Barriers For Patient Adherence
The failure to comply with a medical plan of care can have a variety of origins. Many products are shipped and patients are left on their own to decipher complicated instructions. It may be a device that is difficult to set up and operate, or patients may be expected to administer a series of injections or complete medication titration. Devices may cause embarrassment if they are difficult to hide under clothing. They can be complicated to use correctly or require ongoing maintenance to ensure the device continues to function as intended. There are also practical issues to consider, such as a loud or dark environment that makes it difficult to hear or see device alerts. This “reactive vs proactive” response means the patient has already experienced an issue and a care team needs to respond quickly.
For medical technology used to manage critical illness or disease, preventable adverse events may also occur for several reasons:
- Inadequate education ahead of surgery for implantables or devices used after discharge.
- Ongoing education needs because a sick patient forgets most of their education before arriving home.
- Knowledge deficits that can include the equipment functionality and the disease process.
- Inadequate skills or resources to maintain and manage a medical device or disposables.
- Non-compliance to medical care plans including recommended physical activity and nutrition.
- Inattention to device alerts and settings leading to device malfunction or worse.
Support Device Adherence With Tailored Digital Care Pathways
Many of these potential barriers to adherence can be alleviated with a secure text message-based digital communication platform, resulting in better care, improved patient experience and better outcomes. Care pathways that can be tailored to the requirements of the device, timed to coincide with desired patient activities, and prompt patients to engage regularly with their care plan will help you ensure an optimal patient experience.
Design Content That Supports and Encourages Patients Along the Way
A series of secure customizable messages, questionnaires and video content can provide step-by-step guidance throughout the patient’s health journey, and also deliver nudges along the way to encourage compliance. Offering gentle reminders of the device’s benefit to their health, the positive impact it can have on unpleasant symptoms, and the medical consequences of non-compliance can keep patients on track. You can also reinforce desired behavior and provide personal outreach and encouragement, which builds trust and loyalty.
Consider a patient diagnosed with obstructive sleep apnea (OSA). This diagnosis can be well managed with continuous positive airway pressure (CPAP) therapy and yet compliance is a significant challenge. Patients may not stick with their CPAP therapy because they don’t perceive a benefit, they find the device uncomfortable, or reluctance to bother their partner. A steady cadence of supportive and informative messages can remind patients of the benefit they will experience, the importance of treating OSA, as well as step-by-step guidance helping them stick with the device long term.
Break Down Information Into Well-Timed, Easy to Understand Messages
For devices that are complex or treat very serious conditions, added communication is warranted. For a left ventricular assist device (LVAD), there are important steps patients should complete before the insertion procedure to ensure a good outcome. The patient will also have a more satisfactory experience if they know what to expect during and after this life-changing device is implanted.
In the postoperative period, LVAD patients benefit from surgical site education and regular monitoring, as infections and other conditions can be life threatening. Delivery of timely, easy to understand information about care and maintenance of the device will be important for the patient and potentially their caregivers. A digital two-way communication platform also enables regular check-ins to gather valuable assessment information, collect remote physiologic monitoring data, and deliver alerts to the care team when changes warrant immediate patient follow up. And in light of the COVID-19 pandemic, the benefits of a configurable platform that can support virtual care and delivery of new, changing information are clear.
Activate Patients in Their Care
Connecting with patients and activating them in their care is a proven strategy to optimize medical device adherence. Give patients information and support they need along the way to successfully navigate the use of a medical device and empower them to be an active participant in their own care plan. Using a digital platform enables automation of optimally timed messages, allows for flexibility as patient needs change, and ensures that the care team is alerted when intervention is needed, resulting in more proactive and personalized care.
See How Implementing Twistle Helped Improve Diagnostic Accuracy and Device Adherence
Virginia Mason collaborated with a leading manufacturer of CPAP devices and an independent durable medical equipment company to significantly improve diagnostic accuracy and device adherence.
Learn how they achieved an 80% reduction in testing no-shows and a 14% increase in 90-day device adherence.
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