Harnessing Longitudinal Data for Better Healthcare Outcomes in Long-Term Care

Harnessing Longitudinal Data for Better Healthcare Outcomes in Long-Term Care

Aug 26, 2024PAO-08-24-CL-09

The majority of U.S. long-term care facilities utilize PointClickCare’s electronic health records. The expansive electronic health record (EHR) system also provides an essential resource for pharmaceutical and biotech companies. PointClickCare Life Sciences’ EHR system is cloud-based and purpose-built for post-acute care, with multiple patient encounters and observations daily. The data is structured and comparable across factors like geographic regions and facilities, allowing for deep insights into disease progression, medication outcomes, and patient demographics. PointClickCare Life Sciences’ data can help identify drug repositioning opportunities, extending the therapeutic potential of existing medications. It has been used to develop targeted therapies for underserved populations, including people of all ages living with rare diseases and among the aging population. Access to this data allows companies to precisely understand where their products are needed, how they are used, and the impacts they have; facilitating responsive market strategies and efficient resource allocation. Pharmaceutical companies use these insights to dynamically adjust marketing strategies and accelerate drug discovery, repurposing, and development processes, thus revolutionizing care in long-term settings.

Key Opportunities for Long-Term Care Support and Market Growth in Elderly Care

The healthcare challenges that the often-neglected residents of post-acute and long-term care facilities face make them important users of healthcare services. Forty-two percent of Americans above 65 consume five or more prescription medications, while nine out of ten long-term care residents take more than five, and 65% are on more than 10, typically tailored to population groups that do not match the typical resident profile.1

As the global population gets older and life expectancy rises, the demand from this group is expected to grow considerably. United Nations data predicts that by 2050, the 65 and older population will increase from 703 million in 2019 (6% of the worldwide population) to 1.5 billion (9%).2 A rise in chronic illnesses is driving up both the need and cost for prescription drugs due to this demographic shift. Conditions not traditionally classified as medical problems now commonly receive drug treatment, with medication often being the preferred method for treating an expanding list of health issues.

Moreover, innovations in new pharmaceuticals or repurposing current ones are contributing to increased medication usage. The dynamics within the healthcare and pharma sectors affect this trend extensively. Nevertheless, it's essential to acknowledge the economic impact of this growth in demand. Plans like the Project 2025 Prescription Drug Plan might raise the expenses for nearly 18.5 million seniors on Medicare, affecting these medications' affordability and accessibility for the elderly.

Despite the prospects for pharmaceutical businesses, older adults are systematically left out from clinical trials — often legally — blocking their access to currently developing evidence-based treatments and furthering the risks of polypharmacy and detrimental drug interactions. Additionally, heightened healthcare needs stemming from an aging U.S. populace could result in a pronounced physician shortage estimated up to 124,000 by 2034.

Utilizing real-world data from long-term care facilities is invaluable in enhancing health outcomes for this demographic. Data sources, such as those amassed by PointClickCare from various long-term care settings, provide essential perspectives on disease evolution, therapy effectiveness, and patient experiences; which are vital for devising safe and efficient drug development strategies. Repositioning existing medications approved for use in this group is yielding promising results for other uses and creating innovative combination treatments. This data is also instrumental for designing clinical studies, pinpointing relevant characteristics in residents — demographic, social, or medical — and conducting observational clinical trials to gauge the possible success of future clinical research.

Leveraging a Distinctive Data Asset for Groundbreaking Therapeutic Insights and Healthcare Results

PointClickCare’s EHR software captures comprehensive data sets that support both forward-looking and historical research. The EHR system records a vast array of data points beyond what a prospective cohort study could typically capture, enabling analysis of existing records without the need for additional data collection efforts. This resource proves essential in exploring both rare diseases like spinal muscular atrophy (SMA) and more common ailments, aiding in the discovery of potential risk factors through the examination of historical and baseline data, which is often available for several years before diagnosis, coupled with follow-up periods that extend for a year or longer.

Utilizing full follow-up data sets to evaluate key variables and outcomes within a retrospective clinical trial framework using EHR data yields important knowledge about the relative effectiveness of treatments. By tapping into preexisting patient records to investigate outcomes, comorbidities, and treatment behaviors, this approach contributes to informed clinical decision-making in the face of conditions like tardive dyskinesia or other movement disorders, and examining treatment outcomes over timeframes such as 6, 12, and 24 months.

