In addition to enlisting better patient and physician involvement, advocates argue that changes need to be made in the health care system to ensure better compliance. He is developing office systems and tracking tools that will help physicians address compliance issues. Dr. Ockene and others believe more resources will be directed toward improving compliance as evidence grows about its long-term impact. Already, improvements in electronic monitoring make tracking compliance easier. Electronic ties to pharmacies can tell doctors which prescriptions are being filled and refilled.
Pagers are available to remind patients to take their medications.
And electronic caps for pillboxes help document patients' pill-taking habits. How commonplace such devices become in physicians' practices and patients' homes will depend partly on their proven outcomes. He envisions insurers covering devices that achieve long-term cost savings, whereas pharmaceutical companies may underwrite those that lead to increased drug usage. A number of public health organizations, including the American Heart Assn., have launched campaigns to increase awareness of the problem. But all efforts are anchored on the partnership of physicians.