2. HEALTH 2.0 ADHERANCE MEETING
•The Problem , Size, Causes & Complexity
• Solutions
– Software Solutions - Dan
– Hardware Solutions – Chirag
– Contextual Reminder Stickers – Peter
• We can do better – Blue Sky
3. The Problem Defined
•Poor medication adherence
– defined as any deviation from the prescribed course
of medical treatment – is a significant source of waste
in our health care system.
*New England Health Institute
4. The Problem’s Size: Scope & Costs
•33% to 50% of all patients do not take their
medications as prescribed*
•Adverse Drug Reactions account for nearly**
• 10% of all hospital admissions in the US
• up to 140,000 deaths annually in the US, alone
• sixth leading cause of death in the US
• NEHI now estimates the current cost of drug-related
morbidity, including poor adherence, to be as much as
$290 billion annually – or 13 percent of total health care
expenditures.*
*New England Health Institute **Medscape.com-407005
5. High Adherence Cost Savings
Medical Care, 2005, vol. 43, no6, pp. 521-530 see APPENDIX via Vitality
7. Adherence Causes
Problem Regimens
Financial
Patient Behavior
Missed doses (sporadic forgetter, active decliner)
Gaps between refills (procrastination) (Home Delivery)
Drug Interactions
Psychological
8. Improving Adherence
Source: Avalere Health, NEHI Analysis
Improve Drug Regimen
Reduce Cost Barriers
Address Patient Behavior
Appropriate Medication Use
9. Adherence improvement needs more than
a tech device
Need to overcome multiple Research proved that best
BEHAVIORAL barriers solutions are multi-faceted
– reminders, alarms - gadgets
– Psychological – counseling, education on
– Financial specific condition
– human touch – nurse as a
– Behavioral coach
– Physical – automating Rx refill function
– circle of peers / patients w
same condition
– shared info with family /
caretaker / doctor
– rewards, incentives
Sources:
H McDonald et al: “Interventions to Enhance Patient Adherence 8
to Medical Prescriptions – a Scientific Review”, Journal of American Medical Ass’n, Dec. 11, 2002, vol 288, No 22
via Health-E-Dose
10. Software / Service
Reminder Services via phone
Eliza
Data Driven Healthcare Communications Solutions
Silverlink
Interactive Automated Voice & multi-Channel Communications
Medication Information
SurveyorHealth
Drug interactions & cumulative side effects
DoubleCheckMD
Drug Interactions & My Symptom Interaction Checker
iGuard
Free online Drug Interactions& Clinical Drug Trial recruitment
Mobile Applications
OnTimeRx
Email, Phone & SMS reminders
Personal Caregiver
Dose time & refill reminders & FDA Recall Alerts
11. Studies & Articles
Thinking Outside the Pillbox
New England Health Institute Report, Nov 2009
Express Scripts’ 2009 annual drug trends reportBasic
adherence can save $130B
Drug Adherence Throwdown
Disruptive Women in Healthcare -eBook
Real Solutions for Better Medication Adherence
5 recommendations