With its continuous, real-time, longitudinal collection from the majority of long-term care facilities in the United States, PointClickCare has a significant share of the market. Its cloud-based platform promotes consistency in data across various regions, populations, and clinical scenarios. The platform’s extensive database encompasses vital statistics, health backgrounds, and prescription information and covers the health trajectories of millions of patients across several years, offering an unprecedented level of insight into patient outcomes, diagnostic patterns, comorbidities, and treatment methods.

EHR Data Enhancement in Health Services Research & Development

Leveraging comprehensive data streamlines administrative tasks and improves communication, enabling informed decisions and better patient engagement. The information not only aids in innovating drug treatments and adherence to care guidelines but also supports quality audits and enhancements.

With real-time analytics, healthcare providers can foresee patient outcomes, refine clinical procedures, and cut costs, thus embracing a data-centered medical approach. PointClickCare's consistent data framework enables straightforward comparison across North America, crucial for mitigating care disparities, reducing spending, and bolstering health outcomes.

The ever-expanding data set offers an in-depth perspective on medication management, quality-of-life measurements, daily functions, cognitive evaluations, daily vitals, and adherence to minimum data set (MDS) standards by Medicare, over two decades for millions of patients. Such standardization underpins thorough aggregation and analysis, granting pertinent insights in an evolving healthcare landscape that now includes challenges like long COVID. Access to such data minimizes medical mistakes and unnecessary tests, lowering expenses and enhancing care provision. Real-time data collection also promotes patient engagement by offering access to personal health information, key to individualized treatment plans.

Furthermore, PointClickCare Life Sciences provides this meticulous data to pharmaceutical entities, governmental bodies like the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS), as well as health economists, sociologists, and policy analysts. This detailed data allows for solid conclusions and helps users be responsive to emerging health issues and track contemporary health tendencies and results effectively.

An Investigational Tool to Maximize Clinical and Commercial Outcomes

PointClickCare Life Sciences’ data maximizes clinical and commercial outcomes by providing comprehensive, real-time insights that drive informed decision making, optimize treatment strategies, and enhance market responsiveness.

In a practical use case, PointClickCare Life Sciences’ data was employed by Pfizer to examine long-term care metrics, including changes in body mass index (BMI) and meal consumption rates among long-term care residents. It was initially thought that age-related anorexia, or “wasting,” affected only 2% of seniors. Yet, the data from PointClickCare Life Sciences indicated that approximately one-fourth of the studied group consumed less of their meals and endured a reduced BMI, significantly shifting the understanding of this health issue. This finding emphasizes how real-world data can challenge pre-existing beliefs and aid in more precise drug targeting approaches.

Moreover, the data obtained from PointClickCare Life Sciences shed light on substantial treatment gaps for type II diabetes within nursing home settings, a condition impacting over 30% of their population. Despite 17% qualifying for GLP-1 therapy, merely 4% of those who qualified were being treated with a GLP-1 therapy, uncovering an essential aspect where comparative effectiveness research could contribute to optimizing healthcare service and therapeutic interventions. With access to such data, medical practitioners can investigate the causes of these treatment disparities and refine treatment plans according to individual patient needs, ultimately improving the quality and personalization of care.

This data set aids in understanding drug effects and healthcare delivery across patient groups. It can inform post-market studies, sometimes replacing traditional clinical trial findings, and helps shape outcome-based pricing by showing diagnostic and treatment efficacy. The data tracks a drug's life cycle, analyzing prescribing trends, patient adherence, and regional use to support marketing, discover new applications, and enhance sales strategies.

PointClickCare Life Sciences data also supports guideline concordance and facilitates the development of new clinical guidelines. This alignment not only ensures compliance with existing healthcare standards but also aids in establishing new benchmarks in care, particularly in under-explored therapeutic areas. By integrating real-world data into guideline development processes, PointClickCare Life Sciences enables healthcare providers to adapt to the latest evidence-based practices, ensuring that commercial strategies are both clinically effective and market-ready. Furthermore, this strategic alignment with guidelines enhances compliance and patient outcomes and boosts the commercial viability of new treatments, as payers and regulators often favor therapies backed by solid clinical guidelines.

PointClickCare Life Sciences data sets have enabled a deeper understanding of long COVID and assisted in identifying effective treatments. The data has also been leveraged to explore different management strategies and their outcomes for diabetes patients, investigate the adverse events and unexpected drug–drug interactions for specific medications, conduct comparative effectiveness studies, and identify opportunities for drug repurposing. These capabilities highlight the transformative potential of PointClickCare Life Sciences’ comprehensive healthcare data in enhancing pharmaceutical agility and optimizing clinical and commercial outcomes.

