Why mHealth, rather than physicians, could be the answer to compliance issues
News just in from the boffins at the Institute for the Totally Obvious: ‘Patient non-adherence to prescribed medication costs the U.S. health system an estimated $290 billion annually and can lead to poor clinical outcomes, increased hospitalisations and higher mortality’.
OK, the figure is pretty shocking – roughly equivalent to the entire GDP of Greece – but the idea that patient adherence is problematic is hardly groundbreaking stuff. And actually, in a way, the way this is presented is slightly insidious: the headline from WorldPharmaNews reads ‘Physicians don’t adequately monitor patients’ medication adherence’.
Personally, I think it’s a little rich to point the finger at physicians for current levels of low adherence. Isn’t placing the burden of monitoring drug adherence on already-overburdened doctors (without giving them the tools) a little like telling a horse with a broken leg to run faster?
Apparently researchers found that ‘providers felt responsible for assessing and addressing adherence, but believed patients were ultimately responsible.’ And with the existing pressure on doctors, of course patients are. What’s the alternative? Doctors can’t be around patients 24/7, so obviously much of the responsibility will inevitably have to fall on patients. Until we invent a device that enables doctors to split themselves up into as many versions of themselves as needed, in order that they can follow patients around like their own personal medication bully, this is the way it has to be.
Sorry, what’s that you say? We already have something?.
Yes, OK, I’m being a bit disingenuous here. Of course, we already do have a pretty effective tool to help us to do this. It’s called mHealth.
The problem is, mHealth is still often perceived as a scary new venture by many people in the healthcare industry, despite the ubiquity of mobile phones and mounting evidence that it works for both patients and the accounts department. Yet it’s still not being pushed forward. And if it’s not being pushed, can we blame patients who aren’t using it?
This type of wholesale change to the way we practice medicine needs to come from the top. And we have to take some of the responsibility to really farm it out.
So how do we do this? Let’s start with using it for remote clinical trials. As I have previously reported, mHealth provides a great opportunity to bridge the gap between the ‘perfect’ world of clinical trials, and the ‘real’ world where drug non-compliance actually exists.
But how? I hear you cry. After all, look at what happened to Pfizer!
Well, the first step is to turn properly to social media.
Mashable recently dedicated an article to encouraging companies to recruit using Facebook, following on from big-name success stories. In the same week, TechCrunch revealed the increasing efficacy of Facebook ads. And finally, Mashable also reported that, despite the explosion in apps available, downloads remain stagnant.
Now, the lack of downloads is partly because, as the article notes, the market is swamped with diet and fitness apps, with fewer ‘serious’ health apps available. But surely it’s also got something to do with the fact that we are simply not marketing them properly.
If there are social media success stories from other industries, we can’t we follow suit? Why not apply the concept of job recruitment through social media to clinical trial recruitment on social media? After all, Facebook has the data available to enable us to target the ads effectively. And beyond the ‘general population’ platforms, we have ready-made audiences just waiting to be contacted on sites like Drugs.com and PatientsLikeMe.
And once we’ve got the remote monitoring sorted for clinical trials, it becomes almost inevitable (perhaps with a bit of pushing) that this technology will trickle down through the doctors’ surgeries and into the patients’ hands.
This is a great opportunity for pharma to be at the forefront of improving patient health. Let’s be brave and take the lead.
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