This week, eyeforpharma presents three articles on how to improve adherence through mobile technology. In the second, Niaz Rizwani, associate consultant with Blue Latitude, on 5 compliance-boosting solutions
The father of Western medicine, Hippocrates, is reputed to have said “Keep a watch also on the faults of the patients, which often make them lie about the taking of things prescribed.” Not only is this the premise on which House, M.D. is entirely based, but it also highlights a problem that has plagued medicine since time immemorial, that of adherence.
A patient not taking their medication, refilling a prescription or fully completing a course has many implications. For the pharmaceutical industry, there is an obvious financial impact but, more worryingly, patients simply may not get better. And we’re not just talking about antibiotics for an ear infection here. There are many long-term, chronic illnesses where patients aren’t completing the very therapies designed to save their lives.
Given the number of possible causes—often entirely personal to the patient—for low adherence, there’s no single magic bullet that can resolve this issue. However, the increasing availability of access to the Internet through mobile is providing a variety of ways in which new technology can solve an age-old problem. While simple access to the Internet through mobile devices can help immensely by giving patients better access to knowledge and support, beyond this there are a number of approaches to mobile-driven adherence and compliance currently being tried and adopted. Below,we look at five of these in detail and highlight the adherence barriers that each solution might be able to address.
1. QR codes
You’ll be familiar with QR codes by now; they’re those strange pixelated barcodes squares seen in newspapers, magazines, adverts on the train and even on the telly. A recent study showed that 14 million Americans scanned a QRcode in June this year, usually to buy something. But the same functionality could be utilized for the more noble purpose of adherence.
Placing a QR code on the packaging of medicines could provide a direct mobile Web link to patient information, automated calendar reminders and patient support. More importantly, this step would get this information off the pack, where it often goes unread, and into the pocket of the patient.
Even the humble SMS, the most commonly used data application on mobile phones worldwide, can play a part in adherence. To reach patients in resource-limited settings in sub-Saharan Africa, cheap mobile phones have been used to increase adherence among patients on antiretroviral therapies. Simply sending text message reminders has resulted in a 90% adherence over a 48-weekperiod; some clinical trials for chronic illnesses only report adherence between 43-78%. (For more on SMS, see Patients’ Week 2011: SMS as a tool to increase adherence .)
At the other end of the spectrum of technical complexity, consider the “smartpill”(coming soon to a gut near you). This contains a chip activated by stomach fluids that can relay messages to a sensor (in or on the skin). This sensor may, in turn, communicate to a mobile device that can send information to a doctor. The doctor can then check that the patient is taking the medication and also monitor for adverse reactions with other drugs. A bit too Big Brother? Perhaps, but this is up for FDA approval ... (For more on smart pills, see The role of new technologies in enhancing compliance.)
Technology itself can also be augmented with techniques and interactions to help change attitudes toward medication and health. The current buzzword of choice, for example, is gamification, which seeks to make technology more engaging by leveraging various fundamental psychological and behavioral mechanics. The diagnostics sector is using mobile technology to help patients monitor themselves, but there are now glucometers that can link to your child’s Nintendo to turn self-monitoring into playtime (or so the theory goes…). (For more on gamification, see Future pharma: Making games work for pharma.)
5. Mobile apps
A crowded space these days, among which my personal favorite is an app that uses cough recognition technology to diagnose influenza. Users simply cough into the phone and the app is able to differentiate an everyday cough from potential flu, pneumonia or another respiratory disease.
The greatest influencers in tackling the challenge of adherence are healthcare professionals—and, obviously, patients themselves—but the pharmaceutical industry also has much to lose and much to possibly gain if this challenge can be overcome. Thinking creatively when looking to solve the problem of patient adherence will help drive healthy outcomes for all parties, and it’s clear that mobile technologies can deliver a number o finterventions, which can both encourage and empower patients. Just imagine how impressed Hippocrates would have been …
Niaz Rizwani is an associate consultant with digital business and marketing consultancy Blue Latitude.
For more on adherence, join the sector’s other key players at Patient Summit Europe on May 29-30 in London.
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