In medicine, compliance (also adherence, capacitance) is the degree to which a patient will follow medical advice provided by their health provider. Most commonly, it refers to medication, drug compliance, but can also apply to other situations such as medical device use, self care, self-directed exercises, or therapy sessions and supplements. The FDA states the common barriers to medication adherence:
- The inability to pay for medication.
- Disbelief that the treatment is necessary or helping treatment.
- Difficulty keeping up with multiple medications and complex dosing schedules
- Confusion about how and when to take the medication
- On Physical Patient Adherence Tool
Before proceeding further with my thoughts on adherence tools, apps and hardware, if you or someone you know is looking for a simple tool to remain compliant, have them sign up to our site to get started.
Medicine Compliance Technology
Recently I saw some very interesting physical medication adherence tools, these are $500 electronic gadgets, that seem like they are made by Apple and store up to 10 set of compounds that are dispensed everyday at a pre-programmed time. It is a very “cool and hip” product and definitely will help those with the some funds remain healthy and that is great, however, we have a tool in our pockets, or at most homes already, on a desktop that does the same thing.
During our initial survey of patients (especially seniors) we learned that many are not willing or don’t want to take an interest in even downloading an app that will help them comply with their medication. One of the top reasons patients do not comply to their medication is laziness, and the second being forgetfulness. These two reasons account for 85% of patient adherence levels, among those that have purchased their drugs. So what did we decide to do after learning this? for better or for worse, we decided we will postpone building a mobile app for just a tad bit longer and make our web interface better. Wait, how does that make sense? Well for one our site is fully responsive so it should render great on any phone, secondly with our medication reminder emails, you will get an alert on your phone via an email app (which many people have anyway) or natively. The seniors were not interested in learning or using a new app, but most had email software that they use to keep in touch with their relatives..bingo! The cost: free. I need to do some further research and surveys to determine how easy it is to load these devices and how often people are willing to “reload” them, I think some of them allow you to load up to 60 days worth of drugs.
Now creating a reminder app or even software is not a technological feat in an of it self, but if it is effective and it can help even a few lives, the difference is worth it, at least to us. I think the real challenge is leveraging technology to increase adherence rather in anyway rather then fixating on a reminder app, with this mindset, we can take the whole picture into account, which involves all the steps. Why is this important? In the US alone deaths due to patient medication noncompliance reaches $100 to $140 billion annually. Globally I suspect the cost is 10x this amount and will probably grow in the coming years as baby boomers age.
TrackMyStack Medication Compliance Tool
(& How we are the best!)
If you are looking for a simple medical adherence tool for your friend and understand the need to use one, click here to read our step by step guide to using trackmystack as medication tracking tool and health journal. We are tackling the problem totally differently then any incumbents: First, we have a knowledge base of drugs and supplements, it has taken a lot of time to do research/write just the main important information on supplements and drugs. So if a patient or user wants to quickly learn more about what they are being told to take, they can without leaving our platform, there certainly is no need to “Google it”. This also removes the need for a medication compliance handouts that needs to be given or the pharmacists prescription letter to be put up on the fridge as a reminder of what dosage needs to be taken and when. However, I think the number one thing that needs to be done is that physicians absolutely need to spend more time educating their patients on the problems associated with noncompliance. Information on side effects need to be drilled into the patient, and commonly overlooked issues such as when one may be feeling better, it is critical to still complete their treatment. This, I think should be seen as the #1 compliance tool — something to ponder — are there any unethical doctors out there that may see noncompliance as beneficial for business? Let’s not go down that rabbit hole, as I don’t think it is a real problem that exists for most people.
The second thing we decided to do to improve patient compliance was journaling, journaling helps lessen cognitive load, and it will help you record any symptoms or benefits you may be noticing from your drug or supplement regimen (remember reason #2 — “Disbelief in treatment”) so here we address that as well. The way we figure out what to build next is by talking to patients and thinking like patients first, then confirming our beliefs with potential studies to prove our hypothesis. Surgeon General C. Everett Koop once put it with his customary forthrightness, “Drugs don’t work in people who don’t take them.” and when a support network or a patient does not log an entry with adherence daily, the patient should understand why “the drug does not work”.
