Toward digital-based interventions for medication adherence and safety

ABSTRACT

Introduction

Adherence to the prescribed use of medications is a major problem for many patients. Whether intentional or unintentional, the failure to take medications as prescribed results in an array of health problems, hospitalizations, and increased health expenditures.

Areas covered

The paper reviews the different types of interventions to promote the appropriate use of medications from provider-based to digital-based interventions. These interventions often combine passive and interactive approaches and may include bio-surveillance/monitoring. Many studies have evaluated these interventions in a variety of conditions and patient population, demonstrating mixed outcomes.

Expert opinion

The complexity of the underlying causes of poor medication adherence may warrant personalized interventions that combine passive/interactive and personal/digital options. Enriching patient trials may enable observation of larger effect sizes.

KEYWORDS:

• Medication adherence
• education
• mobile technologies
• precision medicine

Article highlights

• Medication adherence remains a substantial challenge in healthcare, contributing to reduced health outcomes, adverse events, and hospitalizations.

• Medication adherence is impacted by several factors, including perceived need and/or benefit, affordability, and forgetfulness.

• A range of interventions are available to promote medication adherence, particularly digital health tools.

• Utilization of digital health tools to optimize medication adherence will depend on several patient, provider, and health system factors including patient comfort with the application or device, availability of health provider support to set up and maintenance, cost, health provider infrastructure to integrate into electronic medical record, and patient comfort with sharing information with their provider.

• Oversight of the application or device is paramount to address privacy and confidentiality of patient data and accuracy/reliability of the device.

• As digital health becomes more routinely used and accepted by patients and providers, some of the initial barriers may be overcome.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they have received research, speaking and/or consulting support from a variety of companies including Galderma, GSK/Stiefel, Almirall, Alvotech, Leo Pharma, BMS, Boehringer Ingelheim, Mylan, Celgene, Pfizer, Ortho Dermatology, Abbvie, Samsung, Janssen, Lilly, Menlo, Merck, Novartis, Regeneron, Sanofi, Novan, Qurient, National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate and National Psoriasis Foundation. They also consult for others through Guidepoint Global, Gerson Lehrman, and other consulting organizations. They are founder and majority owner of www.DrScore.com, and founder and part owner of Causa Research, a company dedicated to enhancing patients’ adherence to treatment. All other peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.