WHY ARE PATIENT MEDICATION ADHERENCE SOLUTIONS FAILING US?
Our role as designers is to develop solutions which drive increased adherence and, at the same time, adapt to socio-cultural and behavioral challenges.
Despite a myriad of products designed and sold on the market today, there has been very little impact on patient medication adherence rates. There are many factors, intentional and unintentional, for why patients stop taking medications, including patient forgetfulness, the associated negative side effects, the cost to fill prescriptions, and the lack of perceived benefit from the medication itself, to name a few.
Current patient medication adherence solutions ask patients to adopt new and often conflicting behaviors to achieve the benefit of the system, which often results in poor or even negative results. Additionally, there is little consideration of the care model and sensitive provider workflows to deliver this value to patients. Targeting specific patient populations and indicators/demographics is critical to developing personalized interventions and approaches. This is also integral in developing a substantive ROI, which is too often missed and underdeveloped.
Today, almost half of all Americans, approximately 133 million people, live with a chronic condition. People with chronic conditions account for 83% of healthcare spending and those with five or more chronic conditions have an average of almost 15 physician visits and fill over 50 prescriptions in a year. Up to 90% of patients on medication for chronic conditions stop taking their medications within the first year.
Lack of prescription adherence costs between $250 billion and $300 billion annually. We have a crisis forming around us and a huge hurdle to overcome. Driving patient medication adherence is critical to keeping patients safe, reversing the long-term effects of our prevailing lifestyles, and combatting the enormous healthcare expenditure.
We believe we can classify the reasons why products designed and sold on the market today have had minimal influence on patient medication adherence rates into four vectors. They are:
Patient Adoption. Depending on the complexity of the patient, whether they are newly diagnosed, light chronic, or complex chronic, the adoption needs are distinct and different. Therapeutically complex patients have a difficult time and often do not or cannot change their medication management behaviors for a new system or device. It is critical to define new solutions by taking great care to not dramatically disrupt already habitual routines or processes that patients have built for themselves.
Operational Workflow. Many adherence solutions require radical changes to a proven and often sensitive process within a pharmacy, provider, or hospital workflow. These workflows are often very cost-sensitive and require complex change management processes to be developed and deployed. Understanding these workflows and the cost of changing them is important to consider when introducing a new solution into the market.
Patient Target. Currently, adherence aides available try to impact everyone. Unique indicators require targeted, specific interventions and solutions for adherence to be impacted. Understanding the device usage, how that device impacts the therapy or procedure, and ultimately, how it plans to impact the disease state or patient’s life, is critical to the device design in the first place.
Value / ROI. Organizations providing adherence aides today are built off of business cases with lofty assumptions and massive adherence benefits. Understanding that even an adherence lift of 1-2% can be very difficult to achieve in some cases and how we monetize that lift is often missing from the picture. The economics of many products do not take into account the scale required to provide positive ROI and business transformation.
Solving for these four vectors is a critical ask. Design matters in healthcare and we need to develop solutions that will play a role in driving improved patient medication adherence as well as advancing health outcomes.