A recent press release from the European Society of Cardiology indicated that using a smartphone app, which reminds patients to take their medications, improved overall patient medication adherence. From the description, the app reminds a patient when to take his or her medication, and the patient enters a confirmation once the medication has been taken. Measurements based on the Morisky Medical Adherence Scale show the use of the app had a substantial impact on adherence – results showed that percentages increased from 21% to 65% when measured after 90 days. The app also allowed prescribers to monitor the patients’ adherence during the course of the study.
Apps such as this one should be a part of a comprehensive plan to support medication adherence because they provide a critical point of influence that is rarely addressed – the interaction with a patient on a daily basis at a time when the patient should be actually ingesting the medication. Most programs do not have a mechanism to directly impact this behavior, and instead rely on periodic calls, face-to-face conversations, automated phone messages, etc.
Even through a sizable positive impact was seen on adherence rates during this particular study, reduced results may be realized when deployed at a larger scale due to the increase of opt-out rates over time as more patients begin to view daily reminders as an annoyance. An increased number of patients may also choose to simply ignore the reminders altogether. The press release does not indicate how many people stopped using the app during the study, or how many people stopped entering confirmations after the medication was taken. The real possibility of increased drop-off rates over time supports the fact that an app like this can be used to train a person on appropriate medication adherence behavior over a short period, but these types of apps must be used as part of a long-term adherence program if the effect is to be sustained.
READ THE FULL PRESS RELEASE HERE:
“Smartphone app reminds heart patients to take their pills” – Published online October 19, 2019
In another recent article, Kelsey Waddill reports that the concept of using mobile messaging or reminders to support adherence has shown mixed results; however, the article points to optimism in combining mobile reminders with copay reductions or rewards.
The first part of the article discusses the impact of copay reductions on medication adherence, and finds that providing medication with $0 copays could improve adherence rates. Several payers are moving forward with plans to offer $0 copays for specific medications to their members; Blue Cross and Blue Shield of Minnesota went so far as to offer $0 copays for insulin!
Unfortunately, there is no panacea to address medication adherence challenges, which is why multiple engagement and support techniques are needed. Coupling mobile messaging with copay reductions or other financial incentives can increase the impact of the program by lowering the rate of opt-out and decreasing the number of patients who ignore the reminders.
READ WADDILL’S FULL ARTICLE HERE:
“3 Strategies for Payers to Improve Member Medication Adherence” – Published online October 9, 2019
Addressing the points made in these two articles, AllazoHealth has found that most effective programs utilize multiple outreach channels (e.g., live call, mobile, face-to-face, email), multiple types of messaging (e.g., simple reminders, general adherence counseling, medication synchronization education), and multiple support mechanisms (e.g., financial assistance, delivery); however, the challenge with all of that complexity is finding the right combination for each patient at any point in time. An AI platform like the AllazoEngine can dramatically increase the likelihood of positively influencing the patient when they need support. It can balance the efficacy of the intervention, the characteristics of the patient, and the resource constraints of the organization to find the right combination of channel, message, mechanism, and patient to deliver the most effective adherence program possible.
A recent study has confirmed that providing free medications can improve adherence. Unfortunately, even with free medications, a minority of patients were considered adherent, improving to 38% in the study group from 26% in the control group. Therefore, when creating programs to address adherence, we need to have support mechanisms for a range of barriers – cost, transportation, side effects, education, et al. As programs increase in complexity to support patients’ spectrum of barriers, it becomes increasingly challenging to ensure you provide the right intervention to the patient at the right time while not over communicating and causing opt-outs or patient dissatisfaction. An AI platform like the AllazoEngine can use sophisticated models and predictive analytics to identify the best intervention to leverage for each patient and the best time to execute the intervention. Combining a robust program design with an intelligent and continually learning platform to optimize the program outreaches will help your patients improve their adherence and, in turn, help your organizations achieve their adherence goals.
READ THE STUDY HERE:
The CLEAN Meds Randomized Clinical Trial – Published online October 7, 2019
AllazoHealth In The News:
Kory Zelen shares his experience as an intern at AllazoHealth with Linda Schultz, Vice President of Customer Success at Allazo, in the latest Northeast AMCP Newsletter:
Student Chapter Update
Before attending the AMCP national conference in March, I had only a basic knowledge of how a pharmacist can make an impact in the managed care setting. The conference was able to give me an introduction to pharmacists that have had tremendous success in this space. This experience motivated me to get some rotational experience in managed care during my final year of pharmacy school. When I reached out to my new network of managed care pharmacists, they were extremely receptive of my curiosity. One clinical pharmacist in particular, Dr. Linda Schultz, was able to create an intern role for me at AllazoHealth and provide me with the opportunity to explore this curiosity.
My role as an intern at AllazoHealth was to support the development of clinical strategies and customer success for clients that included payers, pharmacies, and pharmaceutical companies. I was able to see the different techniques that are used to improve patient health and how important it is to personalize these techniques to the specific patient and situation. Something that is unique to AllazoHealth is the fact that they leverage artificial intelligence and machine learning to tailor the targeting recommendations they provide to clients. This level of data analytics is not an area that I had any exposure to in pharmacy school and showed me how healthcare and technology can be extremely complimentary to one another.
My time at AllazoHealth has been a great introduction to the managed care pharmacy world overall. As I continue my work as a remote employee during the remainder of my rotations, I am excited to take on more projects to further explore how my PharmD training can contribute to better patient care and collaborative healthcare in this setting. I would recommend to anyone thinking about exploring the managed care pharmacy practice, to just go do it! I’m so glad I did.
Kory Zelen – University of Buffalo
AMCP Student Chapter