Digital devices have become a part of our personal ecosystems. Wherever we go, smartphones or and other digital devices are there to help us navigate our daily lives and the challenges we face. And in healthcare environments too, digital technology is seeing increased uptake, but we need to do more, particularly when it comes to tackling patient compliance.
Patient compliance with prescriptions is poor. For a variety of reasons, including poor communication, difficulty opening packaging and a lack of understanding, patients can find it difficult to adhere to their medical courses. My friend and colleague, Janne Sahlman, co-founder of Popit and medical doctor at Kuopio University Hospital, had mentioned that many of his patients would return for multiple surgeries due to noncompliance with post-surgery prescriptions. And though I knew that there were methods of identifying and quantifying patient compliance with solid medications in smart pill bottles, such solutions were not readily available in all areas. In Europe and Asia, for example, around 80 percent of solid drugs distributed and sold are in blisters and there isn’t a technology to determine when pill consumption occurs. In reality, the industry knows very little about how patients take their pills on a daily basis.
Sahlman, myself and others founded Popit, a MedTech startup, to help track and improve compliance, and our first product targets blister packaging – and it was featured by the European Commission’s WATIFY (an awareness-raising campaign to push the modernization of European industry). But how do we apply the smart pill bottle concept to blisters? Popit Sense is a smart device that can be clipped to a blister pack, where it uses a variety of sensors and patented technology to determine when a medication has been extracted, gathering real-world evidence.
When a pill is popped out from the blister packaging, information is sent to a smartphone app via Bluetooth. According to clinical pilot results (2), Popit Sense was able to improve compliance in 24 women taking a daily birth control pill over the course of two months by over 80 percent. When developing the device and app, we were wary of reminder fatigue, a phenomenon that involves patients ignoring prompts to comply. Our approach: patients only get an alert if a dose is missed. Our results were exciting in that they seemed to indicate that patients began to learn and adopt improved behaviors for taking medications.
Recently, we launched a project in collaboration with Pfizer to help patients with rheumatoid arthritis to take their Xeljanz medicine on time. We’re a small Finnish biotech so it was very exciting for us to partner with such a big company! Upon discussion, Pfizer had already identified patients in some therapeutic groups who felt that they weren’t receiving sufficient support in-between visits to the doctor, contributing to their noncompliance. Our solution was a perfect fit for this need, as we make it possible to send contextually relevant “boost” messages to the patient’s smartphone based on the treatment stage and individual level of adherence. Because of this collaboration, the solution will be rolled out in Finland, Sweden and Norway, providing patients with the Popit Sense device, the app and tailored support messages that take adherence and treatment stage into account. We’re also in negotiations with other companies to provide solutions for different therapeutic areas.
For many patients, health is already digital. People can track their sleep, water intake and refill prescriptions at the touch of a button (or screen) and, therefore, have the expectation that support with medical compliance should also come through this channel. By making the leap to the digital domain, the entire pharma industry can do much better to improve adherence and get the patient (and the healthcare provider) to feel like the treatment as a whole is providing the best possible outcomes.
If pharma companies focus more on the benefits of digital technology for patient compliance then an “Internet of Pills” could become reality. When medication is connected, it is possible to combine the inputs of how medication is taken to the outputs that are already easy to track, such as electrocardiogram, heart rate or blood pressure. Once you have this set of information, it is easier to gather real world evidence, obtain the best possible treatment outcomes and understand how medication is really working.
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References
- European Commission, WATIFY, “Popit, a smart solution to detect medication consumption,” (2018). Available at: https://bit.ly/2Y6Nl4C. Last accessed July 17, 2019.
- Sahlman J, Matero H, Kärkkäinen H, “Pilot study: An on-demand reminder system increases adherence of birth control pill users”. Clin Obstet Gynecol Reprod Med 4. (2018).
