Harnessing the power of nudges for better therapy adherence

Across health systems, one of the biggest challenges healthcare professionals face in today’s culture is patients who either do not take their medications correctly or do not adhere to therapeutic recommendations from their clinicians.

A slow and progressive decline in adherence over time, often times compounds the poor compliance issue. The failure to take medicines and engage with the outlined treatment path adversely affects the outcome of said treatment, and ultimately places a burden of wasted resources on health systems and society.

Studies over the past ten years have emphasised the importance of patients’ perspectives in therapy adherence. The drivers include their cultural background, their own beliefs, their personal circumstances, and the information & resources available to them.

In the realm of digital health, patient engagement and adherence are not merely beneficial; it is quite simply the cornerstone for achieving optimal health outcomes, so we have to address adherence through the lens of patients’ perspectives.

By crafting health applications that contribute to the granular understanding of how patients manage their conditions within the context of their lifestyle, we are creating tighter and more focused feedback loops to drive better decision-making and better patient recovery times.

A common tactic employed across many platforms involves nudges. These are gamified provocations that drive actions like medication adherence or track subjective symptom severity.

However, as we all know with non-stop requests for notifications on websites and apps alike, the standard, repetitive notifications often morph into annoyances and are quickly disregarded by patients.

We believe that the crux of enhancing engagement lies in deploying personalised, dynamic, precisely timed and actionable nudges.

Let’s find out more.

Continuous data analysis in therapeutics

Therapeutics leverage data to deliver precision healthcare that actively guides patients in managing their health.
Digital therapeutics is revolutionising the way healthcare is delivered, making treatments more effective, patient-centred and responsive to the unique needs of each individual.

By utilising a vast array of patient data, from electronic health records, clinical and molecular information, alongside wearable and mobile device sensor data. Therapeutic solutions are actively monitoring real-time physiological parameters, allowing for the continuous adjustment of a patient’s care plan based on accurate data.

These advances have only been available for a decade, as with most challenges in healthcare the accuracy and completeness of data is the big focus for health businesses, hence the need for a focus on adherence.

Nudging patients towards preventative care

Driving behavioural change isn’t easy… and as we well know, whilst the presumption in the modern, affluent Western world is that everyone has access to devices, internet connections and modern, sensor-rich smartphones, we know this isn’t true.

Whilst in this article, we are talking about sophisticated behavioural engines mapped to engaging, gamified smartphone interfaces, we know from our partners and clients that patients and service users regularly admit to ‘not having an active email address for sign on’, ‘only having a dumb flip phone’, ‘not having WiFi in my house’ and more.

So we preface this section with the assertion that these problems will be solved in the coming generation and that digital solutions are inclusive, accessible and for everyone.

Now back to nudges!

Nudge theory is merely a small sub-segment of a much wider topic, the influence that design can have on patterns of human behaviour, but as this article is limited in it’s scope, we will park the conversation about design for behavioural intervention for another article.

Now, let’s take a look at the challenges and innovations in nudge strategy::

• Planning for sustained engagement: The journey doesn’t end when an app exists on someone’s device. It is essential for enduring patient engagement that the app holds prime real estate, and creates & sustains the desire to engage. This may necessitate a user experience customised to individual patient needs, therapeutic area context and socio-economic circumstances
• Adaptive engagement prompts: It isn’t a one size fits all. The nudges that encourage one person could annoy another, by understanding that different people are motivated by different stimulus, you can adapt to deliver a nudge strategy that works
• Personalised Nudges: Dynamic customisation of nudges, tailored specifically for each patient, is critical… but not easy. This involves selecting the optimal data to drive the decision tree, which may need to reflect timing, context, language and approach for each nudge to resonate effectively with the individual
• Anticipatory Support: By proactively identifying and addressing potential barriers, adjusting support to align with evolving patient needs, and aiding patients in navigating therapy-related challenges you will create a trusted partnership with the end user, who will start to see the benefits of the feedback loop and (hopefully) adjust their behaviour accordingly

Ideally, you will understand the end user to such a degree that you will be able to test designed nudges that aim to predict and tailor interventions, determining the most opportune moments for engagement based on every patient’s contextual drivers.

The engagement related to each nudge should collect data that explains (to a degree) each interaction, which over time should allow you to adjust for resonance, timing and output value.

The aim of the game is to create beneficial behavioural patterns, not for the system but for the patient, and as the patient benefits the system passively accrues more nuanced information to generatively adjust and redefine what ‘good adherence looks like’.

Hopefully where this notion takes us, is towards a preventative care future, rather than a reactive remedial care system that is always fighting the tide.

The future of digital health apps

At Waracle, we have worked on some of the most innovative diagnostic and therapeutic digital health applications in the market.

That means that we have an established knowledge of diseases, therapeutic areas, clinical trials, treatment paths and more, alongside the understanding that comes from delivering software solutions in a highly regulated and privacy-focused environment.

Our talented teams have researched, designed, architected and developed health apps at the cutting edge of patient engagement, so if you are looking for a trusted, focused digital consultancy to help you navigate the challenges in your therapeutic area, whether that relates to adherence and compliance or not… we would love to hear from you.