Editor’s Desk

The answer to patient adherence: Check ‘all of the above’

Peter Wehrwein

Quick fixes, magic bullets, secret sauces—none will you find for improving patient engagement and adherence.

Instead, judging by the 4th Annual Adherence and Engagement Summit in Philadelphia last week, look for as much variety in adherence and engagement efforts as you'll see in the people you're trying to persuade to mind their health and take their medication as directed.

For some people, improving adherence—and outcomes that follow—may providing a free lift to their appointments. George Fields, a senior medical officer for CareMore, a Medicare Advantage and Medicaid managed care health plan based in Southern California, told the summit audience that CareMore had significantly reduce the amputation rate among its MA members by providing free transportation and eliminating copayments for items like insulin and blood glucose test strips.

Adam Hanina, CEO and co-founder of AiCure, talked up his company's product, which uses artificial intelligence, facial recognition software and smartphone cameras to monitor whether people have taken their medication.

Direct observation is the gold standard for ensuring adherence, Hanina told the group, and "what we have done is automated the process of direct observation."

Rajiv Shah, CEO and founder of mymeds, a medication management app, hat tipped Mango Health as setting the standard for adherence technologies but made a case for apps that work on the full gamut of devices. He noted that older people may need a larger screen to read and navigate. And pharmacists got props from Shah: "No one else knows as much about medications as pharmacists. We really believe they are the unsung heroes of adherence."

High deductibles can affect adherence and whether people take a new medication may depend on whether they have gone through their deductible, noted Candace Feldman, a rheumatologist at Brigham and Women's Hospital in Boston. She cautioned against education-only approaches to adherence, noting that they can widen existing disparities in health care because educational materials tend to be more effective among people with social and economic advantages.

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