Bridging the Gap: User Engagement in Developing and Implementing Digital Medication Adherence Technologies

OBJECTIVES: To identify and rate the key stages of the development and implementation of digital medication adherence technologies (DMATech) where medication users (MUs) are key informants in providing additional value and relevance, leading to user-informed development and more effective products.

METHODS: A framework outlining the key stages in developing and implementing DMATech was developed based on literature review and iterative refinement group process. An in-person workshop was then conducted with a multi-stakeholder group. The nominal group technique was used to identify valuable MU input stages across the lifecycle of DMATech. Ratings were measured on a 5-point Likert scale ranging from 1 ('not important') to 5 ('very important'), with analysis for consensus and stakeholder differences.

RESULTS: The framework comprised three key phases - innovation, research, and development, and launch and implementation - with 3, 7, and 6 steps, respectively. Five patient representatives and nine adherence experts (researchers, healthcare providers or technology developers) participated representing North America (n=1), Western-Europe (n=4), Central and Eastern Europe (n=4) and the Middle East (n=1). High-scoring steps (≥4.0) included problem definition, idea creation, prototype development and testing, critical evaluation of DMATechs, their healthcare implementation, real-world assessment, and iterative improvement. Regulatory aspects received the lowest scores (mean=2.2). Results showed lack of consensus on health technology assessment (HTA), reimbursement, marketing, and regulatory steps. There were no significant differences between ratings of the two stakeholder groups.

CONCLUSIONS: This study supports the critical role and necessity of MU involvement in various stages of DMATech development and implementation, directly impacting marketability. The observed lack of consensus on HTA, reimbursement, marketing, and regulatory steps underscores the importance of targeted educational programs to bridge knowledge gaps. Future expansions of this study could explore innovative methods for engaging patient cohorts, tailoring input mechanisms to specific user needs, and enhancing ownership of the development process.