Patient adherence is a vital component of public health. When patients don’t take their drugs properly, they don’t work, leading to poor outcomes and, in the worst cases, hospitalisation. This is hugely damaging to not only individual health, but also to the healthcare system as a whole, which spends around $500bn globally in avoidable healthcare costs due to poor medical adherence.
As noted by the World Health Organisation (WHO): “Improving adherence would have a greater impact on health than any potential discovery in medicine.”
Fortunately, technology – specifically smart packaging combined with state-of-the-art communications networks – can help, as Swedish start-up Mevia and Internet of Thingsservice provider Aeris are beginning to prove. Not only can Mevia’s system, supported by Aeris’ global cellular coverage, help individual patients take the right medication dose at the right time no matter where they are, it could also have a big impact on clinical trial outcomes, which can be significantly affected by poor adherence too.
As with any new technology, though, it won’t be an easy road to get the solution into the hands of the patients who need it most. Elly Earls catches up with Mevia CEO Jesper Hassel and Aeris’ vice president of market development Mohsen Mohseninia to find out exactly how the technology works and how they plan to roll it out.
Elly Earls: Why is adherence such a big problem for the healthcare sector?
Jesper Hassel: The biggest issue with drug adherence is that if you don’t take your medication it’s not going to have an effect for you. And one of the biggest reasons for this is that often it’s quite complicated to take your medication. You may be taking it in the way you think is right, but that might not actually be the case. Moreover, in some cases, there can be side effects of medications, which means people might stop taking them for a while and then restart. There are a lot of different aspects to it, which can lead to patients being hospitalised, or having strokes they wouldn’t have had if they’d taken their medication properly. It’s a huge issue for individuals but the societal cost is also enormous.
Mohsen Mohseninia: There are also issues with clinical trials. One of the most expensive undertakings in the medical world is drug trials and typically these have a certain degree of failure associated with them due to the fact that there is no tangible proof of medication adherence – that the individuals on the trial have taken their medicines when they’re supposed to have taken them. That costs huge amounts of money and also pushes the price of drug trials significantly higher and can lead to incorrect outcomes.
EE: Mevia has enlisted the help of Aeris to tackle this issue. Firstly, can you explain what Aeris’ role is?
MM: The Internet of Things is about getting the physical world to talk to the virtual world, to take a sensor and put it on a dumb device and get that device to communicate in real time information about itself, about its surroundings, about how and where it’s being used, and then take that information, store it and use it to make decisions.
Aeris’ role in that is twofold – firstly, we provide the communication services, the air time, the cellular networks that are specifically designed and optimised for the use of these machines. And secondly, we have technology that allows customers to bring in the data that their device sends and store and manipulate it in order to extract nuggets of information that allow them to take decisions.
With Mevia we are only providing the communication services. Mevia has its own technology platform. What Aeris is really bringing to the table is a higher quality of service compared to other players in the market, which allows Mevia’s devices to transmit their information regardless of where they are.
JH: For Mevia’s part, we’re trying to make it as easy as possible for the user to take the right medication dose at the right time. What we do is add printed traces onto packaging so when you take out a pill you’re breaking a trace. The trace feeds into an electronic device, which sends impulses through the package, so when you take any pill out of the package, we know exactly which one it is and when you’ve taken it out. We then use the GSM network provided by Aeris to send this data from the package into our IT system, which can connect instantly with a patient, doctor, care giver or relative in any form of communication that they prefer, be that SMS, email, phone calls or push notifications in a mobile app. What’s great about working with Aeris is that we can set up quickly and easily and in very many different countries. The system just works.
EE: How has the system been used in practice so far?
JH: We’ve had the solution in select trials within partners here in Sweden, primarily within the home care sector, and so far it’s been very positively received.
Currently, employees have to go to individual’s homes and give them their medication, but with our technology, you can do most of those visits electronically. Then, if there is a problem, someone can be sent in to talk to the patient about what’s happening in their life that means they aren’t able to take their medication. Because you don’t have to do those visits as frequently, each patient can have more of a dedicated contact person. Previously, a lot of different people would have been involved, which wasn’t comfortable for the patient.
Although some people working in this sector have been afraid that new technologies would make them obsolete, our technology is doing the exact opposite. In reality, this sort of technology just means that a lot more individuals can get home care and support and makes the overall experience better for all parties.
We are also working on market research studies with the pharmaceutical industry to see if the technology works for certain patient groups. As always happens with new technologies, some people have found it amazing and others are a bit more sceptical, but we’ve found that it definitely helps individuals take their medications better. One individual told us it’s impossible to forget his medications now, which is great feedback for us.
EE: What’s the next step for Mevia and this sort of technology more widely?
JH: Hopefully you’ll be able to walk into a pharmacy and buy Mevia’s technology during the next year in Sweden, and with clinical trials and market research studies, essentially we can do that tomorrow. At present, we’re in a couple of negotiations with pharma companies about starting those trials, but as it’s a new technology and we’re a relatively new and small company, we are still working on making sure they’re comfortable with what we’re doing and trying to find people within those companies that can drive the project internally.
For this sort of technology to become the norm, it will still be several years. It will definitely start popping up more and more, but there will have to be some significant changes in the way medicines are subsidised [before it becomes commonplace], which usually takes quite some time.
The classic saying is that you overestimate what’s going to happen in the short term but underestimate what’s going to happen in the long term. I think in the next couple of years there will be a lot of technologies including ours that are going to grow quite drastically from the size we are today – but I think it’ll take about 10 years until this sort of technology is relatively available to everyone.