Technologies for optimizing medication adherence in older adults needed

Center for Technology and AgingDec 21 2009

Avoiding medication-related errors and improving medication adherence among older adults could save the nation billions of dollars and save thousands of lives, according to information included in "Technologies for Optimizing Medication Use in Older Adults," a recent report produced by the non-profit Center for Technology and Aging, and available at www.techandaging.org.

"More widespread use of technologies that reduce the cost and burden of medication-related illness among older adults is urgently needed," said David Lindeman, PhD, director of the Center for Technology and Aging. According to the Institute of Medicine (IOM), more than two million serious adverse drug events and about 100,000 deaths occur annually due to medication use problems. The New England Healthcare Institute estimates that $290 billion of healthcare expenditures could be avoided if medication adherence were improved.

"Medication non-adherence is responsible for up to 33%-69% of medication-related hospital admissions and 23% of all nursing home admissions," said Lindeman. "As Congress debates ways to improve our health care system and lower costs, it will be critical to put in place incentives that encourage providers to accelerate the use of available 'med-op' technologies."

The report addresses these concerns by providing an overview of the medication-use process and discussing three areas of opportunity for medication optimization: 1) medication reconciliation (comparing medications a patient is taking against new physician orders), 2) medication adherence, and 3) medication monitoring. Within each area technologies being used or under development are described, along with an assessment of their pros, cons, market stage and economics. Some of the technologies described include:

-- Medication kiosks, such as those piloted at the Veterans Health Administration -- Walgreen's online medication history tool for consumers -- Cognitive assessment tests like the Mini-Mental State Exam (MMSE) -- "Rex" the talking pill bottle that assists visually or cognitively impaired patients -- InforMedix's Med-eMonitor System, a portable electronic medication- dispensing device -- Mobile phone apps with medication management, reporting and trending features -- Wireless point-of-care testing devices to monitor medication use

According to the report, of the three billion medication prescriptions issued each year in the U.S., 12% are never picked up by the patient and 40% are not taken correctly. "And yet, effective tools and technologies already exist to greatly reduce these problems," said Lindeman. "Ultimately, medication optimization technologies can lead to significant improvements in the cost and quality of care for older adults."