A medication adherence platform for reducing the cost of medication errors and non-adherence
Flagship Program: Changing Health Trajectories in Chronic Disease
Medication errors – and medication non-adherence by patients – both place a tremendous drain on healthcare budgets, can negatively impact patient outcomes, and consume limited human/clinical resources that are needed elsewhere.
Research has consistently shown suboptimal medication adherence in approximately 50% of patients across many disease subtypes. The annual cost of hospital admissions due to medication non-adherence and errors is estimated to be A$1.2 billion.
Broadly, suboptimal medication adherence falls into two categories – non-intentional and intentional adherence.
Non-intentional non-adherence can be due to forgetfulness, misunderstanding or not possessing the resources/capacity to take the medication as prescribed; intentional non-adherence is a conscious decision not to take one or more prescribed doses (for example, to avoid unpleasant side-effects); and over-adherence is taking too much of a medication (which may result in greater side-effects or life-threatening toxicity).
SAMSON is a smartphone app designed specifically to assist with medication management.
It can be integrated with direct clinical care to target the cognitive, behavioural and affective aspects of medication adherence to form good medication adherence behaviours. It can also provide ongoing daily adherence support for the long-term maintenance of established behaviours.
This project will involve redevelopment of the existing SAMSON app to accommodate a wide range of chronic illnesses, as well as the development of a ‘companion’ online nurse training platform that facilitates online or phone support to enhance medication adherence in low adherers.
A clinical trial will also be conducted to demonstrate clinical feasibility, acceptability and efficacy.
Ultimately, the aim of the project is to build a commercially viable platform that can seamlessly interact with hospital electronic medical records.
This project has the potential to optimise medication adherence and, as a consequence, deliver superior patient outcomes, lower healthcare expenditure on unnecessary hospitalisations and medical interventions, and optimise PBS expenditure (particularly for high cost drugs).
Patients anticipated to benefit the most from the redeveloped SAMSON app are those with a chronic illness requiring oral or self-administered medications, and/or those with complex disease profiles requiring ongoing symptom monitoring and medication management.
While there are many medication adherence platforms on the market, none (to the research team’s knowledge) provide a comprehensive system that enables individual patient management to be directly linked to the patient’s treatment team; nor provide patients with real-time access to self-management information for medication related side-effects.
SAMSON will address both of these unmet service needs.
Using SAMSON, the treatment team will be able to monitor individual patients, intervene when necessary and provide them with individualised coaching around medication adherence. The app’s data collection facility will also enable interrogation of the data to determine trends and ‘at risk’ populations.
To produce a commercially-viable medication adherence smartphone APP that addresses the cognitive, behavioural, and affective aspects of medication adherence, fostering the development of good adherence behaviours that can be maintained long-term in a chronically unwell patient population.
- To rebuild the medication adherence smartphone APP for applicability across a wide range of chronic illnesses requiring self-administered medication (oral or otherwise) which auto-populates medication contra-indications and side-effects from MIMS;
- To build, and establish usability, fidelity and proof of concept of an online motivational interviewing platform for nurses to provide either online or phone based tailored support to non-adherers;
- To test the two linked platform in a range of chronic illness settings, initially in oncology to determine clinical feasibility, acceptability and efficacy;
- To commercialise the two linked platforms.