What Patients Actually Want From Connected Drug Delivery

By BioPhorum

Digital technologies are increasingly being integrated into drug delivery devices, with promises of improving adherence, supporting self-management, and generating valuable real-world data. Yet despite significant investment across the healthcare sector, many connected solutions struggle to achieve sustained patient engagement.

A recent survey conducted with BioPhorum members revealed that the most critical aspect of digital healthcare for drug delivery devices is patient-related benefits. The survey also highlighted that financial challenges are the most significant barrier to achieving success in this digital realm, which is not likely to come as surprise.

Patient-Centric Approach

The survey identified four key topics related to patient benefits:

1. Adherence: Ensuring patients take their medication as prescribed
2. Efficiency: Enabling patients to self-manage their treatment
3. Quality of life: Providing remote or direct measurements of health metrics
4. Lifestyle/behavior: Minimizing the impact on patients' lifestyles

Perhaps equally unsurprising, adherence to treatment regimens ranked highest in our survey. This, of course, is all about getting patients to do what they’re told to do – take your medication. Thinking for a moment about this, this is not about the patient at all — this is an industry measure. It’s true that improving adherence improves outcomes — for both patients and healthcare, but it’s not the driving force for patients that we (industry, HCPs, payers, insurers, whoever) want.

The other aspect linking to importance of digital technology in drug delivery devices, though, is the patient and their experience — though this aspect is a lot harder to quantify.

Using technology to ensure patients are taking their doses has some limited applicability.

From one of our recent podcasts, we’re aware that new apps in this space are generally used for only six weeks before they stop being used. This is reflected in wider market data, including one study that found that 53% of all digital health apps are uninstalled within 30 days of download.¹ Patients, or people in general, must have a driver of some kind to encourage them to use the app. It must fulfill a need.

To explore this a little further, there is learning from consumer wearables. As one source notes: “Increasing patient adherence to long-term treatment is a beneficial and powerful factor for optimizing the effectiveness of therapy in chronic diseases.”²

Pharma companies, on the other hand, are very interested in ensuring that the molecule they are offering in these delivery devices is being provided with this type of data and connectivity solution. Weight management is also emerging as a strong area, especially with drugs such as glucagon-like peptide 1 (GLP-1) and their benefits for type 2 diabetes (T2D). There are a huge drive and opportunity for us to support injection devices for GLP-1 use in T1D, T2D, and weight management.³

The key features of an ecosystem environment are its reduction of burden and increase in confidence for the most important person involved – the user. In drug delivery, of course, it’s the patient who needs to use this particular drug or is on this particular therapy cycle for their own health purposes. Any reduction in burden and an increase in confidence, along with an overall improvement in mental state and quality of life, are the biggest benefits of a digital ecosystem. For example, a parent can see that their child has taken their injection and how it balances with their continuous glucose monitoring data versus their insulin.

That is why patient centricity is an important consideration for any organization developing therapies for self-administration. Beyond the device itself, pharmaceutical companies should seek to support patients by leveraging digital health solutions to guide them through self-administration, symptom management, and communication with their healthcare providers. Building intuitive and scalable digital health solutions is critical to overcoming common barriers to self-administration and bringing valuable therapies to more patients in need.⁴

Wireless connectivity is gaining relevance in the field of drug delivery. The COVID-19 pandemic accelerated the growing acceptance of self-administration. However, self-administration without connectivity is like using a computer without an internet connection – while the primary tasks of delivering a drug can be performed, valuable information regarding device performance and patient compliance cannot be effectively stored and shared for disease management.⁵

What Are The Hurdles For Patients?

• App selection: Much like healthcare providers, patients can quickly become overwhelmed by choice. It can also be difficult for them to find an app that aligns best with their needs, particularly given that people tend to have multiple concerns or comorbidities and want an app that covers as many of these needs in one place, to avoid spending too much time recording details in multiple systems.
• A lack of added value: While symptom tracking for a specific condition can be useful, apps often fail to add sufficient value to patients’ lives, leading to discontinuation of use. With apps, it’s very much a case of “out of sight, out of mind,” so, people need a valid reason to return regularly. A lack of personalization or limited integration with other healthcare apps can thwart this just as much as a lack of validation, regulatory oversight, or unreliable data accuracy. An absence of healthcare provider involvement will only exacerbate the disconnect between the app and the user’s overall healthcare journey.
• A need for comprehensive solutions: When patients are forced to use different apps for different, often interrelated, health conditions, they can soon become frustrated, feeling that they have to simplify their struggles to conform with the requirements of each system. They might be asked a question about chest pain, for example, only for this to be immediately flagged as an emergency, although they know that this is actually due to hypermobility and costochondritis. They may therefore avoid recording this pain altogether, eroding their trust in the app’s capabilities and meaning any doctors involved in their healthcare via the app aren’t getting the complete picture, either.⁶

Learning From Consumer Wearables

The growing number of consumer wearables, including Apple Watches, Whoop Bands, Ouro rings, and Fitbits, offer valuable lessons for the healthcare industry. These devices have successfully integrated technology to provide value, with users seeing sufficient benefit to be willing to part with hard-earned money to collect biometric data, with concomitant lifestyle insights and advice delivered to the accompanying apps. Can this approach be leveraged by pharma or healthcare?

Any new digital health app should truly empower patients to better manage their conditions and more easily share decision-making with their provider. But that alone isn’t likely enough to drive adoption. Connected devices and their apps would benefit from gamification. Without some kind of “reward,” what would lead a patient to overcome the perceived barrier to long-term, committed use? Some studies have taken patients’ suggestions on board and included the reward of virtual coins or leaderboards to incentivize patients’ ongoing engagement with apps.⁶

Will Ahmed, founder and CEO of Whoop, has highlighted that there’s a big difference between what people/customer/patients think they want versus what they need. When Whoop asked their prospective customers for the features that they wanted to see in a new device, they built a long list of disparate metrics, a list that Whoop considered infeasible. The breakthrough here happened when Whoop asked their prospective customers what their biggest problems were. Solving real problems allowed Whoop to develop a device that met multiple needs, relatively easily.

Does this lesson apply to drug delivery? Perhaps the answer lies in asking the right questions. Are your patients asking you to provide apps that will ping to remind them to take a dose? Or are they having issues with something else? What is making life difficult for your patients? Solve that problem and you’ll add value for your patients.

The Future Of Patient-Centered Digital Health

Many medtech companies are already beginning to incorporate always-on biosensors and software into devices that can generate, gather, and share data. Advanced cognitive technologies could be developed to analyze a significantly large set of parameters and create personalized insights into a consumer’s health. The availability of data and personalized AI can enable precision well-being and real-time micro interventions that allow us to get ahead of sickness and far ahead of catastrophic disease.

Consumers — armed with this highly detailed personal information about their own health — will likely demand that their health information be portable. Consumers have grown accustomed to transformations that have occurred in other sectors, such as e-commerce and mobility. These consumers will demand that health follow the same path and become an integrated part of their lives, and they’ll vote with their feet and their wallets.⁷

Radically interoperable data and AI can empower consumers in ways that are difficult to visualize today. Data about individuals, populations, institutions, and the environment will be at the heart of the future of health.⁸

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