Reevaluating medication adherence in the era of digital health

2021 ◽  
Author(s):  
Timothy Dy Aungst
Keyword(s):  
Medication Adherence ◽  
Digital Health

scholarly journals The Association Between Medication Adherence for Chronic Conditions and Digital Health Activity Tracking: Retrospective Analysis

10.2196/11486 ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. e11486 ◽  
Author(s):  
Tom Quisel ◽  
Luca Foschini ◽  
Susan M Zbikowski ◽  
Jessie L Juusola
Keyword(s):  
Health Care ◽  
Medication Adherence ◽  
Health Outcomes ◽  
Fixed Effects ◽  
Digital Health ◽  
Positive Association ◽  
Activity Tracking ◽  
Pharmacy Claims ◽  
The Relationship ◽  
Age And Sex

Background Chronic diseases have a widespread impact on health outcomes and costs in the United States. Heart disease and diabetes are among the biggest cost burdens on the health care system. Adherence to medication is associated with better health outcomes and lower total health care costs for individuals with these conditions, but the relationship between medication adherence and health activity behavior has not been explored extensively. Objective The aim of this study was to examine the relationship between medication adherence and health behaviors among a large population of insured individuals with hypertension, diabetes, and dyslipidemia. Methods We conducted a retrospective analysis of health status, behaviors, and medication adherence from medical and pharmacy claims and health behavior data. Adherence was measured in terms of proportion of days covered (PDC), calculated from pharmacy claims using both a fixed and variable denominator methodology. Individuals were considered adherent if their PDC was at least 0.80. We used step counts, sleep, weight, and food log data that were transmitted through devices that individuals linked. We computed metrics on the frequency of tracking and the extent to which individuals engaged in each tracking activity. Finally, we used logistic regression to model the relationship between adherent status and the activity-tracking metrics, including age and sex as fixed effects. Results We identified 117,765 cases with diabetes, 317,340 with dyslipidemia, and 673,428 with hypertension between January 1, 2015 and June 1, 2016 in available data sources. Average fixed and variable PDC for all individuals ranged from 0.673 to 0.917 for diabetes, 0.756 to 0.921 for dyslipidemia, and 0.756 to 0.929 for hypertension. A subgroup of 8553 cases also had health behavior data (eg, activity-tracker data). On the basis of these data, individuals who tracked steps, sleep, weight, or diet were significantly more likely to be adherent to medication than those who did not track any activities in both the fixed methodology (odds ratio, OR 1.33, 95% CI 1.29-1.36) and variable methodology (OR 1.37, 95% CI 1.32-1.43), with age and sex as fixed effects. Furthermore, there was a positive association between frequency of activity tracking and medication adherence. In the logistic regression model, increasing the adjusted tracking ratio by 0.5 increased the fixed adherent status OR by a factor of 1.11 (95% CI 1.06-1.16). Finally, we found a positive association between number of steps and adherent status when controlling for age and sex. Conclusions Adopters of digital health activity trackers tend to be more adherent to hypertension, diabetes, and dyslipidemia medications, and adherence increases with tracking frequency. This suggests that there may be value in examining new ways to further promote medication adherence through programs that incentivize health tracking and leveraging insights derived from connected devices to improve health outcomes.

scholarly journals The Rise of Digital Health and Potential Implications for Pharmacy Practice

2017 ◽  
Vol 64 (1) ◽  
pp. 32-40
Author(s):  
Mickayla Clark ◽  
Thomas Clark ◽  
Afeefa Bhatti ◽  
Timothy Aungst
Keyword(s):  
Medication Adherence ◽  
Healthcare Professionals ◽  
Digital Health ◽  
Pharmacy Practice ◽  
Daily Practice ◽  
Comfort Levels ◽  
Technological Advances ◽  
Integration Of Technology ◽  
To Come ◽  
The Way

