Meeting the Challenge of Patient Adherence With Medical Devices

The impact of non-adherence

Non-adherence has been deemed the ‘biggest killer’ in healthcare. A lack of adherence causes nearly 125,000 deaths, costing the already strained healthcare system between $100–$289 billion a year,  and affecting more people than any single disease. Up to 10% of hospital admissions and 23% of nursing home admissions are linked to non-adherence. 

With most published figures related to non-adherence of pharmaceutical regimes, the added cost of non-adherence to medical device protocols present an equally bleak picture. Evidence suggests that overall, only a third of all patient adhere to their prescribed treatment protocols (including medical devices, pharmaceuticals, and life-style changes.)

Causes of non-adherence

There are a number of factors that contribute to patient non-adherence. Inadequate patient education is a major cause of non-adherence. When patients either don’t understand the severity of their condition, or how the prescribed treatment will improve their health, then they can fail to follow through on the necessary treatment plan. 

Lack of education about how to correctly use devices can also lead to non-adherence, either because the treatment was not administered due to incorrect device usage, or patients stop using the device because they don’t see any benefits resulting. 

Patients frequently assess their situation and make a judgment whether they think they need to adhere based on their own impressions, rather than on the advice of their physician. If a regime or procedure is too complex or confusing for a patient then they often fail to follow recommended guidelines.

What can be done to improve adherence?

Patient education and understanding is a key factor in adherence. There are two aspects of patient education; understanding the disease/ how the treatment plan will improve their health; and providing adequate technical support for patients using medical devices. Researchers have advocated towards having the patient's own physician provide one-on-one education, and have a trained tech team provide skills training around using the medical device. 

Data integration between various stakeholders has been shown to “facilitate a precision medicine perspective by identifying patients with critical health risks who would benefit greatly from targeted adherence efforts.” Data integration enables providers to react to real time changes in adherence patterns. 

Healthcare regimes should be tailored to fit the lifestyle requirements of each patient. It has been suggested that the more information a healthcare provider has on the individual patient’s living situation and lifestyle, the easier it is to overcome barriers to adherence. In the battle to achieve full adherence, knowledge is power because increased understanding allows the creation of a patient centric approach with a plan tailored to that person’s individual needs.  

The use of wearable devices has been demonstrated to improve medication adherence. To the point that having patients adopt using a wearable activity tracker has been proposed as a solution to improved medication adherence, regardless of whether the tracker provides any reminders about the medication regime. Simply using the wearable device may be enough to encourage greater adherence. 

Digital adherence reminders have proven to be popular with patients. Studies found that not only did patients appreciate receiving reminders to follow required treatment protocols, 67% wanted to receive additional feedback with a summary of their actions and to share that information with their physician.

How connected care solutions can improve adherence

Information is the key to improving patient adherence on many levels. With an increasingly connected world, our ability to collect and disseminate information about patient healthcare choices has increased significantly. Offering the capacity to collect an abundance of real time data, the internet of medical things (IoMT) has been presented as the solution to many of the problems causing non-adherence. 

The essential first step in patient compliance is for patients to understand their condition, how the treatment protocol will help them, and how to carry it out according to instructions. The first step must involve one-on-one contact/instruction for the patient, which could be provided by  the healthcare provider or can be conducted remotely using the connected device streamlining the onboarding process. Connected care solutions can also provide invaluable tools for the second and subsequent steps, for follow up and further instruction. With built-in training and patient engagement systems, patients can access additional information if they are unsure about how to proceed. Real-time alerts indicating whether a device was used correctly can help patients to make the needed adjustments and perfect their device usage. 

Some studies have suggested that continuous follow-ups would help patients know if they are taking their medications as prescribed – connected medical devices can alert patients to when they are not following prescribed directions. Providing patients with information about their own compliance levels has been shown to lead to a nearly 20% increase in compliance. 

This sort of ongoing communication with patients, giving real time input based on their compliance and device usage, can only truly be achieved through using connected IoMT solutions. With constant, automatic data input from patients, connected care solutions offer the ability to both collect and share information. 

By connecting all relevant stakeholders, including patients, caregivers, payers and the medical device company, data relating to adherence can be pooled with many benefits. On the patient level, as shown above, notifications about past adherence can prompt better future adherence. Caregivers are able to respond to indications of poor adherence either following up with patients or correcting protocols. Payers are able to use this data to corroborate reimbursement claims, while medical device companies can incorporate associated learnings into their future product development strategy.  

Connected care solutions can also be used to deploy artificial intelligence (AI) algorithms to predict and adapt to adherence issues. By using AI to analyze and then predict patient behavior, potential adherence issues can be addressed before they occur. 

How to connect existing medical devices for improved adherence

With the benefits of improving patient adherence are obvious, and the advantages of using IoMT solutions to achieve this aim are clear, the question remains of how best to connect an existing device? Creating a medical-grade cloud with the capacity to manage large volumes of data can be very costly and time consuming. As can be developing the necessary infrastructure and integrations to connect hardware and software in a way that enables easy access throughout the ecosystem. 

A growing number of medical device manufacturers are choosing to ‘buy’ rather than build their own system. For example,  when Vectorious created the world’s first direct heart pressure monitor, by partnering with BioT they were able to send patients reminders to charge the implant. 

BioT offers a unique no-code, self-service platform for connecting medical devices, creating connected care solutions from any device. The modular system allows manufacturers to integrate connectivity into their offering in a fraction of the time and cost of developing their own system. Customizable user interfaces enable manufacturers to easily connect patients, caregivers and other stakeholders. BioT’s self-service platform allows manufacturers to make the entire transition in a matter of day (for some cases it only take one day.) 

For a free trial of the BioT platform, click here 

Conclusion

It is no longer enough for manufacturers to launch a new healthcare solution and leave it to users to worry about adherence. The human and financial cost of non-adherence is too high. Thankfully new avenues of positively influencing patient adherence have opened up due to the development of the IoMT. Now is the time for all medical devices to make the move to become connected care solutions. 

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