A Rare Specialty Pharmacy’s Rapid Response to Personalized Patient Education Using QR Codes

QR codes are currently used in various healthcare settings such as hospitals for patient verification but more recently for healthcare related education.

In outpatient settings, pharmacists are often the last point of contact before patients receive treatment. This interaction is a critical point where pharmacists can step in to provide comprehensive counseling to promote positive outcomes for prescribed complex therapies.

It is important that the information provided, whether written or verbal, is not only complete and understandable, but also available for patients to refer to when needed. Overwhelming patients and caregivers with this initial education can be overwhelming and studies show that patients remember less than a fifth of the information they were counseled on.1

As a mail-order pharmacy specializing in rare diseases, delivering such detailed instructions over the phone, through text links, or in print helps overcome some of these educational barriers, but there is room for improvement. The inability to provide in-person advice remains a pervasive barrier for specialty and specialty rare disease pharmacies.

Although PANTHERx Rare Pharmacy leverages virtual counseling to meet the needs of those we serve, counseling is not always readily available when the patient needs it most. As a result, PANTHERx has taken the opportunity to rethink how information can be made available to patients in a timely and meaningful way. Our goal is to fill this gap by providing vital clinical information in a meaningful way that is not only easier to digest, but also available to patients when they want it.

PANTHERx Rare Pharmacy has launched a new initiative using existing technology to provide personalized educational materials available digitally to patients and caregivers. The initiative stemmed from the need to provide timely training in the single administration of a drug in pediatric neurology.

Traditionally, these patients begin treatment with a complex titration with these instructions delivered over the phone by a licensed pharmacist. For this specific pediatric population, a link to an instructional video outlining the drug mixing process was previously distributed to their caregivers via a one-time handout and text message at the start of therapy.

The shortcomings of these delivery methods revealed that many caregivers were unaware of the video’s availability for a variety of reasons, such as patients may not have been signed up for texting to receive the link, the original document containing the link was misplaced and not subsequently provided. mailings, or patients overlooked the information upon receipt. While these methods are considered adequate, they have significant limitations in terms of recalling information or causing consumers to misplace the mailed or electronic document containing that information.

Coming out of the pandemic, companies continue to use contactless methods as a means of doing business. The impacts of COVID-19 can be felt across all industries, but technology has helped us through the pandemic and helped the world reinvent effective ways of communicating. Originally developed in 1994 to track automotive manufacturing inventory, Quick Response (QR) codes have reappeared during the pandemic and proven themselves.2

A QR code is a 2D barcode that can perform a multitude of tasks, from hosting restaurant menus and boarding passes to sharing electronic business cards or streamlining payments.3

With the use of a QR decoder, the code can be translated into almost any information. Luckily, QR decoders aren’t hard to get and use, as most people have one in the palm of their hand: a smartphone.

In 2021, 85% of American adults use smartphones, which represents more than 294 million smartphone users in the United States.4 With the evolution of portable technology, the need to use a computer to access the Internet is decreasing.

About 47% of all web traffic in the United States currently comes from smartphones or mobile devices, with an increase over time, highlighting the growing preference for convenience and accessibility.4

Scanning a QR code only takes a few seconds and can provide the end user with a plethora of information. Simplicity and adaptability make QR codes an invaluable tool, and the data backs it up with a 110% increase in daily usage in 2020 compared to 2019.5

The use of QR codes spans a wide variety of industries, including healthcare. QR codes are currently used in various healthcare settings such as hospitals for patient verification but more recently for healthcare related education.

Just-in-time learning is a concept of quickly providing information to the user at a time when he specifically needs it. In hospitals, QR codes are used to house guidelines or video instructions on how to properly use a certain piece of equipment.

This process not only reduces the time it takes to search for a particular resource or wait for a facilitator’s demonstration, but QR codes can be continually updated with the latest information within minutes. Response from healthcare providers on the QR code app has been overwhelmingly positive.6

With the success and ease of implementation of this process, the use of QR codes in healthcare should be mainstreamed outside of the hospital setting and should not be limited to healthcare providers. QR codes have yet to be routinely used to convey the often overwhelming amounts of patient or caregiver education material that accompanies prescription drugs. The ability to provide in-depth patient or caregiver education via a QR code on a label transforms how we provide patient education materials in the future and removes barriers to understanding and easy access to health care information.

Patient recall of pharmacological treatment and lifestyle information is an important factor in patient encounters and more specifically in chronic disease management. In a study examining patient recall among people with chronic conditions, it was found that less than half of patients were able to correctly recall the name of the drug being discussed.

On average, patients recalled less than one topic per visit, which, in addition to the name of the medication, included instructions, adverse effects (AEs), main effects, compliance, and attitude towards the medications .seven

The rare disease population faces many of the same barriers to quality care as the chronic disease population. Having drug information and educational materials so readily available in a dynamic format could improve patient understanding and lead to better health outcomes.

Based on all the information discussed above, PANTHERx launched a program to attach a personalized QR code to patients’ prescription labels for each refill of the drug. Although third-party organizations may be available to do this for your pharmacy, this service can also be provided in-house to meet the specific needs of the patients you serve.

The following presents a case study with a specific rare disease population. The pharmacy staff handling the new or refill prescription alerts the caregiver to the QR code and informs them of its purpose and instructions for use. After receiving the medicine shipment, patients or caregivers use their smartphone to scan the QR code and view enhanced information via a PANTHERx resource.

The video created encompasses the mixing and administration of the oral solution with step-by-step instructions, available in English and Spanish. The contents of the QR code can address several areas of medication management.

These may include administration videos, AE management recommendations, and proper disposal of medications. Through this new mode of delivery, we are promoting continuity of care by allowing patients or caregivers to access educational information when they need it most.

The goal of this initiative is to improve outcomes for patients by providing them with the tools they need on their own terms. The evolution of this program will depend on the data entered as well as technological advances. This initiative will continue to be rolled out for other PANTHERx Rare Pharmacy programs.

The ultimate goal is to provide patients with QR codes tailored to meet their unique treatment needs, allowing the application of different QR codes, even if it is the same drug. The ability to use patient-specific data to personalize individualized education serves as a platform to improve patient outcomes and improve quality of life for people with rare diseases.

References:

  1. Richard C, Glaser E, Lussier MT. Communication and patient engagement influencing patient recall of treatment discussions. Expect health 2017;20(4):760-70.
  2. QR Code Development History, Technologies, DENSO WAVE. 2022. QR Code Development History|Technologies|DENSO WAVE. [online] Available on : [Accessed 4 August 2022].
  3. Nyu.edu. 2022. [online] Available on : [Accessed 4 August 2022].
  4. US smartphone industry statistics [2022]: Facts, growth, trends and forecasts – Zippia. Zippia.com. https://www.zippia.com/advice/us-smartphone-industry-statistics/. Accessed August 4, 2022.
  5. Timmons J. The Massive List of Use Cases for QR Codes in Healthcare – Ettactics. Tactics | Revenue cycle software. https://etactics.com/blog/qr-codes-in-healthcare. Accessed August 4, 2022.
  6. Karia CT, Hughes A, Carr S. Uses of quick response codes in health care education: a scoping review. BMC Med Educ 2019;19(1):456.
  7. Yeung, Denise L et al. Low Health Literacy Flashcards and Mobile Video Reinforcement to Improve Medication Adherence in Patients Taking Medications for Oral Diabetes, Heart Failure, and Hypertension: JAPhA 2017;57(1):30-3.

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