Direct to Consumer

Oral Presentation

(DTC12-02) The Old Man and the App? Creating an Effective Adherence to Medication Application

Tuesday, April 25
2:20 PM - 2:39 PM
Location: W224 CD

Objectives
- Describe the potential of digital health interventions for older populations.
- Analyze the results of two successful interventions:
An adherence to medication app, designed for patients with several comorbidities, and used by them for extended periods of time, and
An app for adherence to medication and to blood pressure measurement.
- Learn and implement effective ways in which to achieve satisfaction, engagement and behavior change in elderly and tablet-naïve patients using a digital intervention.

Methods
Study 1: Between 2010-2012, the mobile application “Medication Plan” could be downloaded free of
charge from the Apple-App-Store. It was aimed at supporting the regular and correct intake
of medication. Demographic and health-related data were collected via an online questionnaire.
This study analyzed captured data. We analyzed results from 1799 users (74% male, median age 45) for whom data was captured. For this observational study, the DV was frequency and length of using the app.
Study 2: Coronary heart disease patients (N= 24, 50% male, mean age 73.8) with no prior experience with smartphones or tablets, received a tablet with the 'medication adherence' app, and an introductory tutorial session. They used the app for a month, and (in randomized order) also used a pen and paper adherence journal. The patients were recruited from local clinics via cardiac-rehab sports groups (we approached 100 patients), in 2015.

Results
Study 1: Variance analysis showed a significant effect of the users´ age regarding duration of usage (p = 0.025). On average, users under 21 used it for 23.3 days. Usage increased with age, up to users age >60 (103.9 days). “Daily usage intensity” increased with number of prescribed medications, from an average of 1.87 uses/d and 1 drug /d, to 3.71 uses/d for users taking over 7 different drugs daily (p < 0.001).
Study 2: Baseline mean subjectively assessed adherence was 50.0 (SD=3.44), and increased after the digital intervention (54.0; SD=2.01), more than after the paper system (52.6; SD=2.49) (for all pairs, P < 0.001). Logging data showed significantly stronger adherence for the app than the paper system for both blood pressure recordings (P < 0.001) and medication intake (P=0.033). Almost all participants wanted to integrate the medication app in their daily lives and required no further assistance with it.

Conclusion
Study 1: Patients age 60 and over engage in prolonged use of an adherence to medication app. Across ages, usage increases with complexity of medication regimen. This suggests that digital health solutions are required, and adopted, including by patients who are slightly older, albeit self-select to download an app.
Study 2: The results show that, despite being digitally naïve, elderly patients were capable to use an adherence app, which increased their adherence to medication and to blood pressure measurements. Further, following an initial training session, the patients used the app, and preferred it to a pen and paper system.
The results show the great promise of digital health in a scalable manner, as well as the modifications that need to be carried out for it to reach its full potential, including among the older and the less tech-savvy.

Talya Miron-Shatz

CEO
Curemyway, Buddy&Soul

I study medical decision making: my PhD. is in psychology. I taught consumer behavior at Wharton and did my post-doc at Princeton University with Nobel Laureate Daniel Kahneman. I am an Associate Professor at the Ono Academic College, and a Senior Fellow at the Center for Medicine in the Public Interest, New York.
In my vast industry experience I work closely with pharma (Pfizer, JNJ, BMS, Novartis, Abbvie), corporations creating wearables and adherence platforms (Samsung, Nantmobile), and health advertising agencies. My focus is behavior change, in patients and physicians alike. We work on anything from campaigns to adding a behavioral component to wearables, so that they are more engaging and bring added value. Repeatedly, I see how the psychology on motivation and comprehension is necessary for creating sustainable behavior change and bringing an edge to products, in an era when technology is commoditized.

Buddy&Soul, my startup, currently at the IBM Alpha Zone Accelerator, is an online platform for personal development - a perfect vehicle for delivering interventions. It feeds off my research - over 50 peer-reviewed publications in medical decision making, patient comprehension, adherence, and behavior change in digital health.   

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Stefan Becker

Dr. med.
University Hospital Essen

Stefan works as clinical physician and transplant officer at the University Hospital Essen. He specialised in Internal Medicine, Nephrology and Diabetology. He completed postgraduate business studies at The Open University (UK). As head of the NephroTeTe working groupe at the University Hospital Essen his research activity focuses on the development and evaluation of novel strategies to improve drug-therapy and –safety . In this context special focus is set on the effects mHealth and informational frameworks have on adherence of patients with chronic conditions. Between 2010 and 2013 he rolled out one of the most popular and best studied mobile applications in the field – the “iNephro Medication Plan”. As founder of the eHealth Venture Summit he is particularly interested in bringing together academic and business worlds to increase mutual understanding of stakeholders involved in the new technology.

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