Concordance Health Solutions (CHS) is an Indiana company with a mission to improve patient medication adherence in partnership with pharmacists and other healthcare providers. With this SBIR grant, CHS will develop and test an innovative product, the SMARxT Med Reminder (SMR) Plus system, which will extend the capability of the inexpensive SMARxT Med Reminder cap developed with a previous NIH SBIR grant. The SMARxT cap is wirelessly programmed at the pharmacy with the patient's prescription instructions and dispensed with the original prescription package. The SMARxT cap gives the patient visual and audible cues when a dose is due, and it records each time the cap is removed as a proxy for when a dose is taken. The SMR Plus system will upload the data captured in the SMARxT cap to a web-based application to share information back to patients, caregivers and healthcare partners. CHS will design the SMR Plus system and partner with TrueRx to design an electronic interface and test the SMR Plus system with TrueRx's system.
The specific aims of this study are:
Aim 1) Develop the prototype web application, patient interface, and PBM-focused electronic records transfer for the SMARxT Med Reminder Plus system, Aim 2) Conduct a controlled test of the SMR Plus system with a small group of patients in a laboratory environment, and Aim 3) Conduct interviews with patients and PBM administrators to record reactions and comments about the system Prescription medication adherence is shown to improve overall health outcomes and reduce healthcare costs. Improving medication adherence is a current focus area of several NIH institutes and in line with the NIH mission to extend healthy life and reduce the burdens of illness and disability. However, typical medication adherence rates are less than 50 percent for a host of reasons, including forgetfulness and confusion. Systems that remind patients to take the medication plus record and report dosing information are not widely available, and none are offered as part of the original prescription packaging at a cost effective price. An easy-to-use system that is programmed at the pharmacy and dispensed with the original prescription packaging, captures patient dosing history, and reports the data to a web-based system that can be shared with caregivers and healthcare partners will ultimately result in increased medication adherence and better health outcomes. This Phase I project will develop the reporting tools to connect the SMARxT Med Reminder device with a centralized database (web application) that can report adherence patterns to the patient and caregivers, and interface with a Pharmacy Benefits Management system. At the conclusion of Phase I, CHS will have a working prototype of the SMARxT Med Reminder Plus web application and user-friendly patient interface, plus it will have demonstrated the ability to electronically interface and report patient medication adherence data to a Pharmacy Benefits Management system. In Phase II, CHS will refine and further test the system, then conduct a rigorous study of the effect of the SMARxT Med Reminder Plus system on patient medication adherence with the Purdue School of Pharmacy.
Poor medication adherence has been described as a significant public health concern. It is widely recognized that non-compliance with medication dosing schedules negatively impacts treatment outcomes, increases hospitalizations and nursing home admissions, and adds almost $300 billion annually to the cost of care for patients and payers. Studies show that patients routinely overestimate their level of adherence to medication regimens when self-reporting, which complicates the assessment of treatment success by them and their healthcare providers. This project will develop the functionality of the SMARxT Med Reminder Plus system to enable reporting of patient dosing information to a web-based application accessible by the patient and caregivers and integrated into healthcare payer electronic records. This fully functional system will allow the patient and their healthcare team t better assess, improve, and meaningfully influence behavior related to patient medication adherence.