Abbott Laboratories · NYSE:ABT
Abbott Laboratories — Investor Presentation (October 2021)
60 slides from Abbott Laboratories's investor presentation, October 2021
Slide 1: Educational purposes disclaimer
This presentation is offered for educational purposes only, intended to serve as continuing medical education for health care professionals. The content of the presentation represents the views and opinions of the original creators of such content and does not necessarily represent the views or opin
Slide 2: Shhhh… avoiding acute crises in 'silent disorders'
A:CARE CONGRESS Shhhh… avoiding acute crises in ‘silent disorders’ Prof. Michael Strupp Prof. Joseph Zohar Prof. Atul Pathak Professor of Neurology, Department Director of the National Professor of Medicine and Head of of Neurology and German Center for Post-Trauma Center, the Department of Cardiova
Slide 3: Compliance, Adherence and Persistence: personal experience
SHHHH… AVOIDING ACUTE CRISES IN ‘SILENT DISORDERS’ Compliance, Adherence and Persistence. My personal experience, opinion, recipe and vision Prof. Michael Strupp, MD, FRCP, FAAN, FANA, FEAN Department of Neurology and German Center for Vertigo and Balance Disorders University of Munich Germany GLO22
Slide 4: Disclosure
Disclosure Joint Chief Editor of the Journal of Neurology, Editor in Chief of Frontiers of Neuro-otology and Section Editor of F1000. Speaker’s honoraria from Abbott, Actelion, Auris Medical, Biogen, Eisai, Grünenthal, GSK, Henning Pharma, Interacoustics, MSD, Otometrics, Pierre-Fabre, TEVA, UCB, Vi
Slide 5: Didactic concept and content
Didactic concept and content FIRST SESSION: NEUROLOGIST, PSYCHIATRIST AND CARDIOLOGIST … Clinically oriented for your practice and your next patient Concrete examples with real patients’ stories • Covering relevant daily issues in your practice • Various scenarios, illustrated by patients with neuro
Slide 6: Compliance, Adherence and Persistence
Compliance, Adherence and Persistence MY PERSONAL EXPERIENCE, OPINION, RECIPE AND VISION Compliance Adherence Persistence GLO2208852 | Nov-21 | 6
Slide 7: Compliance, adherence and persistence
COmpliance, adherence and persistence MY PERSONAL EXPERIENCE, OPINION, RECIPE AND VISION COnsultation of the patient, family, caregivers, colleagues! COoperation of all of them: teamwork COntrols with pre-fixed follow-up consultations, nowadays also remotely! GLO2208852 | Nov-21 | 7
Slide 8: Compliance, adherence and persistence
Compliance, adherence and persistence MY PERSONAL EXPERIENCE, OPINION, RECIPE AND VISION Easy in acute Difficult in chronic More difficult in Even more monophasic diseases chronic relapsing difficult in diseases with acute (progressive/ (remitting) diseases otherwise healthy effects of treatment non
Slide 9: Compliance, adherence and persistence: concrete issues
Compliance, adherence and persistence MY PERSONAL EXPERIENCE, OPINION, RECIPE AND VISION CONCRETE ISSUES IN YOUR CLINICAL PRACTICE AND SOLUTIONS TO BE CONSIDERED AND EXPLICITLY DISCUSSED WITH PATIENTS AND CAREGIVERS Delay of onset of positive treatment Consequences of non-compliance to effects be ex
Slide 10: Real cases which illustrate some of the problems
Compliance, adherence and persistence MY PERSONAL EXPERIENCE, OPINION, RECIPE AND VISION Real cases which illustrate some of the problems Proprietary and confidential — do not distribute GLO2208852 | Nov-21 | 10
Slide 11: Compliance, adherence and persistence
Compliance, adherence and persistence MY PERSONAL EXPERIENCE, OPINION, RECIPE AND VISION You are suffering from a loss of both organs of balance. We recommended daily D self-physiotherapy six months ago. What was your first impression? First, during these exercises my dizziness was much worse and I
Slide 12: Migraine: delay till there is a benefit
Compliance, adherence and persistence MY PERSONAL EXPERIENCE, OPINION, RECIPE AND VISION Migraine: delay till there is a benefit: 100 days+ GLO2208852 | Nov-21 | 12
Slide 13: Compliance, adherence and persistence
