by Julie Campbell, Director, Healthbox
Improved medication compliance is a key healthcare priority in the U.S., where 50% of patients do not take their medication as prescribed. This lack of medication adherence results in increased morbidity and at least $100 billion per year in healthcare costs. In today’s rapidly changing healthcare culture, increased patient engagement is critical in driving improved health outcomes and treatment plan compliance. As we move more toward value-based care, it’s also integral that stakeholders continue to align in order to ensure patients are engaged and complying with their treatment plans.
Various innovative solutions that demonstrate increased potential for improved treatment plan compliance are emerging. Here are five of the most promising examples of trending approaches to medication adherence on the digital health horizon.
1. Predictive Analytics
When clinicians have tools to help them predict medication noncompliance, they can plan ahead for patients that are the most at risk and identify the most appropriate solutions for them. Predictive analytics, like so many other aspects of healthcare, is key to helping patients get the most of their data through recording and detecting patterns to inform future clinical decision-making. A mix of historical health and prescription data, combined with social determinants of health factors, can go a long way to understanding who is most at risk. Companies who are ahead of the trend already have algorithms built in their products to support this. The insights gathered through these algorithms are critical to ensure that interventions can be applied and tailored to the consumer depending on their risk stratification. Interventions can take the form of education, nudges, tracking apps, automatic refills/delivery, compliance packaging, etc.
Multiple studies published in Lancet HIV explore how predictive analytics has already been leveraged in research studies focused on improving the early identification of HIV. A model in one of those studies flagged 2% of the patient population as at-risk, which helped researchers identify nearly half of HIV cases among males.
2. Mobile Tracking and Gamification Apps
Mobile tracking apps are one of the most common ways medication compliance is maintained—especially by patients who demonstrate a level of engagement in their treatment plan but are seeking additional safeguards. Mobile tracking apps are accessible and affordable resources, and many do more than just send reminder notifications. Companies like Medisafe are taking apps focused on medication adherence to a new level by providing dosage information and medication schedule support, even tracking data like pill colors and shapes for patient reference within the app. Some mobile tracking apps also have features that can communicate to a patient’s friend or family member when the patient forgets or hasn’t indicated through the app that they took their last medication dose.
Diving deeper into smartphone solutions, mobile apps focused on behavior change like Wellth work with third parties to offer financial incentives encouraging individual adherence to medication routines. The third party, such as an employer, contributes a certain amount of money to the individual through the app—which employees get to keep if they adhere to their treatment plan. If noncompliance occurs, the amount of cash begins dwindling. Innovators are trying to understand what motivates true behavior change, and for some, financial incentive is part of the answer; for some others, it is competition. Virtual gamified experiences like this hold immense potential to influence outcomes by providing these incentives to engage. Intuitive mobile tracking apps like these are among the most patient-friendly solutions available focused on preventing medication noncompliance.
3. Convenient Access and Delivery
A growing trend influenced by healthcare consumerism is the convenience of having medication delivered right to a patient’s home. For individuals living in remote areas or for those who don’t have their own means of transportation, access to medication delivery can make or break a patient’s compliance with their treatment plan. Mail-order pharmacies have been around for some time, but a couple of innovations are making this process even more convenient and effective. PillPack will deliver medications to the patient’s home, and it will package each medication based on the specific prescribed dose and schedule for that patient.
In addition, the prescription process is being transformed through telehealth- allowing some patients to consult with their health professional virtually when they need a new or refilled prescription. Mobile ordering and delivery can be key to medication adherence. One of the most common reasons patients stop complying with treatment plans is because they stop seeing their doctors. In some cases, medication refills are dependent on frequent in-person doctors’ visits. App-based companies like NURX are breaking down these potential medication adherence barriers by providing quick access to a variety options for medications like birth control, only requiring patients to have personal identification and a smartphone. By consulting with healthcare professionals through the app’s telemedicine services, it’s not only safe but empowering when patients can both order and change their birth control method as they please and receive medication in their mailbox in days—improving medication compliance through the convenience of online ordering and telemedicine services combined in the app.
4. Compliance Packaging
For medications that include more accompanying risks for overdose or death, like opioids, ensuring the patient adheres to their plan and dosages is critical. That’s why some companies are creating solutions like smart blister packs—similar to common birth control packaging—which can provide a visual indication of whether or not a patient is adhering to medication doses as instructed. POPIT is one example of a company that provides this.
Another exciting and innovative form of packaging that improves medication compliance is the smart bottle. Smart bottles are ideal for tracking adherence to high-cost medications so purchasing parties can know if these medications are being used and delivering results. Using sensors to weigh itself, the smart bottle won’t release another pill until it’s reached the set amount of time between doses. What we’re seeing is that many pharmaceutical companies are willing to spend the money on trials for these solutions—especially when it can help them track whether the medication they are helping pay for is being taken or not.
The blister packs, which are less expensive, are beginning to move into the patient consumption market as well. As this solution becomes less expensive and more efficient, it has the potential to become more mainstream, used by those managing chronic disease like heart disease.
5. Ingestible Solutions
Companies like Proteus are taking compliance packaging to the next level by providing sensor-equipped digital pills. Here’s how they work: the patient wears a patch and swallows the digital pill as prescribed. Once the digital pill hits their GI tract and dissolves, the patient receives an update on its digestion through their patch. This status is also communicated through a mobile app, with which family members or loved ones can connect. This is an example of another solution that is ideal for high-cost medications, such as those used in oral chemotherapy treatment for cancer.
The threat of medication noncompliance increases significantly when the medical condition an individual is being treated for makes it even harder for them to commit to their treatment plan, such as with disorders like schizophrenia. Antipsychotics, the most common medication prescribed to treat schizophrenia, need to be taken daily, and an estimated one-third of patients with the disorder are non-adherent to their treatment plans. Eli Lilly and Johnson & Johnson are working on longer-acting ingestible formulations that would allow a patient to take one dose that lasts around one month versus 30 individual daily doses—greatly increasing the chance of compliance for this group of patients.
Prescription Cost Barriers
It is important to acknowledge that the high costs of prescriptions is a significant barrier for some that leads to noncompliance with the treatment plan. These solutions are not tackling that issue head-on. Some companies, like GoodRx and Civica Rx, are trying to improve price transparency and access to low-cost generics. Startups like these are starting to make a dent in the problem but government intervention will likely need to take place in order to enable meaningful changes in prescription drug pricing.
With so many innovative solutions in the works, improving medication compliance is becoming more of an attainable goal, and more startups, pharmaceutical companies and consumer-centric health service providers are taking note. Through solutions that put patients at the center and engage them in their own health story, the power of these innovations can create behavior change that has a long-lasting impact on health outcomes.