Case Study: Alcohol Use Disorder Pharmacology in Long-Term Care

A recent study that utilized the extensive data set from PointClickCare’s Life Sciences investigated the efficacy of pharmacological treatments for older individuals with alcohol use disorder (AUD) in nursing home environments. The research aimed to assess how nine different AUD medications affected the daily activities of two age groups: those between 18-64 years old and seniors aged 65+, all within U.S. nursing homes. The goal was to determine how these medical interventions affect daily functioning and quality of life.

The study analyzed a variety of information, including medication administration data, demographic details, and clinical attributes of a large segment of patients in long-term care, using the cloud-based health data platform from PointClickCare. This depth of data enabled the researchers to account for factors like additional illnesses, multiple drug regimens, and patient demographics, ensuring the results were solid and reliable.

Findings indicated that typically, the elder group exhibited slightly improved scores in their daily living activities compared to younger participants, hinting that age may play a role in the success rate of AUD medications. Baclofen stood out, with a notable increase of 1.5 points in these activity scores, marking it as potentially more effective for seniors. Conversely, treatments with naltrexone showed a 1.0-point drop in scores, suggesting its prescription should be managed judiciously in older patients.

Additionally, the study revealed differences in ICD-10 Z codes related to the usage of these drugs, indicating various health conditions present in the patients. For instance, baclofen users were more likely to have muscle weakness, while high blood pressure was common among those taking different AUD medications.

This research demonstrates the value of real-world data provided by PointClickCare Life Sciences in offering detailed insights into pharmacotherapy’s effectiveness in actual healthcare settings. These analytical findings guide clinicians toward improved treatment choices and set the stage for further research into tailored medicine for treating AUD in the elderly. This example showcases how data-focused methodologies can significantly elevate patient care in long-term care settings by delivering evidence-based perspectives on various medications, ultimately aiding in refining treatment practices and boosting the overall standard of healthcare.

Harnessing Real-World Data for Drug Repositioning through PointClickCare Life Sciences

The process of drug repositioning, which involves finding new uses for approved drugs, has a notably higher success rate for regulatory approval — around 30% — compared to the 10% rate for new drugs. This increased rate of success can be attributed to the established safety profiles of existing medications, which lower both risks and expenses during development. The real-world data from PointClickCare Life Sciences, encompassing nearly two million patients in long-term care, boosts such efforts by providing a basis for identifying alternative medication applications via sophisticated statistical and machine learning techniques. These data sets facilitate evaluating the consequences of off-label use and other patient outcomes, thereby aiding in creating research designs that sidestep usual limitations.

Moreover, the data sets from PointClickCare Life Sciences are instrumental in assessing different patient outcomes and context dynamics, unearthing patterns that might remain unseen in controlled experiments. Such adaptability is essential for combating a spectrum of diseases, from diabetes to Alzheimer's disease. Discoveries derived from this data also indicate that several symptoms, such as cognitive decline episodes, are often temporary and possibly linked to issues like dehydration, offering broader knowledge about patient health in nursing facilities.

Pharmaceutical businesses leveraging PointClickCare Life Sciences' data can significantly cut down on the time and capital usually needed for the drug repositioning process, proving it to be an invaluable resource for refining therapeutic approaches for a wide-ranging patient population.

Enhanced Entry to PointClickCare Life Sciences’ Extensive Healthcare Data Collection

PointClickCare Life Sciences delivers various options, tailored for ease of use, to access its extensive collection of healthcare data — a service well-suited for the unique requirements of pharma and biotech entities. Organizations may procure the data set as a one-time acquisition; however, subscriptions have proven especially beneficial for continuous observation of treatments, outcomes, or other periodic developments, all through a dashboard specifically engineered for user-friendliness, negating the need for a data expert's intervention. Staying updated with current shifts, intermediate trends, and patient results is among the most straightforward methods companies can employ to enhance their medicinal research and patient care strategies.

References  

1.     Jokanovic, Natali et al.Prevalence and factors associated with polypharmacy in long-term care facilities: a systematic review.” J. Am. Med. Dir. Assoc. 16: 535.e1-12 (2015).

2.     World Population Ageing 2019. United Nations Department of Economic and Social Affairs. 2020.