Monday, January 29, 2018

An objective way to measure adherence?

Adherence to medications is a hard but important thing to emphasize to patients. As an internist, I have patients with chronic illnesses that will likely be with them until their very last on earth. A valuable information I want, and need, is how adherent they've been as regards their medications and lifestyle.

A new development in medicine is the digital health feedback system (DHFS), a device "already being used in clinical trials to monitor adherence and will probably soon be combined with other chronic disease medications." For doctors, this means an objective way of knowing whether, say, a patient has been taking his/her antihypertensive medications daily. How DHFS ultimately affects adherence is still uncertain, but a small randomized controlled trial showed that patients with diabetes and hypertension in whom DHFS was used had better control of their conditions.

Read Swallowing a Spy — The Potential Uses of Digital Adherence Monitoring. An excerpt:

For those of us who struggle, the most effective adherence booster may be giving doctors and patients the time to explore the beliefs and attributions informing medication behaviors. These conversations can’t happen in a 15-minute visit. Given how little our health care system seems to value such interactions, it’s no wonder that skepticism often greets these new, unproven, and costly technologies. But though this skepticism may be warranted, it may also reflect a fear that the technology is intended to replace our efforts, rather than facilitate them. For technologies like digital adherence monitoring to do their jobs, we have to be willing to let them help us do ours.

The short of it is—sure, the device may be helpful, but let's not forget educating patients about their condition.

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