South Africa Healthcare Use of Digital Technology to Improve Adherence to Chronic Medication

South Africa has a high chronic disease burden. Almost eight million people in the country have HIV, translating into lifelong Anti-Retroviral Therapy (ART), and a normal lifespan as long as they keep up with their treatment protocol.  However, adherence can be problematic due to several factors – denial, depression, forgetfulness, lack of understanding in terms of adherence importance, etc. Instilling good adherence habits is particularly crucial in the first few months of treatment, warranting closer focus on this group of patients.

Support options, particularly in the public sector, are limited, and monitoring adherence behavior becomes more difficult as more patients are put on ART. The use of Digital Adherence Technology (DATs) may be a good solution to mitigating these challenges.

There are some DATs already in play. Numerous apps are available that remind a patient to take their medication. Smart pill bottles and boxes, created by Cape Town based Wise-pill, have in-built electronic sensors which record and provide log-times of when the boxes/bottles were opened. The feedback is then sent to the health provider. Smart boxes have been utilized on TB patients.

Other new developments include smart pills, which have an inbuilt sensor that detects when a tablet ingestion and sends a signal to an app or a wearable device. For patients that have a difficulty adhering to daily treatment intake, long-acting ART injectables could provide the answer. 

It is important to note that adherence is a complex issue, and there is no one size fits all solution (although in the public sector there is currently a one-size fits all approach). Technologies will need to continue to adapt to patient needs. Other potential challenges with using DATs that should be considered as part of a product offering:

•    Cost: particularly in the public sector, as funding is limited  
•    Technical issues, such as spotty bandwidth (rural) and power outages 
•    Patient privacy: how would patient data be stored and restricting access 
•    Smart solutions that do not overestimate treatment adherence (smart boxes record when the box is opened, but this does not necessarily mean that the tablet was ingested)

Opportunities 

This is a nascent and solutions-driven market in South Africa. Finding niche applications for DATs is likely to be more successful. As an example, using the technology on new mothers with HIV to ensure they take their ART while grappling with the demands of a newborn infant. 

There may also be other opportunities in other chronic diseases such as diabetes or cardiovascular disease (two major chronic diseases in South Africa) where developing good treatment adherence behavior is crucial.

U.S. healthcare IT technologies have a strong worldwide reputation for cutting-edge innovation and quality, making U.S. firms in this sector competitive in South Africa’s healthcare market.

For more information, please contact:
Felicity Nagel
Commercial Specialist – Health Sciences
Email: felicity.nagel@trade.gov