IBC, Penn Medicine to Study Pill Caps for Drug Adherence

Independence Blue Cross and Penn Medicine are looking at patient use of Vitality's electronic GlowCap, which fits on ordinary pill bottles, to see if the wireless tool increases medication adherence.

Independence Blue Cross (IBC) and the University of Pennsylvania Health System (Penn Medicine) are launching a study to determine how electronic pill caps help patients adhere to their medication regimens.

Researchers will examine if the beeping devices help improve medication adherence.

Vitality's GlowCap fits on ordinary pill bottles from a pharmacy and offers medication reminders, social feedback, financial incentives and automatic refills. A chip inside the cap detects when a pill bottle is opened and sends an alert wirelessly over AT&T's Mobile Broadband Network. The data can then be transmitted to the database of IBC, an insurer for more than 7 million in the United States, including 2.2 million in southeastern Pennsylvania.

The cap alerts a patient to take medication by shining a glowing light, playing a tune, triggering automated calls, or sending text messages or emails.

"One of the greatest challenges to improving health care today centers on changing the behaviors that lead to poor health, whether that is eating right and exercising, getting appropriate tests and screenings, or taking the medications doctors prescribe," Dr. Kevin Volpp, director of the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania, said in a statement. Volpp leads many of the research projects as part of the collaboration between IBC and Penn.

To identify patients for the pill cap study, researchers will examine data from medical claims and authorization records as well as health data from Penn Medicine, Somesh Nigam, senior vice president and chief informatics officer for IBC, told eWEEK.

IBC and Penn Medicine chose to study patients who have suffered a heart attack, have a history of poor outcomes, and have been prescribed several drugs such as beta blockers and statins to help them avoid a secondary heart attack, he said.

"It's a very vulnerable population," Nigam said. Medication adherence rates can drop from 50 to 60 percent to 20 to 30 percent when patients are feeling better, leaving them vulnerable to a second heart attack, he said.

"At some point patients start feeling well, and their rates go down at almost a straight line," Nigam said.

"Evidence shows that patients who take medications such as cholesterol-lowering drugs as prescribed have a much lower likelihood of being readmitted to the hospital or having another heart attack," Volpp said.

"We know that there are tremendous health benefits to increasing medication adherence and improving health behaviors to reduce patients' risk of disease," Volpp added. "It's just a matter of figuring out the best ways to achieve the desired behaviors."

A 2010 study by the Center for Connected Health found a 27 percent increase in medication schedule adherence by users of the Vitality GlowCaps.

The GlowCap now has more efficient wireless connectivity since a few years ago, Nigam said. "The technology in this trial looks a lot more streamlined," he said. Some issues have also been resolved as far as the fit between the pill bottles and the GlowCap, he said.

Although other medication adherence projects have not worked, researchers are hopeful the GlowCap will have positive results, according to Nigam.

IBC and Penn Medicine are currently enrolling patients for the study, and results could be available by the middle or second half of 2014, he said.

Often the number of people identified as candidates for the study by health data is larger than the people who actually enroll, Nigam noted.

"We're trying to really enhance the enrollment rate, and that can really bring the timelines forward," he said.

In addition to the GlowCap study, IBC is looking into how text messaging and other mobile technologies can play a role in medication adherence for patients with chronic obstructive pulmonary disease (COPD), diabetes and hypertension.

"We think that cell phone technology will play a huge role in improving medication adherence and patient outcomes for a whole host of chronic conditions," Nigam said.

Through text messaging, a patient can answer simple yes-or-no questions as well as simple questions such as "How are you feeling today?" or "Do you have pain?" he said.

"You can really ask those questions specific to the disease and get a fairly good idea about where that patient's state is," Nigam said.

The pill cap study is part of a collaboration that IBC and Penn Medicine announced on June 27. In addition to medication adherence, researchers will study how genomic testing can improve clinical outcomes and reduce cancer care costs.