Compliance, adherence and persistence MY PERSONAL EXPERIENCE, OPINION, RECIPE AND VISION D You are suffering from recurrent short attacks of vertigo. We gave you a medication. P Nothing good first, only tired, drowsy and even more dizzy. D What about the short attacks? Well, they are gone, However,
Slide 14: Approach and explanations to the patient
Approach and explanations to the patient TITRATING BENEFITS AND SIDE-EFFECTS … KEEPING THE BALANCE BETWEEN BENEFITS LIKE IN CHEMISTRY TO A PH OF 7 …. AND SIDE-EFFECTS 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 https://www.google.com/search?q=ph&sxsrf=AOaemvLogj18QvYMmZ2KZ0NYeGQu6baqg:1634045926383&source=ln
Slide 15: Menière's disease relapse case
Compliance, adherence and persistence MY PERSONAL EXPERIENCE, OPINION, RECIPE AND VISION You are suffering from Menière’s disease. We were treating you with a medication for two years and you were free of episodes of vertigo. Then you D stopped the medication completely. How long did it take until y
Slide 16: Epilepsy case
Compliance, adherence and persistence MY PERSONAL EXPERIENCE, OPINION, RECIPE AND VISION You have been suffering from epileptic seizures for 20 years. We treated you with three drugs. Then you were free of seizures for two years and you stopped D the medication completely from one day to the next on
Slide 17: Stroke secondary prophylaxis case
Compliance, adherence and persistence MY PERSONAL EXPERIENCE, OPINION, RECIPE AND VISION You suffered from acute weakness of your left arm one year ago. We found out that this was due to a small stroke caused by irregular heart beating and D we treated you with tablets. Two weeks ago you stopped thi
Slide 18: One additional measure to improve CAP
One additional measure to improve CAP TO FINISH MY LECTURE WITH POSITIVE AND OPTIMISTIC STATEMENTS Remote management of your patient! Frequent consultations of your patients possible Evaluation of side-effects, effects and acute events Convenient for the patient: no traveling Doctors and patients al
Slide 19: The silence around ADHERENCE
SHHHH… AVOIDING ACUTE CRISES IN ‘SILENT DISORDERS’ The silence around ADHERENCE Prof. Joseph Zohar National Post-Trauma Center, Research Foundation by the Sheba Medical Center, Tel Aviv University, Israel GLO2208852 | Nov-21 | 22
Slide 20: Disclosures
Disclosures • Post-Trauma Center, Sheba Medical Center, Israel AFFILIATION • Tel Aviv University, Israel I have the following potential conflict(s) of interest to report: Type of affiliation/financial interest; Name of Commercial company Receipt of grants/research supports: Lundbeck, Servier, Brains
Slide 21: Structure
Structure Scope Intervention Practical steps in general Practical steps for psychotropics Conclusion GLO2208852 | Nov-21 | 24
Slide 22: Scope
Scope An estimated one half of patients with chronic diseases maintain adequate medication adherence, and medication nonadherence accounts for 30% to 70% of all adverse medication–related hospitalizations in the United States (Burkhart & Sabate, 2003; Toh, Jackson, Gascard, Manning, & Tuck, 2010) GL
Slide 23: Structure
Structure Scope Intervention Practical steps in general Practical steps for psychotropics Conclusion GLO2208852 | Nov-21 | 26
Slide 24: Intervention
Intervention Increasing patient involvement in treatment have the most potential to improve adherence and hence outcome in mood disorders GLO2208852 | Nov-21 | 27
Slide 25: Structure
Structure Scope Intervention Practical steps in general Practical steps for psychotropics Conclusion GLO2208852 | Nov-21 | 28
Slide 26: my a:care app
my a:care app GLO2208852 | Nov-21 | 29
Slide 27: my a:care app
my a:care app my a:care On To download this FREE of Google Play and charge App, search for iTunes App Store GLO2208852 | Nov-21 | 30
Slide 28: Structure
Structure Scope Intervention Practical steps in general Practical Steps for Psychotropics Conclusion GLO2208852 | Nov-21 | 31
Slide 29: Practical steps: simplifying treatment regimen
