Ano is a Justmeans staff writer for health, and an instructional designer for the newly created Master of Health Care Delivery program (mhcds.dartmouth.edu) at Dartmouth College. Ano brings over a decade of evidenced-based health research and writing, and a Masters of Public Health from Dartmouth Medical School to the Justmeans Editorial section. Special interests include health policy, conflict ...
Should Docs prescribe Mobile health?
Findings published recently in the journal European Psychiatry point to a potential reservoir of unmet mhealth (mobile health) need in the area of depression treatment. The Spanish study followed 7525 patients starting medications for depression to see how many would continue to take their meds for the recommended 12 months treatment period. Within three months 56% had stopped taking their medication, and by the eleventh month, only one quarter were still popping their pills. At the end of a year, only 22% were still taking their medication. Interestingly, patients taking daily meds for multiple chronic health conditions were twice as likely to continue taking their antidepressants. Population studies in Europe suggest that 10% to 13% of the population suffers from depression.
So where does mhealth fit in? Mhealth reminder services abound. From Mexico to South Africa they are being utilized to help increase compliance with medication regimens and healthy behaviors for patients with health conditions ranging from HIV to diabetes. A recent small study reported that asthma sufferers involved in an interactive mhealth program had better health outcomes than controls not involved in the program. In New Orleans the LSU health system uses a variety of mobile approaches to improve their care of diabetes and heart failure. Perhaps most encouraging, a study in HIV patients suggests that social support provided via text messaging may provide some of the same health benefits as face-to-face social support. How? HIV patients who received regular robo-text messages asking them how they were doing were far more likely to consistently take their meds than folks not receiving such texts. Participants reported being motivated by the feeling that someone cared for them.
Since depression has such high prevalence, and the depressed are likely to stop taking their meds, an mhealth approach seems like a reasonable approach to increasing treatment compliance. Not only do reminders remind you to take your meds, but there's the possibility that if properly delivered, might also provide some of the social support that the recent HIV study found. With a condition like depression, social support seems especially important.
So perhaps its time for doctors to start prescribing mhealth reminders to appropriate patients. With the exception of the minimal costs involved, there certainly aren't any side effects. Mhealth solutions already exist to provide this service. For example, Mobile Health Interventions is a company that provides a suite of off-the-shelf and customizable text-messaging reminder and support services. You can customize the text and timing of the SMS message you receive. Their pre-made suite of "expert messages" cover a range of health areas, for example:
- General motivation
- Dental Hygiene
- Procrastination reduction
- Healthy eating
- Internet, TV or Stress Reduction
- Gambling and Smoking cessation
Their services are free for the first three months, then you have to pay. But that might not be a hindrance. A recent small study of SMS health reminders for women to take their birth control pills found that even though those reminders did NOT increase compliance, a majority of women said they would be willing to pay up to $5 for the service. Perhaps if proven effective with reliable studies, insurance would cover the cost of mhealth applications that enhance medication compliance? Maybe pharmaceutical manufacturers would join forces and provide reminder services, since the reminders compel folks to purchase more of their costly products.
Good ideas? Bad? What would you think if your doctor prescribed, or at least recommended, mhealth reminder or health support as part of your office visit?
Photo credit: SINC