Half of Australians living with a chronic disease such as diabetes are failing to take medications as prescribed, resulting in needless deaths, hospitalisations and the waste of healthcare resources.
Sydney start-up Perx Health has decided to tackle this worldwide health problem, developing a NSW government-supported app that gamifies medication-taking so users who adhere to their medication regimen are rewarded with petrol vouchers, movie tickets and gift cards.
"Not taking prescribed medications is one of the biggest hidden problems in modern health care," said co-founder Hugo Rourke.
"What we're trying to do is to change the experience from a nagging chore to something fun and engaging, creating positive reinforcement."
After receiving a $25,000 grant from Jobs for NSW to develop its technology, Perx last year signed an agreement with NSW Health and Sydney Local Health District to pilot the free rewards app with diabetes and cardiovascular outpatients clinics at Royal Prince Alfred, Concord and Liverpool hospitals.
This year, with a new $100,000 "building partnerships" grant from Jobs for NSW under its belt, it plans to launch further trials and find "big business" customers such as health insurers and pharmaceutical companies.
"We're going to be running a randomised control trial with the University of Sydney to prove the efficacy of Perx over standard care and to show that Perx can help people," said co-founder Scott Taylor.
"In the long term, in this connected world, we want Perx to be the motivation platform for health, so that every time you do an activity, whether it's medication or something else, you're rewarded for it."
Multiple studies have shown that in the developed world 50 per cent of people with chronic diseases fail to properly take prescribed medications, with reasons ranging from safety concerns to affordability, from forgetfulness to practical difficulties such as swallowing pills.
The World Health Organization has declared non-adherence as "an increasing, worldwide problem of striking magnitude ??? that is impairing the ability of health care systems around the world to achieve population health goals."
An Australian study found 43 per cent of patients instructed to take statin drugs stopped taking them after six months, and 23 per cent failed to collect their first repeat at just one month.
Professor Tim Usherwood from Sydney University said non-adherence reduced the effectiveness of medicines and could lead the prescriber to escalate treatment unnecessarily and potentially dangerously.
"Electronic reminders, such as text messaging, have been shown to increase medication adherence," he said in Australian Prescriber.
The app helps patients manage their medication routine by sending reminders and following-up, which is especially important for diabetes and cardiovascular patients who may have to take up to a dozen different pills at different times of the day.
The real rewards
Lindsay Alexander, a 70-year-old retiree from Artarmon, said Perx has helped him to stay on top of the 10 medications he needs to take every day for type 2 diabetes, as well as hypertension, cholesterol and kidney stone issues.
"I've been diabetic for 20 years and yes I've forgotten to take my medication many times because when you're out and about and it's easy to forget until you start feeling that something's not right," he said.
Mr Alexander has been rewarded with fuel vouchers and movie tickets, but he said the best part about Perx were the benefits of using his medications properly.
"The beauty of it is that it alerts you to take your medication at the right time and if you don't it will send you a reminder half an hour later," he said. "It's fantastic".
Deputy Premier John Barilaro said if Perx succeeds, it could ultimately reduce impacts on the health system.
"The company has been supported with a $25,000 Minimum Viable Product grant to help develop its technology and is now validating its clinical and commercial potential with the assistance of a $100,000 Building Partnerships grant," he said.
"In the last financial year Jobs for NSW committed more than $23.7 million on loans, grants and financial guarantees to support businesses including $7.5 million in regional and rural areas."