Patient adherence programs are continually searching for more cost-effective interventions that improve clinical outcomes. Tactics have expanded beyond outreach by phone call to digital channels including emails and SMS text messages.
In a trial of text and email interventions for smoking cessation, researchers note that “Emails are easily deployable, inexpensive, and can deliver long, complex messages… The always-with-you nature of the mobile phone and the intrusiveness or push factor of text messages makes this a simple, low-commitment way to receive support.”
Digital interventions offer more choices
The accelerating adaptation of digital channels either used in conjunction with phone calls, or replacing them, has led to an explosion of choices when designing patient interventions.
Outreach by phone call has a fairly limited set of variables that can be modified and tested, including:
- Day or evening call
- Introduction script
- Content script: for example, a reminder call such as “Fill your prescription”; or an offer such as “Change to a 90 day prescription”
For digital interventions, there are many more variables to consider. In a meta-analysis of text messaging for chronic disease adherence, researchers found that adherence programs used multiple strategies for messages, including:
- Frequency and timing of messages
- Messages triggered by patient failure to act (such as opening a smart medicine bottle)
- Content such as: reminders, offers, education, general topics
- Subject lines in email
- Length of messages
In another study of patient interventions for Type 2 diabetes authors noted that patients receiving intervention texts could opt-in to additional text-based educational protocols and customize their delivery preferences.
Managing digital complexity
Artificial intelligence is increasingly being used to manage the complexity of digital patient interventions. Sophisticated AI technology can now predict which channels and combination of variables will be most effective for each patient in an adherence program, while taking into account program cost and objectives.
Since AI can make predictions about the response of individual patients across multiple channels and variables, it enables adherence programs to take a holistic view of outcomes. It offers the opportunity to focus on optimizing overall program performance, rather than the effectiveness of a particular channel that may be limited to testing a small set of variables.
Adherence program changes: making the right decision
AI can also be employed when adding digital channels to an existing adherence program. Without data about effectiveness, adding digital channels to an existing program can be challenging. AI can provide guidance by accurately predicting the effectiveness of adding a particular channel to a program.
Another challenging decision is whether or not to end an adherence program. Programs tend to gather momentum and organizational support as they age, even if they lose effectiveness. AI can supply comparative data that can justify the difficult decision to modify or end a program.
Too many messages for patients?
When adherence programs evolve over time, senders, messages and channels can proliferate unintentionally. Since email and text are lower-cost channels, organizations might be incentivized to over-communicate.
So patients can be inundated with communication such as drug information, refill reminders, dose reminders, 90 day prescription offers, or education about their condition. Often these patients will become irritated and will ignore or opt-out of the program.
AI can provide a view of the entire universe of interventions for each patient and help programs identify redundancies and predict which channel, message, and timing the patient is likely to respond to.
AllazoHealth uses artificial intelligence to make a positive impact on individual patient behavior. We optimize medication adherence and quality outcomes for pharmaceutical companies, payers, and pharmacies. Our AI technology targets individual patients with the right intervention and content at the right time.
Building on our success in adherence, we have expanded our implementation of AI to include closing gaps in care and improving therapy initiation.