Smart Medication Reminders for the Tech-Savvy Patient

When Andrew Stokrp was discharged from his second kidney transplant surgery last month, the Lebanon, Pennsylvania, resident was sent home with a cumbersome list of 32 morning pills and 22 evening pills that -- if missed -- could result in the rejection of his new kidney.

The number of pills he takes in a given day will decrease with time, but for now, Stokrp, 33, has to follow strict medication orders. He's done so with the help of MyMedSchedule, a smartphone app that alerts him of the exact medication, time and dose he needs to take via text message.

"My prescription coordinator at the hospital told me about this app, and it's been amazing and made it a lot easier to keep my medications in line," Stokrp says.

He's not alone.

At 67-years-old, Ernie Wallace of Kansas City, Missouri, says the same app has not only helped him remember to take his liver transplant medications at 8 a.m., 9 a.m. and 9 p.m. each day, but it has also been a valuable tool for informing multiple doctors and hospitals which medications he is currently taking. Wallace's pharmacist downloaded the app for him and synced all his medications.

"It's become very handy on subsequent doctor's appointments when they ask you to bring a list of all your medications. Now, it's there on my phone," Wallace says.

Kathy Powers says she's not even out of bed before her first medication reminder each day. The 51-year-old from Odenton, Maryland, says she developed health issues related to thyroid and adrenal disease, as well as menopausal symptoms, since December.

"Everything hit me at once, and that was the trifecta. I started seeing a specialist and was prescribed a whole slew of supplements -- eight at different times during day. I also take liquid supplements," she says. "I was totally overwhelmed with how to take them and when to take them."

That's when she began an online search for the app that best met her needs. Since she has her phone on her 24/7, she says a text messaging system was the best option.

MyMedSchedule is just one of the growing number of medication reminder apps available to patients. On the heels of the Apple Watch release this week, WebMD announced plans to launch an updated version of its app with a medication reminder feature. The app will allow consumers to view daily medication doses, drug instructions, pill images and reminders when to take medications directly on the Apple Watch.

The reminders give patients four options: take the medication, skip, snooze or dismiss the reminder. If patients choose the snooze option, they'll be reminded in 15 minutes. If they dismiss the reminder, they'll be alerted at the time of the next scheduled dose.

WebMD President Dr. Steven Zatz says the reminder feature was designed to address the issue of medication adherence, or how well patients follow their medical instructions. "There are many reasons for medication non-adherence, including forgetfulness, cost of medications and copayments, fear of side effects and lack of clarity around the effectiveness of medications," he says. "Over the years, there have been a number of efforts to increase compliance; unfortunately, to date no approach has achieved widespread success."

Adherence tends to vary among patients, according to Dr. Patricia Hale, associate medical director for informatics at Albany Medical Center and board member of the Healthcare Information and Management Systems Society. Unintentional non-adherence happens when people simply forget to take their medication. Intentional non-adherence occurs when patients think about taking their medication and make a conscious decision not to, Hale says.

Hale knows firsthand how important a reminder system can be in managing prescriptions. As her mother aged, she required more medications to manage stomach issues, high blood pressure and osteoporosis, in addition to daily supplements. "I went on a search to find tools to help her," Hale says.

But this was six years ago, and her mother didn't use a smartphone. Instead, Hale found a hands-on device that provided alerts and kept track of missed doses. She was able to set up her mother's medication doses exactly how the pharmacist recommended, she says. That was the most difficult feat -- ensuring her mother took her medications at the right time, each time -- even when she wasn't around to assist. It's an obstacle that medication adherence apps may help solve for other caregivers.

"These apps can not only help caregivers ... but it helps health care aides tremendously who come to the home to assist with reminders; making sure things are done properly," Hale says.

The 2015 Healthcare Information and Management Systems Society's Mobile Technology Survey found that nearly 90 percent of 238 health care providers surveyed use mobile devices to engage with patients. Health care providers also reported that mobile health -- or mHealth -- technologies provided savings and improved care.

Dr. Dallas Swendeman, co-director of the University of California--Los Angeles Center for HIV Identification, Prevention and Treatment Services, has studied a prototype app, AndWellness, with alarm functions and medication reminders for HIV-positive patients. He says the app improved patients' medication adherence and reduced factors associated with non-adherence, such as substance abuse and stress.

Lindsey Dayer, a pharmacist and assistant professor at the University of Arkansas College for Medical Sciences, and Dr. Bradley Martin, head of pharmaceutical evaluation and policy at UAMS, authored a study in 2013 examining the potential patient and provider benefits of smartphone medication reminder apps. The study, published in the Journal of the American Pharmacists Association, ranked 160 apps. MyMedSchedule, MyMeds and RxmindMe ranked the highest for their basic medication reminder features and functionality.

In their most recent study, presented at the American Pharmacist Association annual meeting last month, they developed a new grading system that included added app features. Of the 461 apps they identified, the highest ranked based on adherence grades alone included Medisafe, Care4Today and Mango Health.

"For people who have smartphones, this is a very assessable and scalable technology," Martin says. "I personally would like to see more pharmacists, physicians and nurses be more proactive in using this as a potential tool to help people who struggle with adherence with medications."

Martin adds that medication adherence reduces the risk for stroke and death, especially among patients with high cholesterol.

"It sounds dramatic, but it ... really is a matter of life or death when it comes to medications for some patients now," he says. "This is a problem that transcends nearly all specialties of care."

Samantha Costa is a Health + Wellness reporter at U.S. News. You can follow her on Twitter, connect with her on LinkedIn or email her at scosta@usnews.com.