Use of modern technology as an aid to medication adherence: an overview

Sandra C Thompson, Adrian T Walker
Combined University Centre for Rural Health, University of Western Australia, Western Australia, Australia

Abstract: As life expectancy increases, and with it the increased burden of chronic disease, there is increasing reliance on pharmaceuticals for primary and secondary prevention. However, adherence to the regime of treatment prescribed by the doctor is suboptimal for a wide range of reasons. This article explores the role of modern technology in trying to improve adherence to prescribed medications by searching peer-reviewed articles through the online PubMed and Google Scholar databases using the keywords “adherence”, “compliance”, “medication”, “pharmaceutical”, and “technology”, and further citation snowballing. Literature was reviewed to determine reasons for noncompliance and how technology is being used to improve patient adherence. The following factors potentially assist patients to maintain good adherence by helping minimize side effects or simplifying doses and regimens: electronic prescribing and use of shared electronic health records so that all care providers are aware of prescribed medications; reduced costs through improved manufacturing processes; dosing and appointment reminders and dosing aids; improved drugs which are more acceptable to the patient and have reduced side effects; and better condition monitoring by doctors and patients. The areas which are least amenable to positive changes are those that are intrinsic to the patient, such as self-efficacy and motivation, and the quality of the doctor–patient interaction, which impacts upon patients’ understanding of their disease and their trust and confidence in their health care provider. While many new approaches to assist adherence are reported regularly in the media and on the Internet, there is frequently little high-quality evidence to confirm the utility of the approach. Improving adherence is likely to require interventions at many levels. The doctor–patient relationship and interventions supporting patients’ understanding of their disease and confidence in the therapy prescribed remain important areas for further research.

Keywords: compliance, adherence, medication, pharmaceutical, technology