The rise of technology in healthcare has led to dramatic changes in approaches to patient care by healthcare professionals. The realm of digital health has created new opportunities for pharmacists to engage patients in clinical practice. Pharmacies and industry are increasingly integrating these innovations into their businesses and practice. This article highlights areas of digital health for pharmacists to be aware of, in particular regarding areas of medication adherence and disease management. Technology plays a massive role in our individual lives; it has morphed the human experience in ways that were simply unimaginable 50 years ago. We use technology in nearly every facet of our lives. From detecting an appropriate intensity with which to brush our teeth to counting calories lost through the course of a day, technology has made a major impact on individual health. The integration of technology into our everyday lives has changed the way we communicate, how we capture and share our lives with others, how we seek answers, and how we experience life overall. Given this change in the way people operate, it is important that pharmacists adapt to these trends and incorporate technology into daily practice. The incorporation of mobile devices and technology into healthcare has been coined as mobile health (mHealth), which falls under the broader spectrum of digital health.1 –4 Digital health focuses on the integration of mobile tools (e.g., smartphones), wearable devices, and telehealth to help personalize the treatment of patients through the widespread adoption of wireless technology. The idea of involving pharmacists in mHealth has been a topic of recent interest, due in large part to the potential ramifications for the profession.4 Today, patients are using the Internet to research their health questions and help guide their personal health choices, and some of the information they find can be misleading and unreliable. It is of the utmost importance that healthcare professionals ensure there are credible sources for patients to research their questions. As pharmacists, we can research and recommend tools to patients to help solve problems related to drug information, medication adherence, and access, which includes the recent rise of novel technological devices. All of our patients will have different comfort levels with technology; despite this spectrum, there is a place for everyone to feel comfortable using digital health tools. However, there are recent technological advances coming to the field, which are already providing a benefit to patients, ranging from mobile applications to wearable technologies to ingestible medications that notify providers of patient medication adherence. We seek to help pharmacists understand the different areas of digital health, which may have substantial influence on the realm of pharmacy practice in the years to come by addressing current and upcoming digital health developments.

Abstract P135: The Role Of Digital Health In The Management Of Hypertension

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Onoriode Kesiena ◽  
Kofi Seffah ◽  
Navin Kumar ◽  
Eunice Hama
Keyword(s):  
Medication Adherence ◽  
Health Information ◽  
Digital Health ◽  
The Internet ◽  
Chi Square ◽  
Health Technologies ◽  
Medical Appointment ◽  
Use Of Technology ◽  
Use Of The Internet ◽  
Chi Square Analysis

Introduction: Digital health involves the use of technology to delivery health care. It is associated with improved clinical outcomes in various populations. We assessed its role in medication adherence in adults with hypertension. Methods: Data from the 2018 National Health Interview Survey data was used. We analyzed 8,224 respondents with hypertension representing about 69 million United States adults. The independent variables were: Use of the internet to (1) to look up health information (2) to fill a prescription and (3) to schedule a medical appointment and use of an email (4) to communicate with a healthcare provider. The dependent variable was anti-hypertensive medication adherence. Chi-square analysis was used to identify group differences and a logistic regression was used to analyze the association between digital health utilization and anti-hypertensive medication adherence. Results: Of the study population, 7,387/8,224 (89.8%) of the respondents reported adherence to anti-hypertensive medications. Those who were adherent were predominantly > 65 years of age, 4141/7387 (47.8%) and earned > $75,000/yearly, 580/2581 (25.2%). The use of internet to look up health information as compared to those who do not, was associated with 30% reduced odds of medication adherence [OR 0.71, 95% CI 0.59, 0.86, p=<.001]. However, this was insignificant after adjusting for covariates [AOR 0.92, 95% CI 0.89, 1.22, p=0.551]. Using the internet to fill up prescription as compared to those who do not, was associated with 47% odds of medication adherence [OR 1.47, CI 1.14,1.90, p=0.003]. This odd increased further after adjusting for covariates [AOR 1.95, CI 1.37,2.78, p=<.001]. No significant association was found in the relationship between medication adherence and scheduling a medical appointment with the internet or communicating with a provider via email even after adjusting for covariates. Conclusion: Increase adherence to anti-hypertensive medications is associated with online refill of prescriptions. This means that the use of digital health technologies in hypertensive populations can lead to better health outcomes. Future studies should evaluate other aspects of digital health use in hypertensive populations.

scholarly journals Psychiatric Prescriber Attitudes, Experiences, and Proclivities Toward Digital Medicine and How They Influence Adoption of Digital Medicine Platforms

