NONADHERENCE

Quality healthcare outcomes depend upon patients’ adherence to recommended treatment regimens. Patient nonadherence can be a pervasive threat to health and wellbeing and carry an appreciable economic burden as well. In some disease conditions, more than 40% of patients sustain significant risks by misunderstanding, forgetting, or ignoring healthcare advice.

Nonadherence carries a huge economic burden. Yearly expenditures for the consequences of nonadherence have been estimated to be in the hundreds of billions of US dollars (DiMatteo 2004b). Estimates of hospitalization costs due to medication nonadherence are as high as $13.35 billion annually in the US alone (Sullivan et al 1990). In addition to the most obvious direct costs, nonadherence is also a risk factor for a variety of subsequent poor health outcomes.

Glaucoma is a preventable cause of blindness if timely effective and successful treatment is provided. Patient adherence to the medication is a constant challenge that is now recognized as an essential component to treatment. Several studies have demonstrated that patients are more likely to be adherent to their medication if they understand the disease and the rationale for treatment and if their treatment regimen is simplified. Additionally, using eye drops has its own set of challenges that must be recognized and addressed at the clinical level. Although numerous socioeconomic factors are associated with poor adherence, these factors must be addressed at the societal level. Maximizing patient adherence to medication has the potential to reduce the number of surgical interventions required to treat glaucoma, prevent unnecessary vision loss, and save the overall healthcare system money in the long run.

USE OF TECHNOLOGY

Smartphones, tablets, smartwatches, and other mobile devices have grown to become staples in lives. Leveraging these for medication reminders has never been easier due to the fact most users rarely leave home without it. For many individuals, these tools are the primary means of gathering information and managing daily life. If approached strategically, this ubiquity of mobile technology offers a unique and powerful opportunity for healthcare stakeholders to engage with their patients.

TECHNOLOGY ALONE WON’T SOLVE ADHERENCE

Technology is only one component to increasing medication adherence. Recent studies have evaluated technology-based interventions to improve medication adherence by using pharmaceutical databases, tailoring educational information to individual patient needs, delivering technology-driven reminders to patients and providers, and integrating in-person interventions with electronic alerts. Mobile apps used to communicate reminder messages have shown mixed results. Only one study has shown improvement in both adherence and clinical outcome. Current trials suggest that increasing automated reminders will compliment but not replace the benefits seen with in-person communication for medication-taking.

ENGAGEMENT AND COMMUNICATION WITH PATIENTS IS KEY

The beauty of all of this new technology coming to the market is that it can really push the paradigm of patient engagement regarding medication use. No longer restrained to office visits, mobile technology has offered the ability to communicate with patients outside of the clinic and in the community setting where they belong. If technology can help keep them there, and can help bridge the gap between patient and providers and also empower patients, then it should be an option.