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Attrition data from cardiovascular studies show us that the number one reason for drop-off is basic logistics. When patients are physically unable to get to the site, we innovate more around logistical needs.
Bridging the adherence gap: How can technology help people stay on their treatment?
Following a treatment plan leads to better health outcomes, yet about half of people with chronic conditions struggle to take their medication as prescribed over time. The reasons extend beyond simple forgetfulness. Side effects, high costs, busy schedules, unclear benefits, and the daily friction of managing healthcare all get in the way. Instead of focusing solely on the treatment itself, how can we design technology that fits the actual realities of people’s daily lives?
To explore these challenges, we brought together a panel of experts: Gizem Demircioglu, Director of Digital Health Strategy & Innovation at EVINOVA (an AstraZeneca company); Michael Hallsworth, Chief Behavioral Scientist at the Behavioural Insights Team (BIT); and Jon Grossman, Design Director at Smart Design. Drawing on their experiences across digital health, behavioral science, and human-centered design, the panelists discussed what gets in the way of adherence, how design and technology can help, and why successful solutions must account for the realities of patients’ lives.
01 Address the logistical barriers through personalization
Adherence challenges often stem from the practical demands of managing treatment, not simply a lack of motivation. Patients may struggle to get to appointments, coordinate prescription refills, or navigate complex clinical protocols. Designing for adherence means identifying these points of friction early and making treatment easier to access and manage. As Gizem notes, for clinical trials, this can include: combining appointments, enabling remote patient monitoring, and offering at-home endpoint collection to reduce unnecessary trips to study sites.
02 Design around existing, real-world habits
Effective interventions build on how people already behave rather than assuming they will follow an idealized patient journey. Behavioral science offers practical ways to make treatment more manageable, such as connecting medication routines to established habits, reducing unnecessary steps, and accounting for the social and situational factors that influence decisions. For example, if a medication needs to be taken twice daily, patients could build it into their morning and nighttime teeth-brushing routines. Instead of asking patients to change everything, designers can work with existing routines to make adherence feel more natural and sustainable.
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A very good way of ensuring adherence is to form habits, because habits are non-conscious and therefore non-effortful ways of performing behavior.
03 Design for the environment where treatment actually happens
A medical device that works well in a controlled clinical setting may be much harder to use at home. Without a clinician nearby, patients must interpret instructions, position devices correctly, and navigate unfamiliar tasks independently. These challenges highlight the importance of testing products in realistic contexts and accounting for differences in patients’ abilities, surroundings, and support systems. The same principle applies to clinical workflows: adherence improves when the systems supporting patients are designed to work together.
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In a clinical setting you have the medical device, nurse, and doctor there. There’s a lot of structure around helping patients use these really difficult-to-use gadgets. But when you try to send patients home with these things, all of a sudden, all bets are off.
04 Use technology to reduce complexity, not add another layer
Digital health tools utilizing AI have the potential to streamline care, personalize support, and help clinical teams make better-informed decisions. Technology is most valuable when it addresses a specific problem, fits into existing workflows, and accounts for the needs of people who may be unable or unwilling to use it. But adding an app, device, or reminder does not automatically improve adherence. In healthcare, designers must also consider reliability and safety, since inaccurate guidance can have serious consequences.
05 Measure success by health outcomes, not adherence alone
Getting patients to follow a treatment plan is not necessarily the ultimate goal. Prescriptions can become outdated, treatments can have side effects, and a patient’s needs can change over time. Optimizing adherence as an isolated metric risks prioritizing compliance over the broader objective of improving health. Solutions should therefore be designed around specific patient populations and conditions, with success measured by whether they support better outcomes for the people using them.
Designing for better adherence
Overall, the panel suggested that improving adherence requires more than reminders, new devices, or asking patients to do better. It means understanding the practical, behavioral, and systemic barriers that shape how people manage their health, then designing solutions around those realities. Whether through simpler care processes, experiences that build on existing habits, or technology that reduces complexity, the opportunity is to make following a treatment plan easier while keeping the ultimate goal in focus: better health outcomes.