Bringing Digital Health and Medication Adherence into the Classroom

When I was a student in pharmacy school, one of our earliest assignments was the so-called 'JellyBean Experiment,' whereby students were assigned a longitudinal project in which they were to mimic a patient with a chronic condition treated with medications. The assignment is aimed to help students understand the pill burden that patients face on a daily basis, and in my mind, bring in a better empathetic understanding towards nonadherence and how to talk about it. 

I am happy to see that my school still continues this tradition.

Since then, I have matriculated on and now myself teach pharmacy students. In my elective about technology innovations and pharmacy practice, one of my assignments closely mimics what I myself was taught, though with a slight twist.

Can Digital Health Help with Medication Adherence?

Since my elective covers a large segment regarding the use of digital health (which I hope to address over the course of this summer as my elective enters it's 3rd run), I have sought to have students utilize different apps and digital health resources in their own health or mock simulations to demonstrate the utilization of digital health interventions in patient care.

My version of the JellyBean Experiment is that all students are introduced to having a chronic condition that requires treatment via medication. For logistical purposes, I utilize amber dram vials (purchased at a pharmacy/online) which a simple label is affixed. Directions are "1 PO BID." My logic with this was that there was a chance, based on age and gender, that some students may be accustomed to taking at least one medication a day (e.g. BC), but not BID. At this time I do not use jellybeans, but rather tic-tacs. My rationale is based on the fact that I recall some of my colleagues consuming all of their 'medications' as a student (I mean, 60 jellybeans can be tasty...), but most people wouldn't cheat and eat 60 tic-tacs at once.

The students are given this assignment over the course of 4-weeks. Upon initiation of the experiment, I instruct students they are to start their regimen and to try to be adherent without taking any special measures while keeping a log of their adherence. At week two, we spend a few minutes in class discussing what their adherence rate was via a pill count, and recount any of their overall experiences. At that point, students are then instructed to create some tool to help them with their adherence, and while I offer some recommendations, I let the students have free reign. However, most of the students will download an app, based on the fact this is a tech-focused elective. At the end of the next 2-weeks, students then present a short 10-min presentation about their experience with the experiment and what their overall experience was like.  A classroom discussion is then held regarding the pros-and-cons of different interventions taken, and what different interventions could work for different patient dynamics. This year, I am thinking of making students try selected apps or other tools, though I have a few weeks to make that final decision. In the future, I would like to get samples of different digital health intervention tools that focus on adherence and let students test those as well.

Overall, feedback on this activity has been widely positive, and I find that such an activity really gets students interested in the topic. For many students, it is an eye opener on how hard adherence can be. For others, it starts the idea that their phone can be used more than just for entertainment.

I welcome any thoughts or comments below! If you want to read more on Adherence projects for your classroom, feel free to use this tool (that I helped with!) - AACP NCPA Adherence Educators Toolkit