Medication compliance and adherence are the two main issues have to be handled when dealing patients with chronic illness such as diabetes, asthma, cardiac condition etc. Medication compliance refers to the degree to which the patient follows a health provider advice correctly and adherence refers to the behavior of patient related to that advice such as prescription fills and refills on time. Both medication non-compliance and non-adherence may have serious effects on the patient health and chance of relapse.
The common reasons associated with medication non-compliance and non-adherence are as follows
1) Patients such as elderly does not remember medication schedule.
2) Patients doesn’t follow directives deliberately
3) Taking medicines at wrong time and in wrong bio state for example empty stomach, after dinner etc.
4) Too many medications prescribed which results in confusion.
5) Failed to order and fill prescriptions
6) Stopping medications after disappearance of symptoms.
Review of an existing solution
I have reviewed an existing solution MedicineList+ developed by NPS medicine wise, an Australian based not-for-profit and evidence based organisation.
The primary features of this solution are
1) Patients can order prescriptions from the participating pharmacists and download prescription records.
2) Manages multiple patient profiles on a single device.
3) Maintains a record of allergies and reactions, conditions, measurements and test results.
4) Generates a health graph and report and sends an email to the configured health care provider.
5) Ability to add medicines and reminders.
Users and Roles
|Patient||Patient with any chronic illness that requires strict medication.|
|Pharmacist||Pharmacists are responsible for taking orders and dispensing medications to the patient and providing professional advice.|
|Doctor||Doctor recommend/advice the prescriptions and schedule.|
|Nurse||Nurse are responsible for monitoring patient medication.|
|Families||Family members may monitor patient medication by subscribing to alerts in the form of SMS and app alerts if the patient misses medication at any particular time.|
1) Create a patient profile
A patient can create a basic profile with name, contact information and picture. Multiple profiles are allowed.
2) Add medicines
Patient can add a medicine manually by searching from list or scan a barcode of the medicine. Currently it is allowing only one medicine at a time. Patient can also enter non-prescribed medicines.
3) Download prescription records from pharmacy
Patient can download prescriptions list from pharmacy at any time with a six character unique linking code generated by the app.
4) Set reminders
Patient can configure reminder alarms at specific intervals in the specific time zone.
5) Add allergies and reactions
Allergies and reactions plays a significant role in patient’s safety.
6) Add Notes
Patient can add any notes.
7) Add measurements and tests
Patient can add measurements and test results.
8) Add health provider details
Patient can add health provider details with name and email. All the reports are sent to the configured email address.
If the phone stolen or data corrupted, patient has to re-enter everything and may not be able to remember the last medication status such as doses remaining etc.
2) Device change
If the patient decides to use a new phone in the place of existing one, there’s no way to transfer data from old one to the new one. They have to re-register with their pharmacy and import all the past as well as new prescription records along with dosage rules. But same cannot done in the case of historical data such as past vital statistics and doses.
Health provider cannot view historical data such as medications, dose usage, measurements and test results. Historical data can be used for analytical purposes and helps in decision making processes.
Current app stores information on device for offline access raising security concerns. Any patient data treated as sensitive so adequate security measures have to be implemented in order to prevent invasion of privacy.
A Better App?
This one is in my priority list. Currently I’m working on a prototype solution that covers functional points and would address all of the pain points as well.