Improving medication adherence is a tremendous opportunity to improve health outcomes in rural communities, despite the many challenges they face. For the details about why, check out these articles:

• What Are the Top Challenges in Rural Healthcare?
• How Can Medication Adherence Improve Rural Health Outcomes? 

This article introduces the solution for improving the rates at which rural residents take their medication as prescribed: Medication adherence support. Let’s start with a definition.

What Is Medication Adherence Support?

At Scene Health, we define medication adherence support this way:

Medication adherence support is enabling individuals to take their medication as prescribed through proven interventions.

A range of evidence-based interventions address the systemic and behavioral causes of medication nonadherence. Examples include 

• Comprehensive Medication Reviews: A team including a pharmacist reviews all of the medications prescribed to an individual, identifies problems such as incorrect dosage and possible interactions, and helps correct them.
• Medication Organizers and Reminders: These tools make taking medication easier so it becomes more of a habit than a chore.
• Medication Synchronization: All prescriptions for an individual are scheduled to refill at the same time.
• Individual Education: Training and explanation help patients use precise techniques, devices, or protocols correctly. Education also can reinforce the importance of the medication to an individual’s health, how to handle potential side effects, and more.
• Directly Observed Therapy: A clinician watches an individual take the medication correctly.

Medication adherence support is highly effective. Our approach to it at Scene Health achieves adherence rates averaging 80-90%, and it has been clinically validated in more than 30 clinical trials and peer-reviewed studies.

How Can Medication Adherence Support Work in Rural Areas?

Since 2009, Scene Health has developed and implemented medication adherence support in the most remote locations around the world, from Uganda to Mississippi, and in the face of extreme infrastructure challenges, like the aftermath of a hurricane. Along the way, we have learned several lessons to make medication adherence support successful.

1. Nothing Replaces Seeing the Dose Taken

The only way to know whether someone is adhering to their medication prescription or plan is to watch them take the medicine, or directly observed therapy. It’s the standard of care for medication administration in clinical settings. 

That standard doesn’t have to compromise in rural settings. Scene Health has developed and refined video DOT (vDOT), where individuals and clinicians asynchronosly exchange Snapchat-like videos. We have not only seen positive outcomes directly, but we also have participated in more than 30 clinical trials and peer-reviewed studies that validate its effectiveness. In fact, CDC considers vDOT as equivalent to DOT for tuberculosis, which requires complex treatment—and often in rural settings.

2. Behind Every Adherent Individual Is a Human Connection

This connection means even more in rural communities where residents can experience social isolation. When individuals feel seen because their concerns are addressed, their questions are answered, and their well being is prioritized, they are much more likely to be adherent.

That’s why, in addition to our innovative technology, we made a highly qualified and trained care team part of the Scene Health approach early on. Over the years, we have refined protocols, tools, and materials that empower the care team to give individuals a positive and rewarding experience. And this shows not only in our high adherence rates, such as 83% for diabetes, but also our high satisfaction ratings.

3. The Right Technology Delivers Connection Across Any Distance and Schedule

Technology is crucial to medication adherence support in rural areas, but it can’t be just any technology. For a wide range of individuals, the technology must be easy to access and use or else it becomes a new barrier. Participants as young as 8 and as old as 85 have used the Scene Health mobile app successfully, for instance.

One key to this success is our focus on asynchronous video, where participants record themselves taking their medication and share it through the app. Our care team views the video, then shares a reply. Participants not only find asynchronous video convenient, but they also feel more comfortable asking questions and fully explaining challenges or concerns than they would in a live session. This context gives the care team valuable insight to optimize their support.

Scaling Medication Adherence Support in Rural Communities

The potential for medication adherence support to achieve breakthrough health outcomes in rural areas is clear. At Scene Health, we also make it practical for the realities of rural healthcare. That’s why we assembled a comprehensive new guide, Rural Healthcare Transformation through Medication Adherence Support. If you want to close gaps in care for rural communities, this is your starting point for a scalable solution.

Download the Guide

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