Adherence and persistence Adherence and persistence

with medication regimens is highlywith medication regimens is highly

relevant to disease outcomesrelevant to disease outcomes

• Adherence to a medication regimen is generally defined as the extent to which patients take medications as prescribed by their health care provider.1

1. Osterberg L, Blasche T. N Engl J Med. 2005;353:487-497.2. Breekveldt-Postma NS et al. Curr Med Res Opin. 2008;24:121-127.

• Nonpersistence with antihypertensive therapy is associated with an increased risk of myocardial infarction and stroke.2

• Methods that can be used to confirm adherence to a medication regimen include: monitoring of pill count, monitoring of prescription refill rate, and patient use of “smart” pill bottles, but these are all indirect measures.

*Defined as the total number of days of therapy for medication dispensed/365 days of study follow-upACE, angiotensin-converting enzyme; CCB, calcium channel blocker; SPC, single-pill combination

Gerbino PP, Shoheiber O. Am J Health System Pharm. 2007;64:1279-1283.

SPC(ACE inhibitor + CCB)

(n=2839)

Free combination(ACE inhibitior + CCB)

(n=3367)

Medication possession ratio (MPR)*

P<0.0001

88%

69%

0% 20% 40% 60% 80% 100%

Prescription of a single-pill combination is associated with improved Prescription of a single-pill combination is associated with improved adherence rates compared with free-combination therapyadherence rates compared with free-combination therapy

A new device* approved by the FDAA new device* approved by the FDA11 can be included in can be included in antihypertensive pills to monitor the adherence to treatmentantihypertensive pills to monitor the adherence to treatment

• The ingestible sensor is made entirely of ingredients found in food and is activated upon ingestion to transmit a unique number which is captured by an external patch.

• The ingestible sensor does not require any battery or antenna; it is powered by the contact with stomach fluids.

• The ingestible sensor can be embedded in a drug product and can be used for directly confirming medication adherence, as part of a networked wellness system.

Edible sensor attached directly to a tablet

• The networked system has already been tested in hypertension and heart failure populations.

* The Ingestion Event Marker (IEM), by Proteus Health.1. FDA approves digestible microchips to be placed in pills. Medscape. August 3, 2012.