Apple's drug feature is a step in the right direction

Apple isn't exploring anything new with its drug tracking feature for the iPhone and Apple Watch, which the company announced this week at WWDC 2022 as part of watchOS 9. There are already a lot of apps in the market that alert people when they are needed. Take medicine

But trying to get people to take their medicines regularly is a major problem in health care, and about half of people don't take prescribed medications for chronic conditions as directed. This non-compliance costs the healthcare system hundreds of billions of dollars annually because people get sick when they don't take their medicine properly. And even though the device doesn't have everything on experts' wish lists for the ideal drug app, entering the ring could be a helpful development for a tech company like Apple.

"I think it's a step in the right direction," says Seth Heldenbrand, MD, an associate professor of pharmacy practice at the University of Arkansas for Medical Sciences.

The tool lets users input a list of medicines they take and set a specific reminder schedule for each medicine. When it's time to take medicine, people get an alert on their iPhone or Apple Watch. Then, they can hit "Take" or "Skip" to enter the dose. The health app will track how often a user takes their meds over time.

This type of nudge can help improve medication adherence, research shows. This is helpful for a subset of patients where forgetting to take medication is the main reason they can't follow a treatment plan, says Marie de Vera, an associate professor at the University of British Columbia who studies medication adherence. are. But it's less helpful for other groups: If a person isn't taking medication because they don't understand why it's needed, a smartphone alert won't solve the problem.

People who use Apple's Medicines app will be able to share their medication history with family members or others through the sharing feature of the Health app. It can give doctors insight into how their patients are taking their medications, which Heldenbrand says is useful information. But it will only be one-way through the app -- and one-way communication around medicine has historically been less successful than a system where doctors can prescribe back, De Vera says. A nudge works better if they are part of a positive feedback loop with providers.

Providing just a reminder feature may not make for big changes, especially around something as challenging as medication adherence. "A patient may have a high intrinsic motivation to start using something like this and interact - but do they keep using it, and does it really help them keep taking their medications? That adherence needle is a tough needle," Heldenbrand says.

For iPhone users, this feature will be more accessible than some of the standalone apps already in the market. Users won't need to figure out how to download and set up a separate program, especially if they're already using the Health app. Because it is in the existing Apple ecosystem, it also means that users are not sending their health data to any other third parties. "It provides a layer of protection for patients' privacy," Heldenbrand says.

Apps also come and go, and a tech giant like Apple offers more stability to one's routine—which experts say could be good for getting people to keep taking their medication. "It's a long game, especially when we're talking about adherence to medication," De Vera says. "For some patients, it's lifelong. So you need a player who can play the long game."

A medication feature means people and their doctors can see how medication adherence relates to changes in things like sleep, exercise, and heart rhythms on the Health app. Those relationships could also be valuable to researchers looking at bigger-picture trends. Right now, while the data is there to show that some people take medications more regularly when using the app, it's not clear what or how much their health is going to improve, Heldenbrand says. "It's the million dollar question right now."

Of course, this will require Apple to decide to either share the information with researchers or launch its own study to answer some of these questions. If they do, there is a lot to be learned. "It would be very enriching," De Vera says. "And that will lead to a better understanding of how patients are taking their medicines."