Mobile and digital health’s potential to help bring about healthy behavior changes has led a number of companies to target the problem with new connected devices, applications, and services. Some of these have claimed to be highly effective: MediSafe recently stated that their app raised users’ adherence rate to 81 percent over the course of its first eight weeks that it was made available, and Vitality GlowCaps once reported pushing adherence rates to as high as 98 percent, both well above the World Health Organization average of 50 percent. NEHI has stated that digital health offerings similar to these have considerably improved adherence, but the market penetration for these tools is still low.
The challenge for these companies is not just to develop an effective product, but also to figure out who will pay for it. That means addressing the sticky question of whose problem med adherence really is.
Patients don’t take their medication for a number of reasons. Forgetfulness is one, particularly in chronic disease patients who have a large regimen of pills to keep track of and in elderly patients who may have poor memories or become confused easily. But other patients don’t take their meds for psychological reasons: some patients “feel fine” and skip a drug, some are concerned about real side effects. Some, according to NEHI Senior Health Policy Associate Nick McNeill, are concerned about imagined side effects. Finally, many patients stop taking medications because they simply can’t afford the co-pay. This, of course, is not a complete list but it does include some of the more commonly referenced reasons. Digital health could play a role in resolving some of them.