Technology offers tools for ensuring adherence to medical therapy
Novel monitoring solutions will move all stakeholders—not just patients—to a position of responsibility for adhering to prescribed regimens.
The role of the physician must not be undervalued in maintaining adherence to therapy; she (he) plays a vital role in continued patient engagement and behavioral training. Integrating physician-led oversight, patient education, and commitment, and novel digital mobile adherence technologies will help deliver better outcomes.
The push to engage. A “one size fits all” approach to maintaining adherence won’t be effective. We need to better understand the individual patient’s underlying cause(s) for nonadherence, then to tailor a solution to influence and change that behavior. One way to do this is by interacting and engaging more directly (and in a digital manner) with patients to monitor adherence.
A recent example of the move toward direct patient engagement is the agreement entered by Otsuka Pharmaceuticals and Proteus Digital Health to develop novel digital health products. The FDA has accepted for review the combination product of Otsuka’s brand of aripiprazole and Proteus’s ingestible sensor. If the product is approved by the FDA, physicians will be able to prescribe aripiprazole with the ingestible sensor embedded in the tablet and then measure medication adherence and other patient physiologic metrics (eg, activity, rest) through the wearable sensor patch and medical software application designed specifically for patient and physician use.
This technology could have huge potential in mental health care, where patients struggle with both adhering to their medication regimen and communicating with the health care team. Physicians could measure adherence when treating adults with schizophrenia, bipolar disorders, and major depressive disorder; flag those who are not adhering as having higher risk of disease progression and poorer outcome; and allow decisions to be made more quickly based on treatment need.
Developing and enhancing these collaborative and patient-centric approaches will increase self-monitoring and patient responsibility, and encourage behavior change.
‘All-in’ strategy. By continuing to use the latest technologies and connecting them to the range of stakeholders—physicians, nurses, pharmacists, payers—we will develop an all-inclusive adherence intervention strategy. All patients will be integrated, and all of them, and their family, will be provided with positive psychoeducational care and motivational counseling (Figure 5). In addition, such a support-based patient experience must be aligned with the work of clinical care providers. Compliance therapy and behavioral training, together with active patient engagement, can help improve insight, acceptance of treatment, and, over the long term, adherence.31,32
