Indigenous Peoples and Medication Adherence

“Indigenous peoples” (often referred to as, “Aboriginal peoples”) is a collective name for the original peoples of North America and their descendants. In Canada, the Indigenous peoples’ population grew by 42.5% between 2006 and 2016, resulting in the fastest growing population in Canada.

Indigenous peoples have a strong cultural heritage with unique issues to coexist with non-indigenous populations. For example, a recent article in Impact Ethics, managed by the Novel Tech Ethics research team in the Faculty of Medicine at Dalhousie University suggested that Canada’s biggest health problem is indigenous health. In spite of our amazing, free healthcare system, the problems facing indigenous peoples are many.

Examining just one issue, indigenous peoples remain among the most “at risk” for medication non-compliance and medication (and substance) abuse and are among the largest recipients of “daily dispensing” prescriptions. These are prescriptions which are considered to be the most critical and the most “abused” causing doctors and pharmacists sufficient concern that they decide to deliver one day’s worth of Rx drugs every day.

The pharmacist must document the reason the patient is unable to manage their drug therapy independently when dispensed as a 7-day supply. Typical reasons include a risk of intentional overdose, consumption of methadone for the treatment of opioid use disorder, risk of dependence to, or misuse of, a drug that cannot be addressed with weekly dispensing. Other reasons include severe cognitive impairment, severe mental disability, severe psychiatric illness or severe physical disability that cannot be addressed with weekly dispensing.

If we then consider the national Opioid Crisis, indigenous peoples are among the most affected.

RxPense® Benefits for Indigenous Peoples

An advanced and secure medication dispensing system like the RxPense® will significantly increase medication adherence and virtually eliminate double-dosing and overdosing. It will also solve many of the challenges of “medication diversion”. Increasing connectivity to Health Care Professionals (HCPs), including case workers, Personal Support Workers (PSWs) and pharmacists, with additional connectivity to family and caregivers, will provide measurable benefits such as:

• Remote monitoring of medication compliance by physicians and pharmacies, patient conditions, including vitals
• Telemedicine
• Support before and after clinical appointments to “facilitate the patient journey”
• Greatly improved “health equity assessment” – access to relevant data is no longer a challenge
• Vastly reduced travel costs (1 in 5 Indigenous patients travel >250km for consultation/treatment)
• Direct and timely support for missed doses and anomalies
• Virtual support groups and more frequent interactions with PSWs and HCPs

Telemedicine acceptance is rising throughout the world, bringing virtual doctor visits to remote communities. This personal videoconferencing will serve more rural and remote indigenous communities. Combined with advances in digital health and biometric sensor technologies, we can now better support self management. (Bringing Reconciliation to Healthcare in Canada – March 2018). But what does that mean?

Better medication management at home (or LTC/residence) means far fewer hospitalizations and doctors visits; better socialization and productivity; greatly increased quality of life. It means greater autonomy for indigenous patients. It means less emergency care & more home care.