WOONSOCKET, R.I. – Medication adherence is a persistent challenge for people with serious and chronic health conditions but studies have shown that digital tools can help.
Dr. Surya Singh, chief medical officer of CVS Specialty, the specialty pharmacy of CVS Health, shared how the company is using digital tools to engage patients in taking care of their health and sticking to their care plans.
HHTN: How is CVS leveraging technology to improve medication adherence for people with serious and chronic health conditions?
SINGH: For people living with rare or complex conditions that require treatment with a specialty medication, day-to-day disease management can sometimes be challenging. For example, patients may struggle to start or refill their therapy or have unanswered questions about medication side effects, laboratory monitoring and other aspects of their therapeutic regimen. For years, CVS Specialty has provided highly personalized telephone support from a patient’s CareTeam, a team of specially trained pharmacists and/or nurses. Recently, however, we have enabled our patients to access this same type of personalized support digitally, with a secure messaging capability that allows specialty patients to send and receive secure messages from a member of their CareTeam through the CVS Specialty website or mobile app. Enrolled patients receive therapy-specific information and reminders via text-based alerts and can reciprocally ask questions of our clinicians, to which they receive a timely response.
HHTN:What is the impact of this kind of intervention?
SINGH:In a pilot of this capability completed in 2017, we saw dramatic improvements in medication adherence for patients with chronic myeloid leukemia. In fact, for those enrolled, up to 30% more patients achieved optimal medication adherence. Similar results have been demonstrated with rheumatoid arthritis, multiple sclerosis and cystic fibrosis. As research shows, better medication adherence can help improve clinical outcomes and reduce overall health care costs. This digital offering is now available to nearly all of our CVS Specialty patients, and we are seeing patients prefer digital communications with 80% of them engaged in our messaging programs.
HHTN:How does technology empower patients to take more control of their own health management?
SINGH:In specialty pharmacy, many of the drugs have higher rates of side effects and complications, which can cause a patient to stop taking their medication. In turn, medication discontinuation can negatively impact a patient’s disease prognosis and overall health outcomes. By enabling this highly personalized secure platform, we are able to connect with a patient during a critical time in their care, in between doctor’s visits, when they are thinking about their health and are thus more receptive to coaching.
HHTN:How does it work?
SINGH:Powering this capability is a proprietary, company-built database that is loaded with therapy and indication-specific clinical information. For example, for certain therapies indicated for a specific condition, we know that, based on clinical trial data and the drug’s label, patients will likely experience nausea during the first week of therapy. Based on that information, we will time an outbound message to the patient when the nausea is most likely to occur. The message is sent to their mobile device in a text-based alert letting them know that they may be experiencing nausea, which is a known side effect, with a link to ask a medication-related question. The patient and pharmacist can then move into a secure messaging exchange in real-time via mobile device or website, or take that conversation by phone, depending on the patient’s preference. Whether the interaction is digital or by phone, there is a clinician on the other end, helping that patient work through whatever they are experiencing and making recommendations to help best address their health care needs at the time they need it most.
Also included in our CVS Specialty mobile app are condition-specific educational material, lab monitoring information, medication refill reminders, shipping alerts, information on easy ways to order refills, refill order tracking and account information. Altogether, this helps empower the patient to stay on top of their care and better adhere to their therapeutic regimen. Furthermore, when patients are experiencing an issue, the app offers patients an easy-to-use, convenient platform that puts potential solutions at their fingertips.
HHTN: Does CVS have plans to incorporate other digital health technologies?
SINGH: As technology is becoming a critical component of effective and highly personalized health care delivery, CVS Specialty is also investigating other technologies, including wearable devices that monitor patients’ biometrics and provides information to the CVS Specialty CareTeam for evaluation and intervention as appropriate.