The problem of lack of adherence to treatment in patients with mental illness, has been approached through the use of wearables and has also provided solutions.
Lack of adherence to treatment leads to non-adherence to medication, and in addition to affecting other patients, can lead to an increase in healthcare costs. In the United States, only one in three patients with schizophrenia adheres to their medication regimen, and this lack of adherence subsequently translates into re-hospitalization costs.
In the United States, the Food and Drug Administration approved digital aripiprazole, an antipsychotic medication that contains an ingestible sensor to control and track consumption. In this way it was possible to find and provide support to patients with less adherence, however, its high price, 85 times more than generic aripiprazole, makes it far from being a solution for now.
This year a study was published in Nature, on the medication of psychiatric patients and how through activity patterns it is possible to know the adherence of each patient. The study details how through an accelerometer and an electrocardiogram incorporated in a digital medicine system of a wearable or a patch, records of medication intake are obtained and thus know the patient's activity and whether there are behavioral changes directly related to the patient's adherence.
In that study 95 patients with schizophrenia, bipolar disorder and major depressive disorder, all on stable doses of aripiprazole, received a supply of digital aripiprazole for several weeks.
The digital aripiprazole sensors were able to provide an objective measure within parameters of medication adherence. The data collected by the sensor was used to determine how well heart rate and accelerometer data could predict adherence.
“The accelerometers in each patch allowed investigators to calculate an “activity rhythm score” capturing how consistent a person’s step count was from day-to-day. They also calculated a “relative active-interval heart rate” which indicated the intensity of physical activity. Both a high activity rhythm score (indicating that a person’s step count was consistent with their routine), and a high relative active-interval heart rate (indicating intense physical activity as compared to baseline), were correlated with the likelihood that a study participant would take their medications the next day”, explained in their editorial in the journal Nature.
In this way data on high activity rate (such as step count) were associated with greater adherence than those with lower activity rate.
