How is adherence defined?
The World Health Organization (WHO) defines adherence as "the extent to which the patient follows medical instructions." The WHO recognizes that this definition still has limitations; namely, the term "medical" does not cover the vast range of interventions used to treat diseases, and the term "instructions" indicates patient passivity versus active collaboration in their own treatment.
Adherence involves more than just taking prescribed medications but rather reflects the health-related behaviors of the patient, including seeking medical attention, filling prescriptions, scheduling and going to follow-up appointments, and actively making lifestyle modifications for optimal treatment results.
The American Medical Association lists 8 reasons for intentional medication nonadherence, including:
Fear regarding possible medication side effects
Worry about dependence on medications
High cost of medications
Mistrust of medications, pharmaceutical companies, or doctors
Depression, which reduces the likelihood of medication adherence
Polypharmacy, especially in the elderly with several comorbid conditions requiring multiple pharmaceutical interventions
Poor understanding (often due to lack of communication between doctors and patients) that medications may take a while to have a noticeable effect or why medications are used when nothing is wrong (yet) to prevent adverse outcomes, including strokes or heart attacks
Lack of current symptoms resulting in discontinuation of the medication once the patient feels better (with lack of the fully prescribed dose potentially resulting in worse outcomes)
Adherence must also reflect accuracy on the part of the caregiver or health care provider to provide the correct dosage of medications with the right timing when the patient is unable to take their medications independently.
This holds true, especially for individuals with cognitive or physical impairments or for patients in hospital settings with serious conditions—conditions that restrict their own ability to control their own adherence.
What is the scope of the problem?
Poor adherence to medications is a significant source of patient morbidity and mortality, as well as increased healthcare expenditures. According to the literature, up to half of all patients in the United States (US) do not take their medications as directed by their physicians. Experts estimate the problem of lack of adherence to be even higher in developing countries with limited access to resources and health care services.
Experts estimate that around 125,000 preventable deaths occur annually in the US due to a lack of medication adherence. Between 33% and 69% of all medication-related hospitalizations and between 1% to 10% of total hospitalizations are associated with medication nonadherence.
In 2016, the US spent over $500 billion dollars in healthcare expenditures associated with drug-related morbidity and mortality. This avoidable expense accounted for approximately 16% of total US healthcare expenditures for that year alone.
Can 3D pharmaceutical printing provide a solution to patient noncompliance?
In short, the answer is yes. Laxxon Medical's 3D pharmaceutical printing technology is uniquely poised to provide a solution for many of the problems contributing to the lack of medication adherence.
One way 3D printing may decrease nonadherence, particularly in individuals with multiple chronic illnesses, is by targeting the problem of polypharmacy. As the American Medical Association mentioned, taking too many medications is one of the most common reasons why individuals are noncompliant with taking all of their medications.
Laxxon's 3D pharmaceutical printing allows for the active pharmaceutical ingredients of multiple medications to be layered on top of each other – and combined into one tablet. The specific geometric design and formulation of active versus inert layers for each pill improve drug delivery and times the release of multiple doses of these active ingredients throughout the day.
In other words, the burden of taking multiple drugs, sometimes multiple times a day, can be reduced to taking one customized tablet.
This layered formulation of tablets not only can combine medications into one, but it can more accurately control a customized delivery of active ingredients, resulting in fewer medication side effects. This can reduce patient worry and fear about side effects as well as decrease the number of hospitalizations due to medication noncompliance or side effects.
Not only can 3D pharmaceutical printing support personalized, precision medications but it can be done with a speed that enables mass production of these customized medications.
How can QR codes decrease medication nonadherence?
Quick response (QR) codes are two-dimensional barcodes that can be easily scanned by the camera of smartphones or devices. The QR code can connect a person to content stored on websites. This content may include useful information about the medication dose and any potential side effects or simply confirm what medication it is, which may prevent improper dosing.
Scanning QR codes may improve medication adherence because this action allows doctors to telemonitor patient compliance with prescribed medications from afar. If patients and/or caregivers scan the QR code embedded on each 3D-printed tablet before consumption, doctors can collect and track this digital data to confirm how compliant patients are with taking their medications at home.
One recent Italian study confirmed the feasibility of using QR codes to telemonitor drug intake among medically complex, elderly, cardiovascular patients. The researchers emphasized real-time feedback applied to individual medication intake as well as the widespread accessibility and the low cost of QR monitoring. Accessibility would, of course, be limited to patients or caregivers who own smartphones or similar devices with QR scanning capabilities.
Laxxon Medical's patented QR code technology can ensure patient medication adherence and safety, patient access to medication information, and easy physician telemonitoring—ultimately allowing patients to achieve optimal long-term health outcomes while simultaneously reducing health care expenditures.
Laxxon Medical is dedicated to engineering patented 3D pharmaceutical solutions which optimize products and benefit patients. Our goal is to establish SPID®-Technology as a manufacturing process that has the individual and the pharmaceutical partner in mind.
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