New gee-whiz technologies are improving patients' compliance with their drug regimens.
Reasons for non compliance
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In ancient Greece, Hippocrates warned his students they would encounter patients who wouldn't take the treatments prescribed
for them. Centuries later, the Father of Medicine's caution is still being echoed by the likes of former U.S. Surgeon General
C. Everett Koop, who lamented, "Drugs don't work in patients who don't take them."
Patients who don't take their medications or who take them improperly are a plague on healthcare systems around the world.
The World Health Organization estimates that adherence to long-term therapy for chronic conditions averages about 50% in industrialized
countries, and it's even worse in developing countries. Studies have shown that when prescriptions are written, one-third
of patients take the medications as prescribed, one-third take some of the medicine, and one-third don't even bother to fill
the prescription.
Google it
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Patients and society pay a heavy price for the underutilization of medications due to problems with compliance, which contributes
to an estimated 128,000 deaths annually in the United States, according to research cited in the article "Medication Adherence,"
in the Aug. 4 issue of the New England Journal of Medicine. Up to 11% of hospital admissions and 40% of nursing home admissions are due to failure to adhere to medication therapy. And
the direct and indirect costs of nonadherence are approximately $100 billion per year in the United States.
High tech
Since 65% of adults in a recent Harris Interactive poll said they forgot to take their medications, developing devices that
jog patients' memories has been an obvious point of attack on noncompliance. Recognizing the limitations of the little plastic
pillbox and human nature, some enterprising folks have built a better compliance mousetrap. Drug Topics decided to take a look at some of the ones that have literally added bells and whistles to alert patients when it's time to
take their next dose of medicine.
One kissing cousin of the plastic pillbox is MedivoxRx Technologies' Rex, a talking pill vial that helps blind, visually impaired,
and illiterate patients take their meds. Rex and his chatty competitors, including Aloud, Beep 'N Tell, and Talking Rx, use
microchips that allow the patient, caregiver, or pharmacist to record a message about the drug and how to take it.
Higher up the electronic evolutionary chain is OnTimeRx, a Web-based reminder system for the Palm Pilot and Pocket PC crowds
that was developed by Susan Torrico. The Florida pharmacist is now busy preparing to launch OnCellRx for cell phones and pagers.
When MedPrompt entered the patient compliance field 16 years ago, its "better mousetrap" was a cardboard slide designed to
be stuck on the refrigerator, said VP Mike Hamilton. Now the Texas-based firm offers subscribers a reminder service through
a programmed alphanumeric pager or other wireless device. In addition to serving consumers directly, the firm partners with
pharmacies willing to offer the pager service.
"Our clients are organizations and independent pharmacies," said Hamilton. "MedPrompt gives them a good tool to differentiate
themselves from the chains. The consumer price is $39.95, but pharmacies get a discounted price. We customize our programs
to the pharmacy's focus."
Can you hear me now?
If Alexander Graham Bell knew that his invention would morph into the cell phone, he might have decided to become a plumber
instead of an inventor. But since the devices have become a staple of American life, entrepreneurs are trying to cash in by
turning them into a compliance tool.
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