Patient Adherence: Is Technology the Answer for the Best Health Outcomes?

November 9, 2017

We’ve all heard the statistic: more than 50% of patients don’t take their medications as prescribed, which leads to billions of dollars of lost pharmaceutical sales and hundreds of thousands of lives at risk[1].

It’s so much of an issue that more and more medical device innovators are creating systems and devices that remind patients to take their medicine — because that’s the number one patient-reported cause of missing a dose — including things called “smart” pill bottles. If you heard the report on NPR’s All Things Considered in August 2017[2], you know what we’re talking about. Smart pill bottles send visual and audio reminders to take the medicine.

This is a big opportunity for pharmaceutical companies and medical startups alike. Yet, as it turns out, forgetting isn’t really the issue when it comes to medication adherence. It goes much deeper than that.

Patient Behaviors and Attitudes Affect Adherence

The results for a HeartStrong randomized clinical trial published in JAMA Internal Medicine[3] shows that wireless device reminders and even financial incentives do not lead to a significant change in behavior when it comes to taking your medicine on time. So what might be causing people to not adhere to their treatment plan? It boils down to three main themes:

  1. Awareness and education
  2. Attitude
  3. Advocacy

Awareness and Education

Many patients are prescribed a medication without fully understanding the benefits or desired outcomes of the treatment. The prescribing doctor does not have the time to fully explain the treatment strategy, and the pharmacist’s goal is to ensure that the medication is taken as prescribed. Neither source offers the ongoing logical or emotional support that patients need to embrace the recommended treatment plan and follow through.

Without a patient engagement program, patients don’t know they need extra support or don’t know where to go for it, which often leaves them frustrated and negligent of their prescription and health.


Fear, denial, anger, distraction, despair, distrust: all of these feelings and more may accompany a patient as they are prescribed a treatment plan and throughout their health journey. In essence, patients are often not engaged in their own health plan from the beginning and many would like to pretend it’s not even needed.

This is not just a guess. At Legacy Health Strategies, we have gathered data directly from thousands of patients over the last few years that shows the most common attitudes and the resulting behaviors. These attitudes are directly affecting adherence.

Effective patient engagement strategies gather and consider different patient attitudes and segment the supportive content and delivery methods appropriately. Properly trained care managers use these segments to deliver the type of information and support that patients need most at the right time. The Legacy Care Model describes the proven methodology.

Over time, patients and care managers develop a trusting relationship that provides hope and empowers patients to take control of their own health, including adhering to their prescription plan.


If trust and hope are essential to a successful patient engagement, empathy is the clincher. Dr. Kevin Volpp, a physician and health economist interviewed by NPR remains optimistic about medical device interventions like the smart pill bottle, as long as they’re paired with social interventions.[4]

And with good reason. Listening to someone who cares about your health or has been through what you’re about to go through can be very empowering for both parties. A strong patient engagement strategy includes an advocacy program that will enable current and past patients to pass on their experiences to new patients.

Pairing Patient Engagement Technology with Strategy

We’re fortunate to live in a time where we have the experience and know-how to truly engage patients, while leveraging the technology to enable personalization and continuous modifications and improvements. Patient engagement strategy and technology go hand in hand to empower patients, improve patient satisfaction, and increase adherence.

The next step? Encouraging more companies in a position to make a difference — such as pharmaceutical, medical device, clinical trials — to incorporate patient engagement strategies in every initiative. We are here to help make that happen.