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 144-145
Author(s):  
Charles Ruetsch ◽  
Dawn Velligan ◽  
Delbert Robinson ◽  
Chris Jaeger ◽  
William Carpenter ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Medication Adherence ◽  
Learning Style ◽  
Healthcare Cost ◽  
Digital Health ◽  
Opinion Leader ◽  
Test Site ◽  
Self Report ◽  
Uninsured Patients ◽  
Digital Medicine

AbstractBackgroundPsychiatric prescribers typically assess adherence by patient or caregiver self-report. A new digital medicine (DM) technology provides objective data on adherence by using an ingestible event monitoring (IEM) sensor embedded within oral medication to track ingestion. Despite likely clinical benefit, adoption by prescribers will in part depend on attitudes toward and experience with digital health technology, learning style preference (LSP), and how the technology s utility and value are described.Objectiveis to identify attitudes, experiences, and proclivities toward DM platforms that may affect adoption of the IEM platform and provide direction on tailoring educational materials to maximize adoption. Methods A survey of prescribers treating seriously mentally ill patients was conducted to assess drivers/barriers to IEM adoption. Factor analysis was performed on 13 items representing prior experience with and attitudes toward DM. Factor scores were correlated with prescriber characteristics including attitude and experience with digital technologies, LSP, and level of focus on healthcare cost.ResultsA total of 127 prescribers (56% female, 76% physicians, mean age 48.1yrs.) completed the survey. Over 90% agreed medication adherence is important, visits allow enough time to monitor adherence (84.1%), and tailoring treatment to level of adherence would be beneficial (92.9%). The majority (65.9%) preferred relying upon outcomes data as their learning style while 15.9% preferred opinion leader recommendations and 18.3% information about how the technology would affect practice efficiency. Factor analysis revealed four dimensions: Level of comfort with EHR; Concern over current ability to monitor medication adherence; Attitudes about value of DM applications; and Benefits vs cost of DM for payers. Women scored higher on attitudes about the value of digital applications (p<0.01). Providers who perceive non-adherence as costly, and those who believe DM could benefit providers and patients scored higher on the value of DM (p<.05). Those whose LSP focuses on improving efficiency and prescribers with a higher proportion of Medicaid/ uninsured patients displayed concern about their ability to monitor adherence (p<0.05). Willingness to be a Beta Test site for DM applications was positively correlated with concern about their ability to monitor adherence and attitudes about the value of DM (p <0.01).ConclusionsPrescriber characteristics including LSP, focus on healthcare costs, and attitudes toward DM may be related to adoption of the IEM platform. Those with more Medicaid/ uninsured patients were more concerned about ability to monitor adherence while those focused-on cost and benefit to providers and patients viewed DM as part of a solution for managing outcomes and cost. Overall, LSP, patient panel size by payer type, and focus on healthcare cost containment should be considered when developing IEM provider training materials.FundingOtsuka Pharmaceutical Development & Commercialization, Inc.

Review of glaucoma medication adherence monitoring in the digital health era

2021 ◽  
pp. bjophthalmol-2020-317918
Author(s):  
Alaa Erras ◽  
Bita Shahrvini ◽  
Robert N Weinreb ◽  
Sally L Baxter
Keyword(s):  
Intraocular Pressure ◽  
Medication Adherence ◽  
Real Time ◽  
Patient Adherence ◽  
Digital Health ◽  
Glaucoma Medication ◽  
Medication Usage ◽  
Adherence Monitoring

Current glaucoma treatments aim to lower intraocular pressure, often with topical ocular hypotensive medications. Unfortunately, the effectiveness of these medications depends on sustained patient adherence to regimens which may involve instilling multiple medications several times daily. Patient adherence to glaucoma medications is often low. Recent innovations in digital sensor technologies have been leveraged to confirm eyedrop medication usage in real-time and relay this information back to providers. Some sensors have also been designed to deliver medication reminders and notifications as well as assist with correct eyedrop administration technique. Here, we review recent innovations targeted at improving glaucoma medication adherence and discuss their limitations.

scholarly journals The role of the novel MyAlgos e-medicine Platform in promoting patient-centered self-care management in patients with atrial fibrillation: The emPOWERD trial

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
C Lazaridis ◽  
D Mouselimis ◽  
C Bakogiannis ◽  
A Tsarouchas ◽  
A Antoniadis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Medication Adherence ◽  
Care Management ◽  
Digital Health ◽  
Self Care ◽  
The Mean ◽  
Control Version ◽  
To Receive

