With medication errors and suboptimal use costing billions of dollars every year, it’s no wonder that multiple sectors of the pharmaceutical world are exploring new ways to improve patient adherence.
Patient adherence, also known as patient compliance, is the degree to which a patient follows medical advice. In the context of pharmaceuticals, it means taking the right medication at the right time and in the right quantities. Poor patient adherence can cause healthcare problems resulting from forgetting to take a drug, taking too much or too little of it, taking it twice or simply taking the wrong thing.
Poor adherence is a growing problem, and an expensive one too. Researchers at the Center for Injury Research and Policy and the Central Ohio Poison Center at Nationwide Children's Hospital analysed medication errors that resulted in serious medical problems in the US, and found that the rate per 100,000 people doubled from 1.09 in 2000, to 2.28 in 2012. The most common errors were taking (or giving) the wrong medication, incorrect dosages and taking medication twice. The categories most often associated with serious outcomes were cardiovascular drugs (21%), analgesics (12%) and hormones/hormone antagonists (11%).
Other research indicates that suboptimal use of medication, including taking too much or too little, costs $300bn in avoidable healthcare every year in the US. In simple terms, people who take their medicines promptly and correctly are more likely to stay out of the hospital or emergency rooms. So while serious errors are still thankfully rare, there’s still a lot that could be done to improve patient adherence to prevent health problems and reduce the load on healthcare providers.
The simplest way to influence patient adherence is to include information on the packaging of a medication. While healthcare professionals will obviously provide their own guidance, this written information is the last chance to ensure compliance before the patient actually takes the drug.
Patient adherence packaging plays an important role at multiple stages of a drug’s life cycle. During clinical trials, it’s crucial that patients take the Phase III product correctly, or investigators will draw wrong conclusions. At launch, patient compliance depends on starter packs featuring clear reminders, on the carton and possibly also on the blister pack. Later on, adherence packaging helps patients administer the drug and remember refills.
Standard package inserts are created primarily for health professionals, and their language and format may actually confuse patients rather than help them. To avoid this, more and more firms are creating separate patient package inserts, which tell patients what they need to know in clear and simple terms.
Connected to the cloud
New technologies promise to help improve adherence. As populations age and more and more people need to take medications on a regular basis, packaging that can remind them when to take it becomes increasingly valuable. Wearable devices could monitor effects such as patients’ blood pressure to show doctors how medication-taking behaviour is affecting them. Using the data gathered, predictive analytics could identify the patients who are most at risk of medication-related issues.
Medical devices are another area of innovation, and traditional device companies are making more and more investments in connected health solutions. Drug delivery devices can communicate with a mobile device or directly with the cloud, opening up a range of possibilities from simple patient reminders through to valuable insights for carers, physicians, payers and pharmaceutical firms. Matt Jennings, president and CEO of Phillips-Medisize Corp predicts that patients could have as many as six connected items by 2020.
While smart packaging and devices may seem expensive, the growing commercialisation of expensive and sophisticated biotechnology-based drugs could provide the revenues to cover their costs.
Whatever the future holds, patient adherence seems certain to remain a hot topic over the coming years.