Noncompliance refers to the failure of patients to take the medications prescribed to them. This costs the industry an estimated $280 billion each year and results in a 10% increase in hospitalizations. In fact, his issue could already be classified as a major public health problem.
In a study conducted by Dr. Kevin Volpp of the University of Pennsylvania’s Center for Health Incentives, patients with heart failure who were given Internet-linked pill bottles and a cash incentive for taking their pills on time failed to increase medication adherence.
Researchers in drug companies work for years, sometimes even decades, in order to develop highly effective drugs to cure several illnesses. These pharmaceutical companies conduct several clinical trials to establish the efficacy of every medication. After, they go through the tough process of getting approval from the U.S. Food and Drug Administration (FDA).
For medication to work, patients need to take them. A patient’s failure to take the prescribed medication could result in a hospital admission (or readmission). Researchers found that failure to doctor-prescribed drugs have resulted in an average of about 100,000 preventable deaths each year.
Unsurprisingly, one of the most common excuses given for not taking the prescribed medications is forgetfulness. As a result, several companies have come up with different versions of smart pill bottles. The bold idea aims to provide a solution to the “forgetfulness” issue.
To validate the notion that forgetfulness is the reason behind the problem of non-adherence, Dr. Niteesh Choudhry, a physician and professor at Harvard Medical School, conducted a randomized trial of 50,000 patients who were prescribed cardiovascular medications or antidepressants. Each patient was given one of three tools: a standard daily pillbox, a digital cap that functions like a stopwatch, and a pill bottle with toggles marking if the medication has been taken for the day.
The expectation was that patients who used the pill bottle with the digital cap would improve their pill-taking habits, but it surprisingly was not the case. It appeared that a reminder was not powerful enough as there was no improvement in their pill-taking habits, regardless of the tool they were given.
Internet of Things Makes Smarter Bottles
A proposed solution to the problem came in the form of “smart” pill bottles. Riding on the Internet of Things (IoT) technology, several companies developed their own version of an Internet-connected pill bottle and caps that can send reminders, through email or text messages, to take the pills. Relatives, caregivers, and other third parties may also get alerts so they can remind the patient about taking his or her medication. The smart bottles could be purchased from the manufacturers or are given out by pharmacists.
AdhereTech currently leads the pack of smart pill bottles manufacturers, partnering with the world’s largest pharmaceutical companies, pharmacies, and healthcare firms to make give patients worldwide access to the smart pill bottles. AdhereTech’s wireless pill bottles automatically gather and send adherence data, with the company’s robust software system analyzing the information in real-time. Missing a dose will result in the patients receiving customizable interventions such as automated phone calls, text messages, or personalized support.
AdhereTech’s CEO, Josh Stein, claims that patients’ adherence to the medication regimen increased by an average of 24%. However, large-scale evaluations of the smart-bottle technology showed less encouraging results. In a study conducted by Dr. Kevin Volpp of the University of Pennsylvania’s Center for Health Incentives, patients with heart failure who were given Internet-linked pill bottles and a cash incentive for taking their pills on time failed to increase medication adherence. The expected reduction in hospital readmission and lower health care costs did not materialize.
Smart pill bottles, even when partnered with cash incentives, did not work in patients who kept on failing to take their medication. It is becoming apparent that the reason behind medication non-adherence is not forgetfulness. In many cases, patients do not want to take their medications every day as medication reminds them of the illness or illnesses they have, a negative thought they do not want to welcome.
Reminder technology in the form of smart pill bottles is a bold idea, and is a great part of the solution. However, it is highly possible that there may be something else needed to change the patients’ behavior.