Adherence is present in everyone's daily routine. We set alarms to ensure we wake up on time, create calendars to adhere to schedules, and follow routines to better our fitness levels. Despite knowing the logical benefits of adherence, however, we often fall short when it comes to following the doctors’ advice. Medication adherence is vital— complying with treatment plans helps control chronic conditions, ensures effective treatment of temporary illnesses, and improves your long-term health. The high rate of non-adherence to treatment for chronic diseases is a global healthcare challenge that affects millions of lives. 1 in 2 people don’t take their medications as prescribed— a number enormous enough to take cognizance of.

As we enter a new era of digital health innovation, it’s important to realize the impact futuristic technology can have on medication adherence and the health of communities.

In this episode of “Health As We Know It,” our experts unpack the meaning of medication adherence, reasons for non-compliance, and how tech innovations by healthcare companies can be implemented to help people lead healthier lives. 

Our Panelists:

Dr. Mangesh Tiwaskar, Consultant Physician and Diabetologist

Dr. Ashwini Pawar, Director, Medical Affairs, Abbott India

Navigating Nuance in Adherence

Dr. Tiwaskar starts by explaining what true adherence means. It's more than just taking medications on time. It covers a person's holistic behavior, including nutrition, exercise, lifestyle changes, and regular check-ups. But even though it sounds straightforward, many people struggle to stick to these healthy patterns. Dr. Tiwaskar says many factors play a role, like financial situations, social status, and health awareness. 

As the first point of contact, healthcare providers can make a big difference in improving adherence. It is difficult for people with limited medical knowledge to grasp how multiple health conditions affect their bodies. The need for complex medication routines, therefore, needs to be communicated to patients. Sitting down with them to explain and simplify their plans to them can be helpful. This is also an opportunity for doctors to understand their patients better, and gain insight into the reasons for non-adherence. For example, learning about a person's economic and social circumstances allows healthcare providers to tailor more realistic recommendations. In a country like India where patients pay significant health costs themselves, understanding someone's complete context helps shape a treatment plan that they can truly commit to. "It is imperative for all of us who practice medicine to see to it that all the challenges are understood well and accordingly, therapy is designed for the patient," says Dr. Tiwasker.

Leveraging Healthtech Possibilities

Dr. Tiwaskar also shared a general pattern of non-adherence observed by doctors which includes a lower degree of compliance following a visit. Many patients start to skip their medication routines when left unobserved. This changes in the days leading up to a doctor’s visit when adherence goes up due to the sudden realization of a doctor’s appointment drawing close. The challenge for healthcare providers is then to keep track of the individual between visits.

Dr. Tiwaskar shares some clever tips for healthcare providers to check on patients like asking people to show their pill boxes during appointments and consultations with family. Additionally, Healthtech tools can ease this process of bridging this gap between healthcare providers and individuals on a wider scale.

As Dr. Ashwini Pawar builds upon this, leading healthcare organizations need to equip doctors with behavioral science tools to understand the reasons behind Medication non-adherence more deeply. For instance, a patient discontinuing treatment early may seem puzzling when they thoroughly understand the medical rationale for persisting. But there could be an underlying, unspoken factor at play. Doctors equipped with these additional skill sets can probe beyond the typical patient explanations of "forgetting," instead asking questions about the realities of patients' daily routines, and other unspoken systemic barriers in the way of adherence. A doctor’s understanding of human behavior and motivation can help get to the root of non-adherence and nurture the conditions for patients to follow through with medication adherence in long-term.

For example, medication reminder apps and health tracking devices can help both doctors and patients stay connected with various aspects of their health plan including medication, nutrition, and exercise. These apps can not only nudge you to take your medication but also reward you for following the suggested behavior patterns. They act as your cheerleaders, encouraging you to cultivate habits of adherence.