This March 8-15, is World Glaucoma Week. Launched 6 years ago by the World Glaucoma Association and The World Glaucoma Patient Association, events are being held across the world to raise awareness about Glaucoma. Afflicting 9 million people, Glaucoma is the world’s leading cause of irreversible blindness. Due to its slow progression, 50% of patients in the developed world and 90% in the developing world are untreated. While Glaucoma is currently incurable, with early detection and treatment, its progression can be halted.
MEMOTEXT has been working to improve Glaucoma medication adherence since 2012. For our first clinical trial, we designed and operated a telecommunication-based intervention adherence program for Glaucoma patients, in collaboration with Dr. Michael Boland at Johns Hopkins University’s Wilmer Eye Institute, and Microsoft Health Vault. Interventions previously used for Glaucoma patient populations have traditionally been labor-intensive and therefore not cost-effective. The object of the study was to determine if a telecommunication-based intervention would be both effective and cost effective to implement.
The MEMOTEXT intervention was linked to a personal health record and the impact on adherence was assessed. Subjects taking once daily eye drops were recruited from a university-based Glaucoma practice. Those that agreed to participate underwent a 3 month period during which their use of eye drops was recorded electronically (MEMS, AARDEX Group). Adherence was assessed by including doses taken within 4 hours of the median dose time and excluding doses two weeks after the initial visit and two weeks before the follow up visit. Subjects found to have taken less than 75% of doses correctly were randomized either to no intervention or to receiving a daily MEMOTEXT intervention. The messages were scheduled and associated with a particular medication using a Personal Health Record (PHR) established for each subject (HealthVault, Microsoft Inc.)
The results were analyzed two ways, but both methods showed a substantial increase in medication adherence in the intervention group compared to the control group. One analysis showed an increase in the rate of medication adherence from 53% to 64% for the intervention group but no change in the control group. The second analysis of the data showed an increase from 54% to 73% in the intervention group and, again, no change in the control group. 84% of patients in the intervention group found the reminders helpful and wanted to continue using them after the study concluded. And the telephone and electronic health record based intervention was indeed cost effective, offering patients a very affordable solution.
For all parties the results were better than we hoped for. Johns Hopkins published two papers on the results. Glaucoma patients were provided with a health intervention that increased adherence by 16%, was well received by 84% of users, and was cost effective. And for MEMOTEXT it was a milestone, as we had validated evidence that our adherence programs worked. Building off of this success, MEMOTEXT took the validated methodology and applied it to adherence programs for a multitude of conditions in the years since.
With an MSc in the Theory and History of International Relations from the London School of Economics, Noah brings several years of communications experience to MEMOTEXT. Prior to joining, he worked for the Government of Ontario, several small businesses, and most recently on the winning campaign in the 2014 Toronto mayoral election. As someone who loves communicating good ideas to help make the world a better place, Noah is thrilled to be a part of the MEMOTEXT team.