Medication adherence and digital health coaching

*How digital health coaching, which combines behavioral science with technology, can help improve compliance*

How digital health coaching, which combines behavioral science with technology, can help improve compliance

Medication non-adherence is a widely acknowledged pain point in the healthcare industry, responsible for a staggering $100 billion in excess hospitalizations each year.

In a 2009 study, the New England Health Institute estimated that non-adherencealong with suboptimal prescribing, drug administration, and diagnosiscould result in as much as $290 billion per year in avoidable medical spending, or 13 percent of total healthcare expenditures.

An estimated one third to one half of all patients in the US do not take their medication as prescribed by their doctors.

Medication non-adherence is a complex issue. Each person has a unique set of circumstances that impact his or her willingness and ability to stay compliant, from the perceived severity of the condition being treated to the level of trust in their doctor.

To confront the challenge of medication non-adherence, pharmaceutical companies traditionally use compliance programs that often have only short-term success.

Programs such as personal counseling, informational websites, specialized prescription containers, and monetary incentives work for a short time but do not change long-term patient behavior or beliefs, and none address the underlying causes of noncompliance. (For more on the Web and compliance, see Branded websites: Sharing information and creating trust.)

With an estimated annual revenue loss of $30 billion due to patient non-adherence, pharmaceutical manufacturers have great motivation to adapt their compliance programs to more modern applications that empower patients and change long-term behavior.

How to improve medication adherence

A motivation to change or modify their adherence behavior is a key component to improving patients medication adherence routines.

Here are some suggestions to help improve medication adherence.

  • Help patients manage stress and depression, and improve their coping skills.
  • Learn the patients daily routine in order to address specific non-adherence issues. Generic suggestions are of little benefit to the patient.
  • Understand each patients perceived barriers to adherence.
  • Help patients to become accountable for and take ownership of managing their health.
  • Strengthen healthcare provider and patient relationships, including with the pharmacist.
  • Bolster patients confidence in their medications and themselves.
  • Move patients toward intrinsic motivations for adherence that are based on their values and go beyond extrinsic ones like costs and refill reminders.
  • Understand that patients care about their quality of life, not about the drug or corporate bottom lines. A focus only on adherence will often backfire.
  • Recognize that each patient is a unique individual, while also reaching out to entire populations.

By considering the patients full needs, pharmaceutical companies and healthcare providers will be able to offer a more efficient and innovative approach to medication adherence within a broader strategic patient awareness plan.

Digital health coaching

One medication adherence option that is gaining attention is digital health coaching, which combines behavioral science with technology to emulate a live coaching session.

This approach allows for the creation of a personal action plan for each participant that can address his or her unique intrinsic motivations and compliance barriers to medication adherence.

This type of online coaching encourages patients to follow their physicians instructions as well as aims to provide pharmaceutical companies with an effective solution to support medication adherence.

A study conducted with a large pharmaceutical company showed that a tailored digital health coaching programfocused on increasing patient awareness and medication adherenceresulted in a 21 percent increase in self-reported smoking abstinence with nicotine replacement therapy versus a control group that received untailored content.

The technology behind digital health coaching allows for delivery in other mediums as well.

Another study, involving a statin medication, demonstrated a 21 percent increase in two measures of medication adherence when patients received tailored print and IVR coaching versus a control group that received generic information.

These results suggest that personalized and individually tailored online, print and IVR behavioral interventions are promising ways to positively affect the intrinsic motivations for medication adherence, and can potentially reduce healthcare expenses through lowered managed care costs.

Used in conjunction with other patient support programs, digital health coaching can engage and motivate patients to take an active role in improving their long-term health outcomes with proper medication usage and better health choices.

Furthermore, healthcare providers, pharmaceutical companies, and patients need to continue to focus on what the patients unique set of medication adherence barriers are and how to work with them.

With an ever-changing healthcare landscape, pharmaceutical companies need to continue to look at new and unique ways to encourage medication adherence.(For more on technology and compliance, see Q&A: Wireless solutions for patient non-compliance, Pfizers eCard and adherence in emerging markets, and The role of new technologies in enhancing compliance.)

Kevin Wildenhaus, a clinical psychologist specializing in health behavior change, is director of behavioral science and data analytics at HealthMedia, [] a Johnson & Johnson company and part of the Wellness and Prevention business.

For all the latest on compliance, join the sectors key players at Patient Adherence, Communication & Engagement Europe on May 31-June 1 in Berlin.

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