Mobile Phone App Helps Patients Take Medication More Consistently

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					Mobile Phone App Helps Patients Take Medication More
Consistently: Study
By: Brian T. Horowitz

George Washington University researchers, chip maker Qualcomm, wireless carrier
Cricket and app developer Vocel presented results of a study showing how a mobile
phone application helped patients take medication more consistently.
WASHINGTON, D.C.—Patients with high blood pressure did a better job of taking prescribed medication
through the use of a mobile phone application that reminded them when to take their pills, according to
the results of a recent medication adherence study conducted by George Washington University here.

The study results were discussed at a Feb. 9 conference hosted by GWU and included several parties
that supported it, including mobile chip manufacturer Qualcomm, mobile health application developer
Vocel, nonprofit group One Economy and wireless operator Cricket Communications.

GWU's research examined how well mobile technology helped hypertensive patients in communities
underserved by medical professionals stay on their medication regimes. The participants in the GWU
conference also addressed the potential for improvements in mobile health technology.

The study involved the use of Vocel's Pill Phone, which is a mobile phone application that allows patients
to receive audio or visual medication reminders; track records of dosage; and access content from "The
Pill Book" on side effects and interactions. It was the first mobile medication management app to receive
FDA approval, according to Vocel. The study found participants to be "generally satisfied" with medication
reminders from the Pill Phone app.

In addition, the survey revealed high acceptance and prolonged use of Pill Phone. Medication use rates
rose moderately from 75 percent to 82 percent while patients used the app, but dropped when
participants stopped using Pill Phone.

Although researchers expected subjects to be taking one or two pills per day, patients' intake averaged
up to 10 a day and ranged from three to 16.

"We designed the UI around most people on one or two, but people are on about eight a day," Vocel CEO
Carl Washburn said during a panel discussion.

Poor adherence to medication schedules leads to inadequate blood pressure control for more than two-
thirds of patients, noted Dr. Richard Katz, director of cardiology at the GWU Medical Center, which
coordinated the research.

In fact, poor medication adherence costs the health care industry $100 billion a year in avoidable
hospitalizations, according to a Harvard University study.
One Economy, a firm that uses technology to help underserved communities, came up with the idea for
the study and approached GWU to consider the project, Clark D. Ritchie, the company's CTO, told
eWEEK in an interview with the study organizers at GWU.

The university then consulted with Qualcomm's Wireless Reach program, which funded the study.
Wireless Reach provides funding, education and access to programs that connect underserved
communities to wireless technology.

For the seven-month study, wireless operator Cricket supplied 50 low-income Medicaid patients from the
university's clinics with 3G EV-DO handsets running the Pill Phone app. The goal was to test how well
subjects kept to their medication routine. Meanwhile, doctors monitored the participants' progress using a
secure Web site.

The average age for participants was 53 with a range of 33-78. In addition, 96 percent of the Medicaid
participants from GWU's D.C. clinics were African-American, and only 17 percent of the sample had
finished college.

"We were able to take a population with a lot of challenges, and they liked the intervention and they were
able to use it to improve their adherence to medication," Erica M. Whinston, Qualcomm's senior manager
for government affairs, Wireless Reach, told eWEEK.

Representing the test sample of Pill Phone app users onstage at GWU was Dolores Smith. In fact, Dean
Brenner, Qualcomm vice president of government affairs, called the group the study aims to help the
"Dolores Factor."

"It was really easy to use because I'm not good with the cell phone," Smith said. "I usually have to turn to
the kids." Smith noted that she received 34 minutes of instruction on the phone prior to using the Pill
Phone app.

About 65 million Americans (one in three) suffer from hypertension due to poor adherence to blood
pressure medication.

"We're looking at the truly sick, not a group of people that are partially sick or the yoga people that are
incredibly healthy," Robert Jarrin, Qualcomm's senior director of government affairs, told eWEEK.

"You've got a chronic disease that is huge and pervasive, and you've got a technology that is huge and
pervasive as well," Jarrin said. "So the pill phone is a wonderful example of that tool—it can be used in a
widespread way."

Also attending the GWU event were officials from the Federal Communications Commission and NIH
(National Institutes of Health).

"We need to be able to intervene with things that are ubiquitous, and mobile technologies are ubiquitous,"
said Dr. Wendy J. Nilsen, health science administrator for the NIH. "With mobile devices we can collect
information and know why they're not adhering. It's the perfect place where doctors can intervene."

Nilsen called the project "well-designed" and the "perfect thing we want to see in pilot," during an onstage
critique of the study results.

"These efforts show us that m-health is important to the nation, and we see our federal resources aligning
to support it," added Kerry McDermott, health care director for the FCC, who oversees the agency's push
for wireless health, particularly in rural areas.
Mobile health technologies in progress

Dr. Samir Patel, associate professor for the GWU Medical Center, noted that mobile technologies such as
the Pill Phone have "potential to increase medication adherence, but improved methods to test
medication adherence will be necessary."

At GWU, Vocel's Washburn shared with eWEEK plans for version 2.0 of the Pill Phone app, which will be
available later this year.

When doctors want to share patients' pill adherence with other medical professionals, doctors will be able
to send a Facebook-like invitation to patients requesting the ability to share data under HIPAA guidelines.

Based on the study's results, the next version of Pill Phone will have simultaneous reminders for multiple
pills, rather than separate reminders minute after minute, Washburn said.

Version 2.0 will also incorporate the ability to link to patients' EHRs (electronic health records), a
capability in demand in the medical community, as GWU's Katz noted.

Wireless access, digital literacy and mobile app content will be required for mobile health technology to
succeed, according to One Economy's Ritchie. "All three of these need to come together to make a dent
in the national problem," Ritchie said.

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