Predicting Therapy Adherence : A Machine Learning Approach

Abstract

Ensuring adherence to medical therapy has been an open problem in health care practices since the Hippocrates Oath (400 BC) to modern medicine. In an ideal world, people would follow their doctor's recommendations. They would stick to their diet to lose weight, take their medication on time, and use their electronic health devices as recommended by the doctors. But the planned routine is rarely followed, causing a financial burden in the order of billions of dollars for the national healthcare system and many billions of dollars worldwide. A key mechanism to revert a tendency of non-adherence is early personalized intervention, targeting the key factors of undesired behavior, but this task is not trivial. After starting their therapy, individuals have an unpredictable series of life events that may impact their willingness to keep with the necessary therapy routine. Only recently, we achieved the ability to passively collect individual-level therapy data as patients progress in their treatments using digital devices. In this thesis, we proposes various machine-learning strategies that aim to leverage the data collected at the early stages of medical therapies to predict future adherence and recommend early accurate interventions that align with each individual's desired outcomes. We narrow most of the analysis in two sleep apnea therapies, Continuous Positive Airway Pressure (CPAP) and Upper-Airway Stimulation (UAS). But to reinforce the generalization of our methods we also show how they can be applied for the growth-hormone therapy management.