August 10, 2018

Clinical view on adherence tracking devices

Commentary
Julie Carty

We recently completed an interview with Peter Chai, an MD and Medical Toxicology Fellow at the University of Massachusetts, Toxicologist and primary author of numerous publications on digital health studies. Focusing on the clinical perspective, we captured Peter's insights on the following questions.

Which solutions do you see delivering the greatest impact on improving medication adherence?

Measuring Adherence is Difficult Current measures of adherence rely on patient feedback through self-reporting, pharmacy prescription refills and advancing technology like smart pill bottles. These measures of adherence have varying levels of accuracy, and indirectly measure adherence in aggregate. Adherence data is difficult to interpret – how sure can you be for oral medication that the opening of a smart pill cap/box correlates with the patient actually taking the medication. Digital Pills Deliver the Greatest Impact Digital pills provide direct, real-time measures of adherence by monitoring true ingestion events. Medications coupled with an ingestible biosensor that activates only upon contact with the stomach ensures that remote signals of adherence are true. Not only does this improve upon the quality of the data, but ingestible biosensing allows for detection of nascent episodes of non-adherence, allowing clinicians to intervene before behaviors associated with nonadherence become ingrained.

How do you see devices like these incorporating into your daily consults?

As an emergency medicine physician, ingestible biosensors can be used to improve home care, assess post-discharge, discover medication ingestion patterns and help ensure patients adhere to their medication regimens. Real-time medication adherence data already enhances my consultant process with patients. I can address irregularities with prescription patterns at an early stage and without over-reliance on subjective data from patients. The application of smart technology to monitor adherence will only increase. The question is in what form? In a younger tech-savvy population, apps and connected devices will gain traction. In older populations we will need to rely more on passive monitoring and interventions.