Practical steps Very often we prescribe “antidepressants” for anxietyregimen Simplifying treatment disorders or “second – ONCE A DAY generation DOSAGE (for medicationantipsychotics” to depressed for depression and psychosis)patients who that is reached in few weeks show no evidence of psychosis Nico
Slide 30: Specific obstacle: medication names do not match use
Specific Obstacle Very often we prescribe “antidepressants” for anxiety For patients with disorders anxiety or “second or depression we aregeneration facing a antipsychotics” to depressed patients who unique situation show The names of the no evidence medications of psychosis do NOT match their use
Slide 31: Prescribing antidepressants for anxiety disorders
Very often we prescribe “antidepressants” Very often we prescribe “antidepressants” for for anxiety disorders or “second generation anxiety disorders or “second generation antipsychotics” antipsychotics” to depressed patients who to depressed patients who show show no noevidence evidence of psychosi
Slide 32: Current nomenclature: anxious patients
Current nomenclature ANXIOUS PATIENTS Why are you giving me an antidepressant for my anxiety? It must be confusing to find that your anxiety disorder is being treated with an “antidepressant” Proprietary and confidential — do not distribute GLO2208852 | Nov-21 | 36
Slide 33: Current nomenclature and adherence
Current nomenclature and adherence DEPRESSED PATIENTS Is my condition so bad that you are giving me an antipsychotic? It is horrifying to find that your depression is being treated with an “antipsychotic” GLO2208852 | Nov-21 | 38
Slide 34: Impact of atypical antipsychotic nomenclature on bipolar patients
The impact of atypical antipsychotic Nomenclature on patients with Bipolar Disorder: Results of a nationwide patient survey Tina Matthews-Hayes, Greg Mattingly, Stephen M. Stahl, Mehul Patel PATIENT RESPONSES INDICATED THAT THE ATYPICAL ANTIPSYCHOTIC CLASS NAME WAS ASSOCIATED WITH NEGATIVE EMOTIONS
Slide 35: Current naming of psychiatric medications confusing for patients
The current naming (nomenclature) of psychiatric medications confusing for the patients Proprietary and confidential — do not distribute GLO2208852 | Nov-21 | 41
Slide 36: The taskforce
The taskforce FIVE MAJOR INTERNATIONAL NEUROPSYCHOPHARMACOLOGICAL SCIENTIFIC ORGANIZATIONS JOINED FORCES TOGETHER (2008) TO CREATE THIS NOMENCLATURE THESE ORGANIZATIONS ARE ECNP ACNP AsCNP CINP IUPHAR European American Asian International International College of College of College of College of Uni
Slide 37: NBN: Neuroscience based Nomenclature
NBN Neuroscience based Nomenclature GLO2208852 | Nov-21 | 43
Slide 38: Neuroscience
Pharmacologically-driven Neuroscience (Rather than indication- based) nomenclature that embeds contemporary Cell Biology Pharmacology Genetics neuroscience understanding of how medicines work Molecular Biology GLO2208852 | Nov-21 | 44
Slide 39: Antipsychotics Antidopaminergics; Antidepressants Promonoaminergics
Antipsychotics Antidopaminergics Antidepressants Promonoaminergics GLO2208852 | Nov-21 | 45
Slide 40: Download the NbN-2 app
To download the App, search for NbN-2 on Google Play and iTunes App Store GLO2208852 | Nov-21 | 46
Slide 41: NbN drug entry example
Serotonin Reuptake inhibitor Major depressive disorder (except in USA); Obsessive cornpulsive disorder Improves symptoms of depression and anxiety and reduces compulsive behaviour and obsessional thoughts GI symptoms, anxiety and/or changes In sleep early in treatment, sexual dysfunction, Must be gr
Slide 42: The NbN for patients and families
The NbN for patients and families (NbN Very often we prescribe “antidepressants” for p&f) anxiety disordersyet uses scientifically-accurate or “second generation antipsychotics” easy-to-understand terms to depressed patients who in order to explain showhow the no evidence of psychosis medication wor
Slide 43: The NbN patient & family Website
The NbN patient & family Website www.nbnpf.com GLO2208852 | Nov-21 | 49
Slide 44: How to enhance adherence in patient with silent disease?
