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Going Beyond Medicine to Confront A Growing Public Health Challenge

It takes a village. From community to peer-to-peer to public/private partnerships, Teva is on a journey to better understand the struggles patients, caregivers and providers face in treating those with more than one chronic condition.

“My mother has a red folder for her medical conditions which I maintain. And I've got 16 separators. She has numerous conditions ranging from glaucoma, hypothyroidism and severe osteoporosis to a fractured femur, frozen shoulder and psoriasis, and these are neatly labeled on each separator. So I made a list and I thought I should share that with you,” said Dr. Sania Nishtar, Co-Chair, WHO High-Level Commission on Non-communicable Diseases during a recent panel discussion co-hosted by Teva.

Imagine the caregivers and family members providing for the millions of people suffering from multiple chronic conditions who don’t have a cardiologist and global public health advocate as a mother!

“Envision multiple recommendations, 12, 13, even 14 different drug regimens. I prescribe this. And remember, this is not just for a day or two, but for life. And if that process of care is challenging in a place like New York City, I can't imagine what it's like for Sania Nishtar's mother in Pakistan,” said Dr. Sandeep Kishore, Associate Director, Arnhold Institute for Global Health, Icahn School of Medicine, Mount Sinai Health during the panel.

Recognizing the importance of going beyond access to critical medicines, Teva recently brought together public and private representatives from the International Alliance of Patient Organizations (IAPO), Intel, GE Foundation, Mount Sinai Health and the U.S. Department of Health and Human Services during the UN High-Level Meeting on NCDs to discuss the care continuum, particularly related to managing multiple chronic conditions. This effort is part of a broader Teva mission to explore the care journey of the growing number of people who suffer from more than one chronic condition and to better understand the unique insights from a patient and caregiver perspective.

“A lot of people struggle to manage all of the different medications, so we need a combination of caregivers, healthcare providers and payers, but the patient has to be at the center of all of that. We need a voice and we need to be heard,” advocated Penney Cowan, chair of IAPO.

With so many hours spent outside a health practitioner’s office, the need for a holistic approach involving the community, peers, family, caregivers and counselors, as well as education on self-management was at the top of the agenda.

malia Adler-Waxman

During the panel, Teva’s Amalia Adler-Waxman, Vice President of Social Impact and Responsibility, said that through our partnership with Mount Sinai, “We’re trying to understand how conditions are “clustered” together and what does that mean for patients and health systems vs. looking just at single diseases. We are also exploring the role of peer-to-peer collaborations to drive behavior change and novel integrated approaches to patient care. Another aspect of our approach is to support a program with Direct Relief and Volunteers in Medicine to see what can be done in small clinics of uninsured patients in the U.S. around multiple chronic conditions. These initial programs revealed interesting opportunities, such as studies about peer-to-peer relationships where we’re seeing success from coaching that happens outside the clinic.”

“I don't know how many providers think about the patient who is at the center of treatment that they have to be part of the treatment team. So we can't tell them to live with the pain. We have to teach them how to do it. And so that's where a lot of the peer-to-peer comes in,” said Penney Cowan.

“The coordination of care is often fractured. You hear one thing from one provider and you hear something else from another provider. We have to change our care model. We have to flip it. We have to go out into the community to prevent bad behaviors before they happen,” added Dr. Sandeep Kishore.

One chronic condition sufferer, Roslyn, who receives care from the Mount Sinai Health system reminds us what it is like to navigate this world as a patient. “You have to find strength somewhere, whether it is in friendship, meditation, support groups. It is important for people to realize that even with the pain, that you're still really, deep down inside, the person that you always were and to not just see the pain, but the person as an individual.”

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