Motivation
Adherence alerts: SAM integrates data on dispensed medications with the patient’s discharge prescription and uses decision algorithms to alert users to instances in which patients have not been adherent to their discharge prescription. This includes when they have failed to fill prescribed medications, have refilled discontinued medications, or have filled prescribed medications at the incorrect daily dose. In response to an alert, users can select from a dropdown menu an option explaining their situation (eg I did not purchase this medication because I am concerned about side effects). This information is transmitted to the pharmacist managing the patient, who can follow-up with the patient or caregiver to resolve the issue.
Side effect checker: Patients often discontinue medications due to fear of or prior experience with side effects.43,44 However, when taking multiple medications, it is not obvious which drug, if any, may be contributing to new symptoms. The side effect checker aims to help patients understand which medications may be implicated in a new symptom and prevent discontinuation of medications that are not implicated. Users can look up the side effects of each of the patient’s medications, as well as the frequency of their occurrence. Alternatively, users can access a list of side effects associated with the patient’s overall medication profile, along with the medications in their list that are associated with each side effect.
Interaction checker: Drug-drug interactions are among the top medication-related informational needs identified by patients.45 Providing patients with this information aims to help avoid known interactions, and could also have the benefit of discouraging medication discontinuation due to fear of interactions. This feature generates a list of drug-drug interactions between medications in the patient’s list and any over-the-counter medications they consider purchasing. The severity of each interaction is also displayed.
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Behavioral skills and support
Caregiver connect: Patients can identify caregivers involved in managing their medications and provide them with access to the app. This allows caregivers to provide practical and emotional support and to share ideas to facilitate optimal medication management.
Rate my med: Patients value opportunities to connect with other patients with similar problems and treatments.46–48 This feature increases social support by providing opportunities for patients to share their experience with a medication (eg effectiveness and side effects) and read about the experiences of other users using the same medication.
Pharmacist connect: This feature aims to empower patients and caregivers to seek relevant information, as needed, for shared decision-making and to receive support for problem-solving, including for adherence problems. Patients and caregivers can communicate with hospital pharmacists using a secured messaging service to ask questions related to their medications, describe concerns and side effects, and resolve medication adherence issues.
Pharmacist dashboard: The dashboard allows hospital pharmacists to manage a group of patients, receive and respond to questions from patients and caregivers, manage adherence alerts or potential medication-related problems, transmit and manage requests for consultation from treating physicians, and document services. In this pilot, hospital pharmacists were available to respond to patients and caregivers for the first 30 days following hospital discharge. Beyond that point, patients and caregivers still had access to the app, with the exclusion of the pharmacist connect feature.
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