The
MEMOTEXT Patient Adherence Intervention Abstract
Problem:
"Drugs don’t work in patients who don’t take
them." ~ C.Everett Koop M.D.
Background: According
to studies, only about 50 percent of American patients typically
take their medicines as prescribed, resulting in approximately
$177 billion annually in direct and indirect costs to the
U.S. economy. Besides an estimated $47 billion each year
for drug-related hospitalizations, not taking medicines
as prescribed has been associated with as many as 40 percent
of admissions to nursing homes and with an additional $2,000
a year per patient in medical costs for visits to physicians'
offices. (NCPIE Aug, 2007)
Hypothesis: Combating the barriers to adherence requires a disciplined, rigorous, traceable approach. This approach must encompass the worldview of stakeholders, patient related factors, treatment related factors, stakeholder specific requirements and an iterative, interactive patient centered solution designed to modify patient behavior.
Methods: The MEMOTEXT methodology is based on the premise that intense, interactive communications throughout the course of treatment can positively modify behavior, based on the ability to determine and influence treatment and patient related variables. The MEMOTEXT iterative assessment and dialoguing process accommodates all stages of patient journey and promotes change by integrating with individual patient needs for education, incentives, interactive coaching, motivation, reminder cues and stakeholder/ peer support.
Participants: Patients, Pharmaceutical and Device Manufacturers, Payors, Employers, Managed Care, Disease Management, Not-for-Profits, Pharmacies and Health Care Providers.
Intervention: MEMOTEXT integrates behavior modification, education and real-time support into the everyday lives of patients using technology appropriate to the patient population and condition. MEMOTEXT’s ability to learn and remember previously reported knowledge, intentions, and behaviors allow the patient adherence platform to modify content and dialogues for the same individual over time. Over time, these dialogues adapt to the changing attitudes, beliefs and circumstances of each patient.
Analysis: Application of multi-disciplinary assessments throughout adherence programming allows for segmentation and a highly personalized approach to overcome treatment and medication non-compliance. MEMOTEXT is a methodology, constantly refined, constantly validated. MEMOTEXT interventions are data driven and rely on a correlation of patient self report and impact measurement using both direct and indirect compliance measurement criteria. MEMOTEXT focuses heavily on research and development on an ongoing basis with 3rd party research and academia.
Results: Success metrics are defined situationally with parameters of medication compliance carefully delineated and appropriate to the health behavior intervention. Additionally, measurement methods must be valid, reliable, and sensitive to change throughout an intervention. Adherence to target treatment is assessed using self-report methods, biochemical measures, medication counts, and automated refill review strategies.
Discussion: There is no universally optimal solution. However, through patient-centered social, mobile and speech (interactive voice response and speech recognition) communication, education, coaching, support and a precise mix of technologies appropriate to a patient’s journey and ability, MEMOTEXT can provide a level of support and intervention that is tailored to the needs of individual patients.
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