcare for rural populations
- Improve medication compliance
- Ensure appropriate medical interventions based on health guidelines
- Reduce healthcare expenses
- Reduce occurrence of diabetes and reverse pre-diabetes
- Promote smoking cessation
- Help people living in rural areas access preventive healthcare
Research shows that INTERxVENT’s personal and community-based programs help people improve quality of life and are effective in assisting people with specific geographical or social considerations. People living in rural areas, for example, have less access to preventive healthcare services than those in urban communities. Yet a recent study demonstrated that INTERxVENT can help people who might not otherwise have access to lifestyle-management programs improve their physical and mental health through behavioural change.
Medication
Medication also poses a challenge for governments; ongoing research suggests a tendency amongst physicians to over-prescribe medication. This trend exists mostly on account of the easy availability of pharmacological alternatives—despite their reported high cost and ongoing dependence—and a healthcare system that isn’t set up to promote lifestyle management. By encouraging healthy lifestyle changes, however, INTERxVENT programs have been shown to help people improve their health using very little medication, and in some cases none.
In a recent study, unmedicated patients at risk of cardiovascular disease were put on an INTERxVENT program that included exercise training and nutrition counseling. Patients remained unmedicated throughout the study. After three months they achieved their goals, supporting the importance of lifestyle interventions even without adjunct drug treatment.1
Cardiovascular disease
Cardiovascular disease provides another good example. Lifestyle changes can make a considerable impact in dramatically reducing deaths. In one study, over 60% of people with risk factors for cardiovascular disease, such as high blood pressure and hyperglycemia, reduced their risk within three months by participating in an INTERxVENT program. Similar results have been shown for the treatment of hypertension, hyperlipidemia and hyperglycemia; but due to the widespread availability of medication, the value of health and wellness programs is often discounted by clinicians and health insurers.2
Diabetes
Research has also demonstrated the effectiveness these programs in treating diabetes. In a four-month study of more than 900 men and women, INTERxVENT programs helped 43% of men and 44% of women reduce symptoms of prediabetes, a precursor to full-blown diabetes, through simple lifestyle modifications such as increased exercise and proper nutrition. In addition, researchers believe that lifestyle changes can help prevent type 2 diabetes. Eating healthfully, controlling weight and exercising are key. Studies show that INTERxVENT programs’ focus on key factors can help delay the condition’s onset.3
Smoking cessation
While quitting smoking can be challenging, INTERxVENT’s mentored smoking-cessation program has proven to help smokers end the habit and improve their health. One in three smokers who fail to quit smoking will eventually die of a smoking-related illness. On average, smokers die 10 to 15 years earlier than their nonsmoking peers. But smoking is a difficult habit to shake. In fact, only one in three smokers is able to successfully quit before age 60.
With a strong commitment and a solid support network, smokers are more likely to be successful in their quit attempts. INTERxVENT’s smoking-cessation program, combined with its other cardiovascular-risk-reduction programs, has proven successful in helping nearly 25% of smokers quit and 38% reduce consumption within one year.4
Risk identification
The INTERxVENT solution also addresses the issue of identifying at-risk patients.
As an example, the Alberta government—in conjunction with the Alberta Medical Association—has launched a new billing code in April 2009 that allows physicians to receive an additional annual fee for managing patients with complex care needs. MCI Medical Clinics Inc., which has eight locations in Alberta, has subsequently licensed INTERxVENT to screen all of its clinics’ Alberta patients in order to find those who qualify for the new billing code.
Additionally, institutions such as hospitals, cardiac rehabilitation facilities, diabetes clinics, community access centres and academic institutions can license INTERxVENT and provide it to patients.
In Ontario, for example, INTERxVENT could help the government dramatically reduce diabetes costs. The Ontario government has made fighting diabetes a top priority, most notably through its recent announcement of a diabetes initiative and its plans to invest $741 million in new funding on a comprehensive diabetes strategy over four years to prevent, manage and treat the condition.
To meet the health needs posed by diabetes, and to meet the demands of its licensees, INTERxVENT Canada has created a diabetes module intended specifically for people with the condition. Additionally, INTERxVENT has been working on a pre-diabetes module to help identify people at risk of diabetes and to prevent them from developing the condition.
A preventative program for diabetes would introduce considerable cost savings. A diabetes patient costs Ontario’s healthcare system over $3,000 in the first year of treatment, and if the patient has complications, this rises to over $5,000. Moreover, for each patient that requires in-hospital dialysis, the cost to the Ontario healthcare system over the course of a year is more than $56,000. Additionally, diabetes puts people at risk for other serious health complications such as heart disease and stroke, kidney and eye disease and limb amputations. INTERxVENT Canada therefore feels that its preventative program will be of great interest to the Ontario government and other provincial governments seeking to cost-effectively reduce the incidence of chronic disease.
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1. “Getting risk factors to goal: Lifestyle intervention is worth the effort in patients with hypertension, hyperlipidemia, and /or hyperglycemia.” 2004-ACC Annual Meeting.
2. “Need for and clinical effectiveness of a neurologist supervised, nurse case managed stroke risk reduction program.” 2001, June-Stroke.
3. “Effect of gender on effectiveness of therapeutic lifestyle changes in men and women with prediabetes.” 2007-DMAA Annual Conference.
4. “Stage of readiness to change multiple behaviors at entry to a phase 2 cardiac rehabilitation program.” 2001-ACSM Annual Meeting.