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Transcript of Memotex tmh2011
Study Title: The Impact of Automated Reminders Linked to a Personal Health Record on Adherence with
Glaucoma Medications:
The Automated Dosing Reminder Study (ADRS)
MEMOTEXT Corporation Trial with Johns Hopkins UniversityWilmer Eye Clinic –
Funded by Microsoft BeWell Fund
www.memotext.com1877-MEMO.TXTTwitter @memotext
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What Really Works?!
• What is MEMOTEXT?• Overview: Automated Dosing
Reminder Study (ADRS)• Problem/Hypothesis• Methods• Moving the Needle• Lessons Learned ~ Organic solutions
MEMOTEXT is an:• Iterative methodology• Interactive dialogue• Inference based
…speech, mobile and social media patient adherence solution.
Stage of
ChangeRECRUITMENT
Personal History
Disease/ Med
LiteracyASSESSMENT
Self Efficacy
Depression
INTERVENTION
Locus of Control
RE-ASSESSMENT
What is MEMOTEXT?
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What really works?!
This project received funding from the Microsoft HealthVault Be Well Fund.
Lead by: Michael V. Boland, MD, PhDAssistant ProfessorDirector of Information TechnologyWilmer Eye Institute and Health Sciences InformaticsJohns Hopkins University
Johns Hopkins University: Approached MEMOTEXT® to provide an automated, customized and interactive adherence solution for glaucoma daily medication - a study entitled "The Impact of Automated Dosing Reminders on Medication Adherence using HealthVault“ (ADRS).
Launched: June 2009
Prelim results presented at American Glaucoma Society March 2011Automated reminders linked to a personal health record are a practical option to improve adherence
www.memotext.com
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Problem: Non-compliance to Glaucoma medications leads to severe complications.
• Problem: cost- staff time to interact with patients
• Problem: lack of patient education • Problem: poor adherence in almost half of
study patients• Problem: patients self –reporting after the
fact is not reliable• Problem: Lack of patient/family control
Hypothesis:The Automated Dosing Reminder Study tested the hypothesis that automated, telecommunication-based reminders can improve adherence with glaucoma medications in patients known to have poor adherence.
www.memotext.com Glaucoma adherence study overview
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Recruitment Channel: JHU Research / Wilmer Eye Clinic directly into Microsoft HealthVault
Poor adherence is defined as taking < 75% of doses during the monitored period.
N= 428 glaucoma patients treated with once daily therapy.
Subjects were monitored electronically for 3 months (MEMS, AARDEX group).
White coat effect: adherence rate was calculated from 2 weeks after the baseline visit until 2 weeks before the follow-up visit.
• Monitor Adherence
3 months
• Poor Adherence
• Good Adherence
Randomize
• MEMOTEXT group
• Control group
3 months
www.memotext.com Methods
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Recruitment/EnrolmentPatients selected
1. Medication: Travatan, Xalatan and Lumigan
2. Frequency (daily/weekly)3. Media (sms/IVR)4. Time of message(s)
www.memotext.com Methods cont.. enrolment
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Patients receive weekly, bi-weekly or daily
messages via voice / SMS
Acknowledge / confirm action
Snooze call Repeat this message
49.02 % of voice messages were conf./acknowledged in real time. 2% of calls were snoozed and called back.
SMS and IVR Calls
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FINAL RESULTS Initial (%) Final (%) p
Control 49 ± 26 50 ± 31 0.83
Intervention 51 ± 19 67 ± 19 0.003
Moving the needle
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Avg. Age 69
Sex (% female) 52
Ethnicity (%)
European 59
African 34
Asian 5
Hispanic 1
Other 1
• Medication adherence is a problem in a significant population of glaucoma patients
• Automated reminders linked to a personal health record:– Are a practical option to improve adherence– Allow patient or family control over reminders– Significantly improve adherence with daily medications
• A simple, elegant intervention increased adherence by 16%
• Recommendation was to develop method to predict non-adherent patients.
Do the difficult things while they are easy and do the great things while they are small... Lao Tzu
Stage of
ChangeRECRUITMENT
Personal History
Disease/ Med
LiteracyASSESSMENT
Self Efficacy
Depression
INTERVENTION
Locus of Control
Summary…From simple messaging to intelligent dialogues.
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• Find us to learn about how we create self-learning SMS, speech and social adherence interventions.
• www.memotext.com• [email protected]• www.Twitter.com/memotext • 877-MEMO.TXT• Txt or call me: 416-520-3301
Keep in touch!
And they all lived happily ever after…