Biomedical big brother

Last week, we mentioned how medication adherence is a problem that costs a ton of money. In that study, researchers couldn’t get patients to increase their adherence through time-tested techniques like bribery. Well Otsuka has partnered with Proteus Digital Health to come up with a new solution—pills with sensors that register when the medication has been taken. While targeting schizophrenia medication adherence might not be the best patient population to start with—delusions of being watched are literally right there on the symptom list—it’s still an interesting idea. The sensor is tiny and made from digestible materials, but requires the use of a skin patch that you need to replace every week. We’ll keep watching to see if this sticks (we’ll be here all week.)

Show me the money (it didn’t work)

What motivates you? What do you care about? Behavioral economics is a bourgeoning field that tries to explain why we, as humans, make the decisions we do and people are winning Nobel prizes for it. Alright then, let’s try it on one of the most perplexing healthcare issues in the world, medication adherence. It is estimated two-thirds of medication-related hospital admissions in the US were because of noncompliance, at a cost of ~$100 billion a year. A recent study pulled out all the behavioral economic stops (money, clinical support, peer pressure) to see if medication compliance could be improved after a heart attack. A heart attack, not indigestion, a heart attack. The results? Nope. No difference between the two control groups. Holy cow people. Help me help you.

4. A stroke of technological genius

Otsuka and NEC are teaming up to create a medicine “bottle” to help increase medication compliance. Apparently the threat of a 2nd stroke isn’t incentive enough for many patients. About half wander off course from their medication regimen after about six months. The new bottle will flash an LED light when a dose is due and will alert a patient’s prescriber of non-compliance. Pletal, Otsuka’s clot-fighting drug that reduces the chance of a second stroke, is optimally effective when taken uninterrupted so there are potentially large health benefits from the technology. This is all well and good until some do-gooder applies the technology to beer bottles that tell your doctor how much you drink. We’re just sayin’ it’s a slippery slope. That’s all.

3. Steep price for non-adherence among diabetics

When doctors tell you to take your medicine, eat well, and exercise, you should listen, right? Especially if you have a chronic illness like Type 2 Diabetes. Easier said than done, it seems. The IMS Institute for Healthcare Informatics has released a report showing that under 40% of Type 2 Diabetes patients globally achieve optimal levels of adherence and persistence. 4-15% of costs related to treating Type 2 Diabetes complications are associated with failure to properly follow medication and treatment regimens. In the US, these avoidable complications cost Medicare $4 billion every year. Ouch. Let’s all try listening to our doctors. Let’s lace up our sneakers and go find some Pokémon. Our bodies and wallets will be healthier for it.