The #4 reason of confusion as to when to take one’s drugs and the quantity is the basic premise of TMS and I think we have the foundation in place and see people complying at a much higher rate than before. Another issue relating to the problem of disbelief is not the treatment being effective or not, it is that 20% of patients perceived possible side effects of taking them. We are working on releasing graphs and statistics as part of our info pages, where users can see which side effects are common and what other patients like them experienced during the course of their treatment.
Another less common reason, #7 reason for non-compliance is “Worries about the social stigma associated with taking medicines.” — I think by having a social network of patients undergoing the same treatment or taking the same drug, albeit online, may help alleviate any stigma that may persist when one may not have or know people going through the same condition in real life; support networks work, and we make it easy to see what similar patients are taking and what symptoms/conditions they deal with daily.
Patient Adherence to Medication
With our admittedly limited testing of patient adherence to supplements and with small pharmaceutical companies, we have noticed that many users are more likely to use the platform when they have a support community and I feel by making a treatment stack public (anonymously — under an online alias), patients can be held more accountable by our community and by others offline, such as family and friends if provided the URL to your stack. A lot of patients that we observed, went further and decided to create wellness stacks to prevent their health from deteriorating, prevention as they is better than the cure. Noncompliance because of forgetfulness, laziness, improper knowledge and disbelief were to put it bluntly “thrown out the door” by our users.
Hopefully this short brain dump on medicine compliance/tools and how we “stack” up against other methods was interesting to someone, and if you are a patient, a family doctor, pharmacist or someone looking to improve their own health or someone else’s, get in touch with us with tips or comments or we recommend you start using our platform (for free) to improve the efficacy of your treatment for your chronic condition or your goal by letting us helping you adhere to your stack in a more meaningful (and fun) way. Some last words below on health goals:
Compliance of Health Goals
“Compliance” implies that patients are passive actors in managing their chronic conditions. “Adherence,” according to the World Health Organization (WHO), suggests just the opposite: that doctors and patients team up to help patients actively engage in maintaining their health. As I have always said, good health starts at home and now more than ever patients need to start monitoring and quantifying their own health. This does not mean do not seek medical consultation from an expert rather take your regimen a step further and actively try to manage your health with your doctor, by keeping logs of any side effects, compliance rates, mood, anxiety or anything else, you provide evidence or help your medical practitioner by giving them the data needed to try to identify any patterns quicker, they will appreciate it and you will benefit. Another term being used is “concordance” which is intended to convey an active partnership between the patient and the health care professional, it is primarily used by the Royal
Pharmaceutical Society of Great Britain.
Many people are amazed to know the vast amount of users we have using our platform for non illness related health issues. I am talking about the amateur body builders, people with mild stress, people that want to age gracefully (the anti-agists), people that want better cognitive function (the nootranauts), etc. This can be attributed to the ease of use of our platform, the effectiveness of having reminders to help manage goals, and need I say, the fun aspect involved in working on one’s “personalized stack”. Even though a lot of these “treatment stacks” are not generally “prescribed” by health care professionals, an MD is generally there to help “fix you up to get back to normal.” I think the question asked by many quantified-selfers on our platform is “What If I can feel better than I always have, or how do I get to my peak performance?” Being healthy does not generally need to stop at not being sick, but feeling your absolute best at all times, and I think this is where and why “functional medicine” comes into play, it’s about looking at your whole body and making sure everything is running as smoothly as possible at all times. This way you will hopefully not get sick as often but you will also feel better than average as well, something current medicine does not focus too much on.
Patient care is always improving and we want to play a role in helping patients recognize the importance of routines and adherence, by providing patient education and tools that make a positive impact.