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Digital Health Coaching
Personalized Behavioral Intervention Aids Adherence, Saves Money

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A conversation with Steven Schwartz, Ph.D., Research Director, HealthMedia, about its digital health coaching solution that emulates the experience with a human coach or counselor but that is delivered on digital platforms that include the web, CD, iPhone, IVR, SMS and digital print. (See guest bio.)

Aired LIVE on: Tuesday, June 22, 2010

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Background

A recent study published in the journal Population Health Management finds that personalized health messages delivered through interactive technology can improve medication adherence to a cholesterol reducing drug, or statin, that helps reduce the risk of heart attack.

The study, conducted by HealthMedia, Inc., a Johnson & Johnson company and pioneer in digital health coaching, as well as AstraZeneca, and Humana, found that people who received a personalized behavioral intervention showed greater medication adherence versus those who received a non-personalized intervention. Results indicate that personalized behavioral interventions are promising as a way to positively affect the intrinsic motivations for medication adherence, and potentially reduce employer health care expenses through lowered managed care costs.

"Interactive technology based on behavioral science can easily and inexpensively reach large populations of health care consumers in diverse health care settings," said Dr. Steve Schwartz, Research Director at HealthMedia, Inc. "It's an effective way to engage and motivate them to take an active role in improving their medication-taking behavior and managing their chronic conditions."

Adherence to a medication is typically defined as the extent to which patients take medications as prescribed by a health care provider. The benefits of improved medication adherence include fewer emergency room visits, lower absenteeism, higher productivity, decreased inpatient hospital stays, decreased morbidity and mortality, and better controlled health care costs.

Non-adherence to medication regimens can result in an additional $100 billion in annual health care costs Osterberg, New England Journal of Medicine, 2005 and $50 billion Peterson, Amer. J. Health System Pharmacists, 2003 in indirect productivity losses nationwide. Statins are often prescribed for people with cardiovascular disease to lower the level of cholesterol in the blood and lower the risk of a heart attack.

The study was designed as a real-world effectiveness trial to mimic the way the intervention would actually be implemented in a managed care organization. The study sought to determine if patients can benefit from personalized, interactive health messages delivered through interactive technology.

To maximize the validity of the findings, the personalized behavior intervention represented a mixture of elements from evidence-based adherence-enhancing strategies grounded in several behavioral theories. Subjects in the experimental group received personalized behavioral support interactions delivered via an interactive voice response (IVR) system based on their cholesterol-related knowledge, attitudes, beliefs, and perceived barriers to medication adherence, and were mailed a tailored guide that reinforced similar themes. They were reminded to refill their prescriptions on a timely basis, received positive reinforcement including tips for overcoming barriers and avoiding habit formation, and were encouraged to follow up with their doctor. The control group received behavioral advice from one IVR call that was not personalized, coupled with an untailored self-help cholesterol management guide received through the mail.

Questions/Topics Discussed

  • Can you define adherence? What causes non-adherence? Why it is important to improve adherence? How does improved adherence benefit patients, payers, and pharma companies?
  • Give us an overview of HealthMedia® Digital Health Coaching and how it is being used. Give us a review of the study published in Population Health Management.
  • What is the role of social media (eg, Twitter) in improving adherence?


Guest Bio

Steven Schwartz, Ph.D.Steven Schwartz, Ph.D. leads internal and external research projects and studies, develops proposals, provides scientific guidance to program development staff, and sets the company's scientific and product development agenda. He also holds a position as an adjunct research investigator with the University of Michigan Healthcare System. Most recently, he was the director of research at the Oakwood Healthcare System and was an adjunct lecturer for the University of Michigan-Dearborn Department of Behavioral Sciences. Dr. Schwartz received his bachelor of arts in general psychology from Wayne State University, an M.A. in experimental psychology from the College of William and Mary, and a Ph.D. in clinical/health psychology from Virginia Commonwealth University.


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