Tackling medication nonadherence with advanced technologies

Pharmaceutical and life sciences companies can now address intentional noncompliance with AI, IoT and more—we explain how.

Intentional medication nonadherence—when patients consciously choose not to take prescriptions as directed—is an age-old problem in need of a new approach. With nearly half of all patients failing to follow prescribed treatment plans, this behavior has a real impact, contributing to up to 50% of treatment failures in chronic disease and driving an estimated $100 billion to $300 billion in avoidable healthcare costs annually in the US alone.

So how can pharmaceutical and life sciences companies respond? The answer may be in a text. Or a connected device alert. Or an AI agent. In other words, a wide array of technologies, from simple automated reminders to dynamic agentic tools, can be the key to improving an adherence rate that has remained stagnant for decades.

Intentional nonadherence factors and how to overcome them

Reducing medication nonadherence requires companies to understand the unique motivations and challenges of each patient and address them through targeted interventions.

For example, one study showed that patients who received reminders from a smart inhaler had a median adherence rate of 84%, compared to just 30% among those who did not.

Based on industry research, our expert team identified six common drivers of intentional nonadherence:

1. Real or perceived improvement
2. No real or perceived improvement
3. Negative side effects
4. Lack of product understanding
5. Convenience
6. Financial concerns
   

While this article focuses on intentional nonadherence, the strategies and solutions mentioned may also be effective in reducing unintentional nonadherence, which includes issues like forgetfulness, misunderstanding dosage instructions and mixing medications.

Four examples: How technology can help tackle medical nonadherence

1.    Simplify medical information and create interactive patient experiences with generative AI

Adherence starts with understanding. Rather than conducting surveys or focus groups to determine how to improve the readability of treatment materials, generative AI-enabled tools may be an effective way to adapt documentation to match patients’ and caregivers’ health literacy levels.

For example, students at the University of Central Florida are researching how ChatGPT can be used to simplify patient education documents and improve readability.

In addition to making medical documentation more understandable, generative AI tools can also assist in answering direct patient questions about their treatment plans. For example, pharmaceutical companies can train a large language model on a treatment’s use, side effects and warning signs. An AI tool can then use this knowledge to directly answer patient inquiries, such as “What should I do if I’ve missed a dose?” or “Should I take this medication with food?”

Generative AI can also help address concerns about side effects (“I have nausea after taking this medication. Should I call a doctor?”) or questions about perceived lack of improvement (“My skin condition looks the same even after two weeks. Is this normal?”). Using AI technology this way not only offers timely, personalized support but ensures that patients receive answers using approved, reliable, official sources. The chat tools can also be programmed to urge the user to seek care or contact emergency services, when appropriate.

2.    Use connected technology to track patient engagement and offer early intervention

In the Internet of Things era, anything can be connected: nebulizers, inhalers, bottle caps, blister packaging, even the pill itself.

For example, Merck launched its Growlink app to support patients undergoing growth hormone replacement therapy by connecting smart injector data directly to healthcare providers and caregivers. The app also delivers timely reminders and progress updates, helping patients track measurable improvements and stay engaged—even when real or perceived setbacks occur.

When designing adherence solutions, companies must remember to tailor programs to match the needs, motivations and challenges of different patient populations. One example of a mismatch can be found in a drug-device product that combined a common tablet with an ingestible sensor to track adherence. While it was a revolutionary technology, the product ultimately failed because it treated people with schizophrenia—a group that tends to be suspicious of surveillance or data-sharing.

Finally, it’s important to note that connected technology typically relies on automatic data capture and sharing from the device, as opposed to patient input and updates. This makes adherence program participation far more convenient.

For example, AARDEX, a medication adherence solution provider, developed a medication event monitoring system that uses a sensor embedded in a bottle cap to record when medications are opened. These smart caps help keep patients on their treatment path while giving medical teams reliable data to spot behavioral patterns for future interventions.

3.    Personalize content, support and supplementary services through generative AI

Adherence is a dynamic issue. Unfortunately, the simple act of missing a single dose with little or no noticeable change can erode the treatment plan. This is why it’s so important that adherence programs are not one-size-fits-all: patients rarely fit into the same category from week to week or month to month.

While personalized experiences may have been difficult to achieve at scale in the past, the advent of intelligent automation and generative AI offers pharma companies the ability to customize many patient interactions, whether text, in-app alert, email, or even in-pharmacy offer.

For example, one global pharmaceutical company leveraged generative AI to personalize email campaigns through dynamic modular content based on the individual’s behavior, preferences, motivations and goals. Patients who received the dynamic emails had an adherence rate of 87.8%, versus 78.3% for those who did not.

Personalized outreach can be used to effectively address almost all factors surrounding intentional nonadherence. For example, a pharma company may notice that a patient with a chronic disease is skipping medication at regular intervals. While this could be simple forgetfulness, it may also be a deliberate action meant to stretch a prescription when money is tight. In this case, the company could proactively reach out with information about a payment support program or offer discounts to help improve adherence.

4.    Leverage agentic AI to simplify and guide the patient experience

Managing chronic conditions or complex treatment plans can be overwhelming for patients, which can lead to gaps in adherence. With the help of AI agents, it’s possible to lighten the load of patients and caregivers by managing high-friction parts of the patient experience.

For example, a virtual nurse agent could provide medication reminders or symptom monitoring. A care coordinator agent could help schedule follow-up appointments, assist with transportation and coordinate between providers.

Agents can also be created to assist with administrative issues such as financial assistance, insurance coordination and pharmacy management.

Connecting digital touchpoints to create an intervention ecosystem

As with any consumer campaign, the most effective adherence strategies are those that deliver personalized messages connected across multiple channels. Mobile apps, connected health devices, intelligent chatbots and even simple text reminders can work together to create a "surround sound" experience, ensuring the right message or prompt reaches the patient at the right moment.

For pharma companies, creating this intervention ecosystem can also include developing patient programs in conjunction with other stakeholders, such as payers, providers or pharmacies, as well as programs for caregivers, such as parents caring for children, adult children caring for elderly parents, or spouses and partners caring for one another. Creating multiple touchpoints for both patients and their support systems can strengthen the sense of community and collaboration, helping to build trust and drive more meaningful, lasting outcomes.

For example, Aetna’s Rx Healthy Outcomes combines value-based insurance strategies with proactive pharmacist engagement to improve medication adherence after a heart attack or cardiac procedure. Pharmaceutical companies could potentially incorporate some of the above applications, such as a dynamic content campaign or AI-enabled pharmacy support agent, to expand and enhance existing program services.

By working together and using technology, it is possible for pharma companies to begin to tackle medication adherence—one text, alert, email or agent at a time.