Are smartphones the key to patient adherence?

Maddi Ginsberg

Poor adherence to treatment plans costs upwards $100 billion annually. Moreover, nonadherence causes up to 70% of medication-related hospital visits. But nonadherence isn’t necessarily an indicator of apathy or unwillingness to change; far more often it’s due to a myriad of factors which can include forgetfulness or misunderstanding the treatment plan. Doctors can take all the right steps and still, adherence to long-term treatment for chronic illnesses is just around 50%.
The first, and possibly most challenging hurdle to battling nonadherence, is understanding whether care protocols are being followed. There are a variety of options for monitoring adherence — refill rates, biological and mechanical monitoring, and more — but the majority of these methods are invasive, inaccurate, expensive, or time-consuming. The simplest, and often central, indicator used by physicians is self-reporting. However, self-reporting is also inherently inaccurate and far from seamless, relying on memory and pencil and paper recording.
Now with the advent of ever-advancing smartphone technology, the key to adherence may be (literally) right in our hands. Smartphones could help bridge the gap between physician and patient to improve communication and outcomes. This technology enables patients to stay on track and become more involved in their own health plan by giving them immediate access to their tracking tools, making reporting faster and more efficient, and doing some of the physician’s’ analysis for them right on the device. In addition to tracking adherence, devices also offer the potential benefit of helping the patient understand the care plan, receive immediate feedback, and ask questions and get answers in real time.  
Though many are still in the early stages of adopting these innovations, Noom has already seen success in clinical research. In one study, Noom created a 15-week program for 100 office workers and compared it against an in-person weight loss program that took a more conventional approach. Noom started its participants with a session on overall wellness, a group nutrition class, and three in-person fitness classes. The rest of the program was reliant on the Noom Health app, which allowed individuals to track digitally 24/7 and connect with support groups virtually. Against the conventional approach, which offered in-person weekly meetings with a personal trainer, in addition to many nutritional and physical classes, Noom retained 98% of all participants, while the conventional approach lost 50% of its adherents.
Overall, Noom users lost three times as much weight as those in-person group did. The Noom group members were able to pursue their weight loss independently with the support of the mobile app and their respective virtual groups with limited in-person interaction. Noom participants adhered far more to the mobile approach than those in the conventional group.
For a larger-scale but similar study, Noom measured adherence as defined by total logging. About half of participants who stayed with the program for three months lost more than 5% of their starting weight. Moreover, for every additional 10% of adherence, patients lost nearly 3 BMI points more than those who were less adherent.
Noom’s research indicates that smartphones can be a powerful tool for increasing adherence, and with stronger adherence comes better results and healthier patients. Thanks to the already-pervasive and ingrained usage of smartphones, healthcare professionals can look forward to creating a healthier population with everybody’s favorite tech.