Students Use Telehealth Technology to Improve Medication Adherence

The University of Tennessee (UTN) College of Pharmacy has partnered with AdhereHealth to offer a unique way to help the community during the coronavirus disease 2019 (COVID-19) pandemic.

The partnership aims to help low-income and other at-risk groups properly take their medications for chronic illness during the COVID-19 pandemic. Through the partnership, pharmacy students call patients to remind them to take medications, answer questions, and help them find food services if they are in need.

The pandemic has exposed many at-risk communities such as disabled, low-income, and elderly people to medication nonadherence. Additionally, those living with chronic conditions may not be able to adhere to their medications and may not have access to needed services and support. According to Jason Rose, CEO of AdhereHealth, nonadherence accounts for half a trillion dollars annually—or 16% of health care spending in the United States. Only half of patients with chronic conditions take their medication as directed, and with the pandemic, nonadherence is expected to worsen.

AdhereHealth is a medical company aimed at eliminating medical waste by helping patients adhere to their medications. The partnership with UTN College of Pharmacy helped address nonadherence and the changing needs of the college and its pharmacy students.

“There were 2 things happening in March concurrently. One is, ‘hey, we need to find some really high-quality rotations because we’re losing the ability to put our students in rotation sites.’ And so that was an urgent need,” said Kenneth Hohmeier, PharmD, associate professor and director of Community Affairs for the UTN College of Pharmacy, in an interview with Pharmacy Careers®. “Concurrent with that, news was breaking at that time that looks, morbidity, and mortality for COVID are not equivalent for all Americans. We have a proportion of our population, African Americans in particular, who are at highest risk for complications due to COVID.”

The partnership between UTN College of Pharmacy and AdhereHealth is designed to spread knowledge on how to avoid COVID-19 transmission and help with chronic disease management in underserved communities. According to Hohmeier, members of the African American community with a chronic illness were the most likely to develop COVID-19 complications. They were also the most likely to forgo adherence to medication for their chronic illness in favor of acute prevention of COVID-19.

“The hidden epidemic that I think most of us saw in the pharmacy world through this whole thing, this whole COVID-19 pandemic was—and we’ve got evidence to back this up—when there is an acute condition like COVID-19, like a cancer diagnosis, patient focus is on that and that becomes their sole responsibility, and all the chronic disease treatment goes out the window,” said Hohmeier.

Ten students started on the partnership project in May, and 4 students completed the project through the end of August. The program eventually trickled down to 1 student and was expected to conclude September 31, 2020. However, both UTN and AdhereHealth are interested in partnering again in 2021.

“We developed a program with 10 of [UTN’s] students so that they could leverage our technology platform in the midst of this awful COVID-19 crisis, that they could use our technology platform to reach out to patients that were at high risk for COVID-19 and work with those patients telephonically to improve…access to care through understanding of the medications that the patients are on, and things of that nature,” said Rose.

Leanna Estredge is a PY4 pharmacy student at UTN participating in the program, who told Pharmacy Careers® her rotation was put on hold, and that the AdhereHealth program is helping to fill the gap. Every day, between 9 am and 4 pm, she calls patients who are nonadherent to their health care plans and reminds them to take their medication. She also helps to remove barriers patients may be facing, like setting up a delivery service if transportation is an issue. If a patient is food insecure, Estredge can help them find food services.

“A lady that I called one day, she had recently lost her husband, so she was kind of lonely…first thing I did was go over her medications with her, especially the one we were calling about, that she was not taking as directed. Which, of course, losing her husband had an impact on taking her medication correctly, and I just went over the importance of taking her medication every day, why she was taking it, and she felt a lot better about that,” said Estredge.

She was on the phone with the patient for 3 hours.

“I offered her some other services like, I told her we could get her set up with a food service if she needed it,” Estredge said. “I mean, she just lit up because she said, ‘you know before you called me I had no idea when my next meal was going to come from or where it was going to come from…and it’s just a huge blessing that you called me.’ ”