Hand holding a mobile with the Growlink app on the screen.

Tracking Digital Drug Adherence for Merck

Delivering a patient-centred design process to help improve drug adherence for Merck Group.


Frontend.com worked with Merck to design a connected health solution that syncs data from a patient’s smart injector device and communicates it with their doctor and home carers. It provides a remote monitoring solution designed to motivate and engage the patient with their therapy while logging and communicating therapy adherence with the patient’s care team.

Medication Adherence Problem

Non-adherence to prescribed medication is a significant global healthcare problem, particularly for patients with chronic conditions requiring long-term treatment. Across multiple chronic illness areas, the figures show that six months after starting a course of treatment 50% of patients are no longer adherent. This results in complications in patient health, increased hospital visits, and in severe cases, death. According to the US Surgeon General, 125,000 patients die annually due to non-adherence. It causes problems for the physicians too, making it difficult to define an effective course of therapy. This particular problem is more acute for younger patients and children.

Graph showing adherence drop-off rates for medication.

Graph showing adherence drop-off rates for medication.

Growlink App

Growlink™ is an adherence app that works in sync with an auto-injecting device. It is designed to monitor adherence, deliver reminders, and communicate data with the patient’s physician. The app is specifically designed to augment the patient’s experience of using growth hormone replacement therapy. Typically patients with growth hormone deficiency are diagnosed in early childhood and they need to administer daily injections until adulthood, and sometimes beyond.

Unique Users

The particular challenge, in this case, was the age-range of the patient group, which encompassed their significant development years. Frontend.com conducted research among patients, and their parents, to understand the goals and challenges that they face in maintaining their daily medication regime. In particular, we researched the younger patients use of smartphones and apps and assessed what features they would find useful. We conducted similar studies with their parents and found that there was a strong convergence between both groups.

A selection of Growlink app user interface mobile screens/

The patients and their parents were shown prototype app designs and asked to complete tasks under our observation. Whereas initially held views indicated that very distinct apps would be needed to engage both children and adults, for example, a fun lighthearted child-centred app and a more serious adult version. In actuality, the patient research suggested that this was not the case. In addition, we probed what other design elements would engage and motivate these users in order to create the most appropriate and effective solution. It was discovered that for parents, the growth of the child during the early years was of particular concern, whereas after medication administration handover and during adolescent years, adherence monitoring became important. For patients, positive reinforcement was found to be a key motivator. 

Three user interface mobile screens from the Growlink app.

Our Solution

The Growlink solution is comprised of a primary user app, paired with multiple viewer apps. The primary user role is assigned by the physician and this can be either the patient or if they are a minor, the patient’s parent or guardian. All reminders and notifications are sent to this primary app. The secondary viewer app has an oversight role where the patient’s adherence, missed doses, and educational information can all be seen. The viewer app also provides an option for users to record their growth and correlate their height and weight against ethnographic growth norms, and when the time arrives, facilitate the handover of responsibility from parent to child through the app’s educational content and discreet monitoring functionality.

The benefit of this dual app platform is that it patients can visualise the benefits of their therapy as well as learning about the adverse effects of non-adherence. From the physician’s viewpoint, it provides greater insight into drug adherence and enables them to make the correct therapy decisions in confidence.

Two Frontend.com team members collaborating at a computer monitor.Two Frontend.com team members collaborating at a computer monitor.