SHHHH… AVOIDING ACUTE CRISES IN ‘SILENT DISORDERS’ How to enhance adherence in patient with silent disease? Prof. Atul Pathak Cardiovascular Medicine, Hospital Princesse Grace, Monaco Risk Factors and Heart failure: Molecular and Clinical Investigations, CNRS 5288, Toulouse, France University Pennsy
Slide 45: Disclosures
Disclosures RESEARCH GRANT AND HONORARIUM Astra Boeh- Abbott Merck Novartis Servier Zeneca ringer GLO2208852 | Nov-21 | 58
Slide 46: Prematurely stopping therapy is associated with subsequent mortality
Prematurely stopping therapy is associated with subsequent mortality KAPLAN-MEIER MORTALITY CURVES 1 TO 12 MONTHS AFTER MI, BY THIENOPYRIDINE THERAPY AT 1 MONTH AFTER MI 1 in 7 patients with heart attack who receive a stent are no longer taking clopidogrel by 30 days 1 in 6 patients who receive a st
Slide 47: Extent of nonadherence across the population
Extent of nonadherence across the population For every 100 Filled by the Picked up from the Taken properly Refilled as prescriptions written pharmacy pharmacy prescribed 100 50-70 48-66 25-30 15-20 At any given time ~50% of patients are non-adherent Christensen A, Osterberg LG, Hansen EH. J Hyperten
Slide 48: Adherence is the process by which patients take their medications
Adherence is the process by which patients take their medications as prescribed TIME Initiate Implement Persist Patient does Patient delays, Patient not initiate omits or takes discontinues treatment extra doses treatment Binary (yes/no) Dosing history Time to event Different forms of nonadherence V
Slide 49: Non-adherence is multifactorial
Non-adherence is multifactorial Socioeconomic factors Lower social economic status associated with lower adherence Health care system factors Team-based care and post-hospital follow-up improve adherence Medical condition-related disease factors Concomitant conditions and comorbidities can impact ad
Slide 50: Intentional and unintentional reasons for non-adherence
Intentional and unintentional reasons for non-adherence SELF-REPORTED REASONS FOR NONADHERENCE (%) 50 42 40 34 30 27 22 21 20 17 17 16 12 10 0 Forgot Ran out Away from Trying to save Had side Was too busy Rx wasn’t Didn't think Rx Didn't like home money effects working was needed taking it Medicatio
Slide 51: Intervention effects vary based on intervention type
Intervention effects will vary based on intervention type Cognitive Behavioral Knowledge Skills, abilities Attitude Reminders, cues Beliefs Contractual obligations Multilevel Norms interventions are needed Macro Meso Micro Behavior Focus beyond providers Barriers exist at Motivation/ Environment/Pol
Slide 52: Difficult to change a health behavior
Difficult to change a health behavior GLO2208852 | Nov-21 | 66
Slide 53: Plan to motivate!
Plan to motivate ! MOTIVATIONAL INTERVIEWING Plan Make your patient change Define a patient-centered goal Build relationship GLO2208852 | Nov-21 | 67
Slide 54: How to help a patient with a silent risk factor to change?
How to help a patient with a silent risk factor to change? Precontemplation (Not ready) Am not concerned I can’t anymore Maintenance (Continuing Contemplation (Interested) THE new behaviour) I know I should BUT CHANGE I am still doing INDIVIDUAL MAY JOURNEY EXIT & RE-ENTER AT ANY STAGE Action (Recen
Slide 55: Prochaska and Di Clemente's Stages of Change Model
Prochaska and Di Clemente's Stages of Change Model Precontemplation Contemplation For any behavioral situation • 40% in precontemplation • 40% in contemplation • 20% in preparation or action Preparation Maintenance Action Prochaska and Di Clémente, Stages of Change: prescriptive guidelines for behav
Slide 56: How to help a patient to change?
How to help a patient to change ? Precontemplation (Not ready) Relapse Inform, create doubt Analyze causes, remember and reinforce successes, Maintenance (Continuing Contemplation (Interested) THE new behaviour) Stimulate understanding CHANGE Anticipate difficulties INDIVIDUAL MAY JOURNEY EXIT & RE-
Slide 57: Medication adherence and decision-making preference
Medication adherence and decision-making preference Decision making preference has an in impact on medication adherence Length of patient provider relationship impact decision making preference Patient preference influenced by • Trust in physician, • satisfaction with care • confidence in decision S
Slide 58: Motivational communication
Motivational communication Use microskills to elicit and reinforce self- Ask Listen Summarize motivational statements (change talk) Invite Acknowledge Ask permission to work together GLO2208852 | Nov-21 | 72
Slide 59: Predicted medication adherence scores: motivational interviewing evidence
Evidences MOTIVATIONAL INTERVIEWING (MINT) COUNSELLING Systematic reviews and RESULTED IN STEADY MAINTENANCE OF MEDICATION meta-analyses show ADHERENCE OVER TIME COMPARED WITH USUAL CARE (UC) beneficial effect of motivational strategies in 60 55.41 56.92 55.21 various contexts such as Adherence scor
Slide 60: Conclusions: Approaches improving patient's behavior
Conclusions: Approaches improving patient’s behavior Patient-centred therapeutic approach Improves readiness for change • Relevant to patients who needs to be identified • Change the way you communicate • Change the way you behave Improves outcomes when added In hypertensive patients, practice-based
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