Why haven’t we solved adherence already?


byKEEP Brain Trust

We’re at the point in the year where many of us who had resolutions for the new year have either worked them into our daily routines or tossed them to the wayside, having failed to get our new selves far from the starting line. We took the fresh start of a new year to (attempt to) see a fresh version of ourselves, with changed or new behaviors.

There are times, however, when adjusting our behavior is less elective, so to speak, like when we’re sick or injured. We might need to rest more, do physiotherapy exercises, or watch what we eat. Quite often, we need to adhere to medication. Unfortunately, as we know from new years resolutions at very least, making even small tweaks to our behavior is easier said than done.

In healthcare, we’ve been trying to solve adherence - to new behaviors, to taking medication - for decades. We can measure it, we can predict it, and we can score it. We’ve even named different kinds of adherence. But we (still) haven’t been able to drive it effectively.

The issues posed by non-adherence are neither new or going away. Non-adherence is an ever-increasing challenge. For one, it’s amplified by a massive cohort of aging baby boomers, many with several coexisting chronic conditions. We’re also becoming evermore adept at treating what ails us, meaning we can treat more of what ails us, but these treatments often require sustained behavior change. More bluntly, technology is transforming healthcare. But the degree to which the fruits of this innovation is realized - improvements in health outcomes, quality of life, and society more broadly - relies on our ability to identify and create effective ways to drive consistent use.

To date, and especially more recently, we’ve created a cacophony of endless reminder and tracking apps. But there’s been no paradigm shift. There’s been no change in how we might or could approach medication non-adherence. By and large, we’ve been repackaging the same information and strategies in different vehicles of communication - whether it be by email, SMS, phone calls, or app reminders. Dozens of ‘smart’ products ranging from electronic pill boxes and bottles to blister packages capture medication intake in real time but have not been widely adopted. We've iterated our way to now without marked results to show for our efforts.

KEEP brings a new angle to driving adherence. Unlike many of its predecessors, KEEP leverages a combination of hardware and software to target medication adherence.

KEEP is discrete yet highly visible.  The well-meaning, long-standing guidance of storing pills in drawers or closets out of the way has meant that there’s been a perceived tradeoff between visibility and safety: while medication on a countertop or table provides invaluable visual salience, leaving it there also obfuscates any privacy and safety considerations. In contrast, storing medication in a drawer or cabinet provides privacy and safety but fuels our forgetfulness since we don’t typically see what’s in these locations from pure happenstance. The visibility of medication no longer jeopardizes its safety with KEEP.

KEEP redefines discretion when it comes to medication adherence. It allows us to keep medication out of the hands of those who shouldn’t have access while also leveraging what we know about behavior to drive adherence: that salient visual cues in our environment can tremendously affect our actions.

In efforts to move care beyond clinic calls, we’ve been trying to bring medical equipment, pill bottles, and the like into the home without making it part of the home. But if we can take care of ourselves and our loved ones, at home, in the warm and familiar spaces that we live in, clinically chameleon products like KEEP help remind us that managing our health is part of our everyday lives while quietly supporting us along the way.

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