Abstract Funding Acknowledgements Type of funding sources: None. Background The emergence of digital health has revolutionized most aspects of healthcare. Meanwhile, atrial fibrillation (AF) remains the most common sustained arrhythmia associated with high morbidity and impaired quality of life. Patient-perceived treatment burden can be further optimized by digital health interventions utilizing smartphone technology.  The MyAlgos platform is an integrated software system designed to enhance the remote management and communication between the patient and the healthcare practitioner. The mobile application encourages patient self-management through educational modules and tools to improve medication adherence. The web-based platform allows the health care practitioner to receive live updates on patient status and design personalized self-care management plans. Purpose  To investigate whether the use of the MyAlgos platform by AF patients is safe and improves the quality of self-care, quality of life (QoL), and hospitalization rate. Methods We designed a single-center, randomized, controlled, prospective, open-label, pilot study to compare the effect of the use of the full-feature MyAlgos platform version versus a stripped-down control version of the platform on the QoL, medication adherence and hospitalization rate in patients with paroxysmal AF.  The full version of the e-medicine platform includes active patient education, communication with the medical team, medication reminders as well as the full record of clinically significant data such as heart rate and blood pressure. Specialized algorithms monitor patient data and alert physicians for potential AF episodes. The control version only allows the recording of patient’s heart rate. Results A total of 80 patients with paroxysmal AF were randomized in a 1:1 ratio to receive either the full or the control version of the MyAlgos Platform. The mean age of all patients, 53 (66%) male, was 58.1 ± 9.1 years. Hypertension and diabetes were present in 47 (59%) and 7 (9%) respectively. At baseline, the majority of patients had AF-related symptoms classified as European Heart Rhythm Association (EHRA) I (45%) or EHRA II (24%), while the mean Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) score was 70.1 ± 17.0.  Between the two groups, there were no statistically significant differences in the baseline characteristics of the participants. Conclusion The emPOWERD trial will provide data on the impact of a novel e-medicine platform on the QoL, medication adherence and hospitalizations of patients with paroxysmal AF. We anticipate better outcomes for the subjects receiving the full version of the MyAlgos platform, allowing it to positively affect the further management of paroxysmal AF. Abstract Figure. The MyAlgos e-medicine Platform

scholarly journals Building MedVenture – A mobile health application to improve adolescent medication adherence – Using a multidisciplinary approach and academic–industry collaboration

2021 ◽  
Vol 7 ◽  
pp. 205520762110198
Author(s):  
Pooja Mehta ◽  
Susan L Moore ◽  
Sheana Bull ◽  
Bethany M Kwan
Keyword(s):  
Content Analysis ◽  
Medication Adherence ◽  
Mobile Health ◽  
Research Team ◽  
Qualitative Content Analysis ◽  
Digital Health ◽  
Healthcare Providers ◽  
User Engagement ◽  
Engagement Strategies ◽  
Industry Collaboration

Objective Mobile health (mHealth) tools are increasingly used to support medication adherence yet few have been designed specifically for the pediatric population. This paper describes the development of a medication adherence application ( MedVenture) using the integration of patient and healthcare provider input, health behavior theory, and user engagement strategies for adolescents with chronic gastrointestinal disease. Methods MedVenture was created by a multidisciplinary research team consisting of a gastroenterologist, a social health psychologist, software developers, and digital health researchers. Healthcare providers and adolescent patients were interviewed to identify barriers to medication adherence, explore ways that technologies could best support medication adherence for both patients and providers, and determine user requirements and core design features for a digital health tool. Intervention mapping was used to match themes from qualitative content analysis to known efficacious adherence strategies, according to a conceptual framework based on self-determination theory. Iterative design with review by the research team and two rounds of user testing informed the final prototype. Results Three themes were identified from content analysis: 1) lack of routine contributes to nonadherence, 2) adolescents sometimes purposefully forgo medications, and 3) healthcare providers would prefer a tool that promotes patient self-management rather than one that involves patient-provider interaction. These findings, combined with evidence-based adherence and user engagement strategies, resulted in the development of MedVenture – a game-based application to improve planning and habit formation. Conclusions Academic-industry collaboration incorporating stakeholders can facilitate the development of mobile health tools designed specifically for adolescents with chronic disease.

Sign in / Sign up

Export Citation Format

Share Document