Jerry Fahrni

MedFolio, more medication compliance technology

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Jerry Fahrni

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Seems like everyone has some piece of technology designed to help patients with medication adherence and/or compliance.

What’s interesting to me is the number of different approaches there are out there to solve the problem. MedFolio looks similar to the old style medication organizers. It’s probably the most labor intensive solution I’ve seen, but then again it may be the most useful. Hard to say. From the videos I found on YouTube it looks like it’s been around for a while.

From the MedFolio website:

“The MedFolio Electronic Pillbox was designed by a pharmacist who has spent countless hours in “brown bag” medication sessions with patients of all ages.  Therefore, the features of the MedFolio Pillboxfinally address the needs of patients, caregivers, and their healthcare providers.  The unique physical features of the MedFolio Pillbox were designed to keep medication identification and organization simple.  The electronic pillbox can be easily transported to every medical-related appointment or the individual pill storage boxes can be detached from the device for those individuals on the go.  The unique built-in pill identification system is a portfolio of every medication stored in the pillbox, thereby giving the patient/caregiver the confidence to engage in medication management discussions with their healthcare providers.  In order to help patients in remembering to take the “right dose at the right time”, advanced medication reminder systems have been incorporated into the electronic device. The MedFolio Pillbox connects to a personal computer by USB and installed software allows the patient/caregiver to easily customize the device to their specific medication regimens and dosing times.  The medication information stored into the memory of the pillbox will initiate audio alert and visual lighting reminders from the device.  Additionally, the software program will communicate with a secure website to offer the option of receiving electronic messaging reminders (e-mail and text message) for each scheduled medication dosing time.”

Medication compliance/adherence is a pretty hot topic. Probably has something to do with the cost associated with it. According to the National Consumer League “Poor medication adherence is a $290 billion problem annually, with three out of four Americans reporting that they do not always take their medication as directed, and causing more than one-third of medicine-related hospitalizations and nearly 125,000 deaths in the United States each year.” Yeah, that’s not good.

So in theory better adherence/compliance could save healthcare a big ol’ pile of money. Health Affairs found that better adherence to diabetes medications could lead to reduced hospitalizations, fewer visits to the emergency department and could potentially save billions in healthcare dollars.(1) The researchers concluded that “… a typical accountable care organization with 10,000 Medicare beneficiaries might be able to save up to $1.1 million annually in emergency department and hospital costs by improving adherence among its patients with diabetes.” Hey, it’s not $290 billion, but it’s better than a poke in the eye with a stick.

Everyone knows the problem, but figuring out how to fix it has brought about some interesting solutions. They run the gamut, from public service announcements and dedicated websites such as www.ScriptYourFuture.org, to simple technologies like the GlowCap, the Pill Timer, MedReady, and the use of simple short messaging services (SMS), i.e. text reminders (2-8), to highly advanced and complex systems designed to automated medication adherence tracking such as the Proteus system, which was approved by the FDA last year. There is an endless array of tools designed to help patients adhere to their medications. Which one’s the best? Who knows, probably a combination of things.

References:

  1. Jha AK, Aubert RE, Yao J, et al. Greater adherence to diabetes drugs is linked to less hospital use and could save nearly $5 billion annually. Health Affairs.2012;31(8):1836-46.
  2. Pop-Eleches C, Thirumurthy H, Habyarimana JP, et al. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS. 2011 Mar 27;25(6):825-34.
  3. Montes JM, Medina E, Gomez-Beneyto M, Maurino J. A short message service (SMS)-based strategy for enhancing adherence to antipsychotic medication in schizophrenia. Psychiatry Res. 2012 Aug 16. [Epub ahead of print].
  4. Fischer HH, Moore SL, Ginosar D, et al. Care by cell phone: text messaging for chronic disease management. Am J Manag Care. 2012 Feb 1;18(2):e42-7.
  5. Lester, R., Ritvo., Mills, E., et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomized trial. The Lancet. 376:1838-1845.
  6. Strandbygaard,U., Francis, ST., Backer, V. A daily SMS reminder increases adherence to asthma treatment: A three-month follow-up study.Respiratory Medicine. 2009; 104:166-171.
  7. Hanauer DA, Wentzell K, Laffel N, Laffel LM. Computerized Automated Reminder Diabetes System (CARDS): e-mail and SMS cell phone text messaging reminders to support diabetes. Diabetes Technology & Therapeutics. 2009; 11:99-106.
  8. Miloh T, Annuziato R, Arnon R, et al. Improved adherence and outcomes for pediatric liver transplant recipients by using text messaging. Pediatrics. 2009; 124:e844-e580. (free full text PDF)

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