Battling Nonadherence: What Actually Works?

James F. Sweeney

Disclosures

May 07, 2019

In This Article

Fear Is Not a Motivating Factor

Scaring patients with the consequences of nonadherence also doesn't work, Tsai said, explaining that warning a diabetic patient that he will have to take insulin if he doesn't manage his diabetes might cause him to view the drug as a punishment.

He also uses a pointed interviewing style more likely to get to the truth. For example, rather than asking a patient whether is he is taking his medications, he asks how many doses he's missed.

Using Technology to Motivate Patients

It used to be that the only opportunity physicians had to motivate, prompt, and check on patients was in the exam room.

However, in the past two decades, technology has made it easier for healthcare professionals to monitor patients' adherence, remind them of what they should be doing, and contact them when they're not doing it. Dozens of companies provide hardware and software tools designed to improve adherence. They include such things as text messaging; smart pill bottles; apps; connected devices, such as inhalers; incentive and gamification programs; and more.

How effective tech has been is the subject of debate and conflicting studies. What's clear, however, is that tech will continue to be a part of comprehensive adherence programs.

Jason Rose, MHSA, CEO of AdhereHealth, said the most effective technology will rely on data, but add a personal touch. For example, AdhereHealth (formerly PharmMD) scrapes data from pharmacies, physicians, insurers, healthcare systems, and elsewhere to identify instances in which patients are not filling prescriptions, not taking medication, or otherwise not adhering to treatment plans.

The company's clinicians then contact the patient, not just to remind them but also to determine why they're not adhering to the treatment plan.

"We'll ask whether they have food in the fridge or whether they have access to a pharmacy," Rose said. "We try to get to the root cause, because that's the best way to address it long-term."

The platform can provide the patient with additional information and resources, while the in-house pharmacy can deliver medication to the patient's door. AdhereHealth also will review patient medications to look for ways to save money or simplify the regimen.

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