Are patients taking their prescription medicines just as the doctor ordered? Turns out, chances are high they are not.

A 2011 report in Mayo Clinic Proceedings estimated that a shocking 50% of patients with chronic illness don’t take their medicines as prescribed. Long-term pharmacotherapy plays a significant role in helping combat disease, reduce health resource consumption, and lower hospitalization and mortality risk, however, the benefits of this type of medical intervention are largely missed due to poor medicine adherence.

 

Myriad reasons avail themselves as to why such a large number of patients don’t take their drugs as prescribed. These include:Cost and patient inability to afford regular doses

  • Communication barriers
  • Complex medicine regimens
  • Provision of care by multiple providers
  • Lack of family or caregiver support
  • Health illiteracy
  • Fluctuating patient attitude (don’t think they “need it”)
  • Too frequent dosing
  • Similar sounding pill names, shapes, and colors
  • Miscommunication about adverse side effects

High price points may be mitigated with free samples, health care reform, international ordering, coupons, and generic drugs, while the communication and drug scheduling comes down to the clinicians and patients/caregivers themselves. Is there a way to integrate technological innovations in the health and wellness space, like pill tracking apps, into a strategy for increasing medicine adherence in patients with chronic illness?

Research says yes, there is the potential for effectively bolstering medicine adherence by incorporating pill reminder and medical management applications and technology both in day to day patient life as well as in clinical practice. 

Some of the top rated drug tracking apps include:

Medisafe Medication Management and Pill Reminder App

Medisafe’s own research in conjunction with IMS Health found that their top-rated medication management and pill reminder app increased medicine adherence in patients with high blood pressure and high cholesterol when compared to a matched control group. Not only does Medisafe offer an app for download (iOS or Android) that can import your drug names and dosing from an existing pharmacy account (for most large commercial pharmacies), but their HIPAA-compliant, cloud-based infrastructure incorporates ‘connected’ pill bottles, api integrations, and more to help healthcare providers and patients connect and communicate more effectively.

Care Zone Health Info Organizer App (previously called AARP Rx Carezone App)

The Care Zone app for iOS and Android integrates a variety of health management features including journaling symptoms, pill and appointment reminders, contact lists for quick access to doctors, nurses, caregivers, etc., private and secure sharing capabilities, as well as to-do lists, calendars, notes, and a news sections.

Pillboxie

This iPhone (and iPod Touch) only app was developed by a registered nurse and solves the problem of medicine adherence complications from confusion over names and looks of pills. With a unique visual interface that physically lets you see the pills you’re taking and drag and drop them into the right days and times, Pillboxie’s pared down offerings still allow for users to set reminders, organize schedules, and share important information.

Care4Today

This app for iOS or Android claims a comprehensive interface that goes beyond medication reminders. Refill notifications and dosage reminders help navigate medication adherence while appointment alerts, activity and exercise logs, and progress trackers aid patients in advocating for and reporting on their own health and wellness with their doctors.

Pill Reminder - Drugs.com

With similar features as far as storing prescription name, dosing, and schedule information, the Pill Reminder app from Drugs.com (for iPhone) also sources real-time interaction and drug side effect data for patients to access. A personal notes feature plus pill reminders and the ability for you to take and upload pictures of your medicine for greater clarity help this medicine adherence app stand out.

How Can Clinicians Reinforce Good Medicine Adherence Practices?

While pill tracking apps can level the playing field for many patients with chronic illness who struggle with sticking to the proper dosing of their prescription medicine, clinicians can play possibly the most important role. Experts recommend clinicians practice:

Reducing dosage frequency: The more often a patient needs to give themselves medicine, the seemingly higher the risk of complications. Current meta-analyses have found that reducing dosage frequency from multiple times a day to once a day can improve medicine adherence and even decrease healthcare costs.

Address health illiteracy: Clinicians and doctors should practice recognizing and acting on the signs that a patient is having trouble reading the prescription information or discharge orders which have been shared with them. Prescription drugs often have long, complicated, unpronounceable names, and many prescription drugs looks like other drugs, with similar colors and shapes. Walking through complicated drug regimens should take time and clinicians should aim to:

  • Clarify the brand and generic names of the drugs
  • Explain what the drug does and how it helps with the patient’s condition
  • Discuss side effects and how a patient should manage and report them
  • Talk about tips for taking medicine - pill boxes, reminders, apps, etc.

Communicate with Family / Caregivers: Especially for older patients and those being discharged from the hospital or following up from a procedure, injury, or major medical condition, communication with a caregiver support system including family members, friends, and private caregivers is important. Clinicians should try and speak in person with caregivers to talk about medicine regimens and self-monitoring tools for the home like a blood pressure monitor and an accurate pulse oximeter.

With an estimated 125,000 deaths attributed to it yearly, poor medicine adherence is a public health issue clinicians and patients should be addressing.  Prioritizing adherence strategies with pill tracking and medication management apps is one potentially effective way to start.

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