The right medicine for every patient

Half of the people who are prescribed a medicine do not use it or do not use it properly. This often has negative consequences for the quality of life. Moreover, infidelity in therapy costs society unnecessarily a lot of money, say Jos Kosterink and Job van Boven of the UMCG.

Many drugs prescribed by doctors do not work for everyone. About half of the patients benefit from it; the other half do not, or only experience the side effects. Also, worldwide, no less than 50 percent of people who are prescribed drugs do not take these drugs or take them incorrectly.

Kosterink sees all too often that a medicine does not work or causes unnecessary side effects. “Sometimes the patient doesn’t take the drug while the doctor thinks he does. He then thinks that the medicine is not working properly and prescribes an extra medicine.
While that is not necessary at all and can even be harmful.”

Support from a distance
Assistant professor Job van Boven of the UMCG conducts research in the field of effective drug use. His central research question: how can we ensure that patients and society benefit as much as possible from the medicines that are prescribed?

“We are looking at, among other things, how we can best support patients in the field of therapy compliance,” says Van Boven. “Nowadays, this is increasingly done digitally, remotely. After all, in these times of Covid, many patients no longer visit the hospital or the doctor as often. We try to support people as best as possible in their home situation. For
example, by connecting drug use to an app that sends reminders, feedback and motivational messages.”

Therapy Adherence
Therapy adherence is a hot topic. The UMCG established the northern Therapy Adherence Expertise Center MAECON and declared 18 November the Day of Therapeutic Adherence. “Within MAECON, various disciplines are working together on a number of innovations to
guide people in the proper use of medicines,” says Van Boven.

“Such as smart inhalers or a smart spacer that help patients take their puff in the right way. Or an innovative pill jar that reminds the patient that it is time for his medicine. The patient receives a reminder on his phone. If he wishes, his doctor will receive confirmation of when
the medicine has been taken.”

Not to monitor the patient, but to be able to intervene proactively, if necessary. Van Boven emphasizes: “If you see that someone is not taking a medicine or is taking it incorrectly, it
offers an opening for a conversation or an intervention. Why does someone not take the drug? Does it not work or does it have side effects? Then the dosage may need to be increased or decreased. Does anyone forget? Then the partner may be able to help. Is it too expensive? Then there may be a cheaper alternative.

“We are concerned with efficient use of medicines: how can we make medicines more personal for the patient and thus more effective, safer and more cost-effective?”

Drug concentration in the hair
A new technique that is currently being developed together with professor of bioanalysis at the UMCG Daan Touw is to be able to measure the drug concentration in the hair of the patient.

“We do this to see whether someone is taking in the right amount of the drug over a longer period of time, so that we can optimize the therapy,” says Van Boven. “Measurements in the blood only provide a snapshot. Your hair, on the other hand, is a kind of micro-reservoir, a
historical database of everything that has flowed into your blood over the past month – or even months – in medicines, metals, et cetera.”

However, the technology is still in its infancy. For example, it is still being investigated to what extent the measurements are influenced by factors such as hair color and exposure to UV light or hair dye. “But”, says the researcher, “it is certainly a promising innovation for the future.”

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