We’re excited to share Part III of our Compounding and Compliance series, where we discuss common compliance challenges faced by healthcare professionals and how Personalized & Compounded Nutrients is working to create innovative solutions.
As mentioned in our previous entry, we will continue to share data related to compliance and intervention with the goal of enhancing compliance/adherence and health outcomes. The problem of adherence is widely recognized in today’s scientific literature.[1] Many studies assume or demonstrate an average adherence to a single drug therapy to be around 50%-70%,[2] which does not vary significantly across the condition treated[3] or the age of the patient.[4] Furthermore, many studies demonstrated that traditional intervention intended to enhance adherence, such as: motivation, education, self-assessment and theory-based interventions, were either inconclusive or ineffective.[5],[6] One important conclusion to draw from this information is that adherence is in-fact a significant problem.
As a healthcare practitioner this should be an important consideration when prescribing nutritional therapy, as patient adherence to supplements will likely face similar issues, even if there is sparse data on supplement therapy adherence specifically. One reason for this is that supplementation more often than not includes multiple formulas, even for patients focused on health optimization. Studies demonstrate a negative correlation between the number medications and adherence.[7] For this reason alone, we believe that supplement compliance is expected to be even lower than the 50 to 70% figures associated with single-drug therapies.
We at Personalized Nutrients believe that there are a few ways in which we can help address these issues. First of all, we believe that it is important to understand as much about the adherence of an individual as possible. True to form, we believe that patient care should be Personalized. It is worth noting that a traditional supplementation dispersion model is often difficult or impossible for the clinic to track. Simply having access to this information, even if effective positive intervention is limited, is empowering. It may help to shed light on health outcomes and reduce uncertainty about effectiveness of particular treatments.
To this end, as mentioned in our previous entry, we are working on the development of compliance tracking tools with various levels of input, requiring anywhere from zero up to daily input. Meaning that every healthcare practitioner utilizing Personalized Nutrients will have some level of compliance data, even with zero input from the patient, up to a timestamped and dose tracking level of data. Another reason that we are interested in providing these tools is because there is some promising research that points to significant improvements in compliance rates utilizing technology. One such study noted a significant improvement of 86.3% as compared to 62.66% control group, in patient daily adherence to hypertensive medication over 12 months, utilizing a smart phone app.[8]Also, a meta-analysis showed significant positive outcomes in 27 trials that utilized mobile app assisted self-care interventions.[9]
We look forward to continuing to work with healthcare practitioners to create innovative ways to Personalize healthcare. Any feedback to this regard would be much appreciated and well considered. Be on the lookout for Part IV of our serious and please leave any questions or feedback in the comments below!
[1] Marcum, Z. A., & Gellad, W. F. (2012). Medication adherence to multidrug regimens.
[2] World Health Organization. (2003). Adherence to long-term therapies: evidence for action.
[3] Briesacher, B. A., Andrade, S. E., Fouayzi, H., & Chan, K. A. (2008). Comparison of drug adherence rates among patients with seven different medical conditions.
[4] Hughes C. M. (2004). Medication non-adherence in the elderly: how big is the problem?
[5] Marcum, Z. A., Hanlon, J. T., & Murray, M. D. (2017). Improving Medication Adherence and Health Outcomes in Older Adults: An Evidence-Based Review of Randomized Controlled Trials. Drugs & aging
[6] Patton, D. E., Hughes, C. M., Cadogan, C. A., & Ryan, C. A. (2017). Theory-Based Interventions to Improve Medication Adherence in Older Adults Prescribed Polypharmacy: A Systematic Review.
[7] Marcum, Z. A., & Gellad, W. F. (2012). Medication adherence to multidrug regimens.
[8] Márquez Contreras, E., Márquez Rivero, S., Rodríguez García, E., López-García-Ramos, L., Carlos Pastoriza Vilas, J., Baldonedo Suárez, A., Gracia Diez, C., Gil Guillén, V., Martell Claros, N., & Compliance Group of Spanish Society of Hypertension (SEH-LELHA) (2019). Specific hypertension smartphone application to improve medication adherence in hypertension: a cluster-randomized trial.
[9] Liu, K., Xie, Z., & Or, C. K. (2020). Effectiveness of Mobile App-Assisted Self-Care Interventions for Improving Patient Outcomes in Type 2 Diabetes and/or Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials
