The U.S. healthcare system is highly fragmented in nature. Poor patient engagement, rising healthcare costs, and an unclear support program are all signs of gaps in therapy, resulting in worsening health conditions, increased doctor visits, prolonged hospitalization, and adverse affects and mortality.
As such, the pharma industry is increasingly searching for ways to identify and bridge gaps in therapy, seeking to personalize outreach strategies and improve patient engagement, quality performance, and individual health outcomes. Anticipating patients most at-risk for medication non-adherence is especially important in treating patients with chronic and often costly conditions, as the consequences of medication non-adherence (or other gaps in therapy) are often more substantial.
Additionally, the COVID-19 pandemic created numerous gaps in therapy. According to the Centers for Disease Control and Prevention (CDC), approximately 41 percent of U.S. adults have either delayed or avoided medical care during the pandemic, putting off medication refills due to financial burdens, supply chain struggles, mental health challenges, and more.
Here is what you need to know about predicting and addressing gaps in therapy:
What Are Gaps in Therapy?
Although they can manifest in many ways, some of the most common examples of gap in therapy include:
Poor Medication Adherence
Medication non-adherence is probably the most common issue as far as clinical gaps in therapy are concerned. Poor adherence to prescribed medications can lead to negative health outcomes, unwelcome side effects, worsening health conditions, and even mortality. Plus, medication non-adherence negatively impacts the health system as a whole by increasing the costs of care due to having to manage adverse effects from not taking medications properly.
Skipped Prescribed Health Sessions
Patients following prescribed medical treatments are essential in maximizing health outcomes. This can include everything from physical therapy to returning to a healthcare provider for a follow-up. These treatments are often prescribed or required because they are intended to help a patient on their health journey. When a patient misses these sessions or follow-ups, it can lead to a greater risk of poor health outcomes and slower or halted recovery.
Difficulty with Quantity Limits
Insurance plans use quantity limits to define how much of a drug patients can fill during a specific time period, but they can be a hassle to work with. They might not always line up with how much medication a patient has been prescribed to take, which in turn makes it difficult to get a refill for those who’ve run out. This can result in missed doses until the next allowed filling period.
Using AI to Determine Next-Best-Actions
Bridging gaps in therapy is possible with the right technology, data, and strategic approach. Pharmaceutical marketing is now leveraging artificial intelligence (AI) to identify next-best-actions, which are determined by analyzing millions of consumer data points across all channels. AI-powered patient engagement programs powered by next-best-action modeling make a positive impact on medication adherence, initiation, and other gaps in therapy.
How? Using AI, machine learning, and predictive analytics, it is possible to predict each patients’ risk of medication non-adherence, dropping out before refilling, or similar gaps in therapy. Once the AI identifies high-risk individuals with the greatest likelihood of being influenced by an intervention, it predicts the best channel, messaging, timing, and frequency for each of them.
For example, if a patient indicates that they won’t be refilling their prescription, predictive AI can deliver the next-best-action in the form of an SMS, phone call, or other best-suited intervention method, to change patient behavior.
This highly personalized approach allows pharma and other healthcare organizations to provide clinical education that closes gaps in therapy and improves quality performance—and your organization could be next.
Let’s connect to discuss how AllazoHealth uses data analytics to identify and bridge therapy gaps, improving patient outcomes and enhancing quality performance in the process.