Innovative Solutions Prompt Medication Adherence

NOVEMBER 01, 2006
Eileen Koutnik-Fotopoulos, Staff Writer

Medication adherence is an ongoing problem in the health care industry. For patients, nonadherence to their medications could have deadly consequences. The US health care industry estimates $100 billion is the annual price tag for nonadherence. Research has also indicated that traditional intervention programs have failed to maintain healthy adherence rates. PAR3 Communications Inc has developed outreach solutions to help retail pharmacies, pharmaceutical manufacturers, and health system administrators improve medication adherence through personalized patient interactions.

Recently, PAR3 and Vitality Inc, a developer of device-enabled services designed to motivate medication adherence, launched an initiative. Vitality has developed GlowCaps, which replace standard pill-bottle caps and use low-cost wireless technology to continuously monitor patients' dosing behavior. Integrated into Vitality's proprietary network,the GlowCaps simply glow when it is time to dose and become more insistent if doses are missed. The technology works through a timer and transmitter in the cap that sends a signal to a night-light device in the home that also glows. The night-light device further sends a signal to a modem attached to the patient's telephone line, which transmits a signal to the vendor. If further intervention is needed, interactive voice or text notifications are delivered to patients and caregivers using PAR3's communication solutions.

"Adherence is a major problem across all demographics. It's such a widespread problem," said Joshua Wachman, president of Vitality. The company wanted to work with a partner that could handle the back-end communication, and PAR3 fit the profile. "It's a natural fit because they are already in the market with pharmacy. It's a nice synergy between both companies," he explained.

Michael Ross, MD, vice president of health care for PAR3, said "We are working with Vitality on a visionary approach to patient intervention that combines leading technologies to better address adherence by understanding patient behavior. By addressing dosing behavior in real time, rather than weeks after a compliance lapse, we can improve patient health, while reducing the rising costs associated with nonadherence."

Together, the 2 companies will monitor how patients are taking their prescribed medications and deliver personalized patient communications that include motivational, instructive, and diagnostic messages. Vitality is conducting a pilot program with GlowCaps at Meridian Health System in New Jersey, which is scheduled to begin by the end of the year. PAR3 and Vitality's will launch their integrated offering in early 2007.

Patient nonadherence is a scenario all too familiar to Dr. Ross. He said, if you follow patients taking long-term medications for 6 months, "you'll see the patients become nonadherent. It's really a precipitous decline in the first 3 months." Dr. Ross emphasized the key to patient compliance is ongoing, open dialogue with patients.

In May 2005, PAR3 deployed its Prescription Fulfillment Suite with Duane Reade. The system automatically contacts patients, initiates a dialogue, and promotes medication compliance. The technology forms a 2-way communication conduit between the pharmacy and its patients. The proactive notifications maximize prescription compliance by identifying and triaging patients at greatest risk for nonadherence and alerting patients about available refills and last-fill scenarios.

Dr. Ross explained that patients interact with the message by using their telephone keypad or speaking a response. The questions and options can be customized for each pharmacy setting. Patient summaries are sent to a group of pharmacists who make outreach calls the following day. PAR3 works with 68 health care customers, allowing them to tailor the system to their specific needs.

"It's not enough for a pharmacy to get the prescription filled. The pharmacy has to get it out the door," said Dr. Ross. The one-on-one contact "elevates the dialogue between the patient and provider," he added.

Duane Reade, which automatically enrolls patients in the program unless they opt out, has seen positive results with the PAR3 platform. Of the patients receiving an automated call, twice as many were compliant with their medication refills, compared with those who did not receive a call.