At PQA 2026, Synchronyx Makes the Case for Real-Time Medication Intelligence: Why Patients Miss Doses, and When Risk Actually Surfaces
New cross-therapy real-world evidence surfaces what claims and refill data cannot see, and reframes what the industry has long called the "adherence problem"
BALTIMORE, MD, May 13, 2026. Synchronyx, the medication intelligence company behind Tappt® Health, today presented new real-world evidence at the 2026 Pharmacy Quality Alliance (PQA) Annual Meeting that reframes a long-standing clinical challenge: not just whether patients take their medications, but why they don't, when that risk first emerges, and what it takes to surface those signals early enough to act.
The poster, Beyond the Pill Count: Real-Time Dose-Level Monitoring to Identify Demographic Disparities in Medication Adherence Barriers, draws on a cross-therapy, multi-institution dataset captured through the Tappt® Health platform. It extends the company's PQA Gold Medal-recognized work in oral oncology adherence to a broader population spanning multiple disease areas and care settings, and asks a more fundamental question: what does the adherence problem actually look like when you can see it at the dose level?
What the field has been measuring, and what it has been missing
The clinical literature on medication adherence is deep and consistent on one point: nonadherence is not a single behavior, and it does not have a single cause. Foundational research in patient medication beliefs established that patients make active, considered decisions about their therapies, continuously weighing perceived necessity against concerns about side effects, long-term risk, and disruption to daily life and identity. This intentional form of nonadherence operates through entirely different psychological mechanisms than unintentional nonadherence, which is driven by habit failure, disrupted routine, and cognitive load. They are not interchangeable, and they do not respond to the same interventions.
Yet the measurement systems that most adherence programs rely on, including proportion of days covered (PDC), medication possession ratio (MPR), and pharmacy refill records, treat nonadherence as a binary outcome derived from supply-side proxies. A prescription refilled is not a dose taken. A dose not taken is not necessarily disengagement: it may be a provider-directed clinical pause, a supply chain failure, an unreported side effect, or an unmet informational need the patient has no channel to communicate. Refill-based metrics cannot distinguish between these. They detect a gap in supply, not a gap in behavior, and they detect it weeks or months after the moment when intervention could have made a difference.
This is not a minor methodological limitation. It is the reason adherence programs consistently find themselves responding to a problem that has already compounded, with an intervention calibrated to a barrier they cannot see.
What dose-level, real-time data changes
Beyond the Pill Count surfaces patterns that are difficult, if not impossible, to recover from claims data alone. Three findings carry particular weight from a behavioral and clinical standpoint.
The window of highest risk is earlier than most programs are designed to address. Consistent with the broader literature on therapy initiation, the analysis confirms that patients are most likely to disengage in the earliest weeks of treatment, a period when new medication routines are fragile, side effects are novel, and concerns about necessity and safety are most active. This is also the period that refill-based monitoring cannot see. By definition, a refill-based flag cannot fire before the first refill cycle. The gap between when risk emerges and when it becomes measurable by conventional tools is precisely the window in which early intervention matters most.
The barriers patients report reflect the full complexity of intentional and unintentional nonadherence. When patients are given a low-friction, real-time channel to report a missed dose, the reasons they provide span the full behavioral spectrum: side effects and medication concerns (intentional, belief-driven), forgetfulness and disrupted routine (unintentional, habit-based), and supply or access failures (structural). These are not clinically equivalent. Behavioral strategies that are effective for habit-based forgetting, such as reminders, implementation intentions, and cue-routine-reward structures, are ineffective and potentially counterproductive for patients whose nonadherence is rooted in active ambivalence about their therapy. Distinguishing them requires capturing the reason at the moment it occurs, not reconstructing from a refill gap after the fact.
A meaningful share of what conventional metrics count as nonadherence is clinically intentional. Provider-directed treatment pauses are a routine feature of oncology and chronic disease management. PDC and MPR-based calculations absorb these pauses as adherence failures, inflating the apparent problem and mischaracterizing the patient-provider relationship. Real-time reporting makes the distinction visible, which matters for measurement accuracy, for clinical trust, and for the validity of any outcomes analysis built on adherence data.
Why platform design determines data quality
The clinical value of real-time adherence data is inseparable from the experience of generating it. This is the central and underappreciated lesson of the mHealth literature on engagement in real-world deployment.
Across electronic monitoring systems, from early electronic event monitoring systems (MEMS) to contemporary app-based medication diaries, a consistent pattern emerges: engagement decays steeply in the first weeks of deployment among real-world patient populations. Patients who do not perceive immediate, personal relevance in a tool stop using it early, and they stop disproportionately among those at highest clinical risk. What persists is a biased, self-selected sample of the most engaged and most adherent patients, generating data that overstates adherence and systematically underrepresents the patients who most need support.
Tappt® Health is designed against this pattern. The recording moment is embedded in a physical interaction the patient is already performing when they engage with their medication, eliminating the behavioral gap between the dose event and the act of logging it. Reporting a missed dose or a concern requires minimal effort and is delivered at the moment of maximum contextual relevance, when the patient is already thinking about their medication. This approach draws on the same principles underlying ecological momentary assessment (EMA) and just-in-time adaptive intervention (JITAI) frameworks in behavioral medicine: that interventions and reporting prompts calibrated to context and moment outperform those that require patients to initiate a separate behavior on a fixed schedule. Reducing friction at the point of reporting is not a design convenience. It is the mechanism by which the data becomes ecologically valid and the population representativeness shifts toward the patients who matter most.
When patients engage because participation is natural rather than burdensome, the data that emerges reflects real-world medication behavior across the full risk spectrum. And when care teams receive that signal in real time, the system has what it has long lacked: the opportunity to respond to a barrier before it becomes a pattern.
Why it matters
"When patients have a real-time, low-friction channel to tell you what is happening with their medication, the data they generate does not look like what the field has assumed," said Tamar Sapir, PhD, CEO of Synchronyx. "We are not seeing a population of patients who forget. We are seeing patients who are actively managing side effects they have not told anyone about, navigating supply failures that no refill system would catch, and making considered decisions about a therapy whose necessity they are still weighing. That is not a compliance failure. That is a communication gap. And when you look at who carries the heaviest burden of those unreported barriers, it is not randomly distributed. The patients facing the most complex, structurally rooted obstacles to adherence are precisely the patients that conventional monitoring is least equipped to see. Real-time patient-reported data does not just improve measurement. It changes the clinical interpretation of what nonadherence is, who is experiencing it, and what the appropriate response actually looks like."
About the PQA Annual Meeting
The Pharmacy Quality Alliance Annual Meeting convenes health plans, pharmacy organizations, measure developers, pharmaceutical manufacturers, and quality leaders to advance medication-use quality across the U.S. healthcare system.
About Synchronyx
Synchronyx is a digital health company building the medication intelligence layer for real-world patient journeys. Its flagship product, Tappt® Health, combines battery-free smart labels with a patient companion app and a care-team dashboard, giving pharma, specialty pharmacies, health systems, and clinical trial sponsors visibility into what happens between prescription and outcome. Synchronyx is a six-time award winner, including the PQA Gold Medal (2025).
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Media contact: info@synchronyx.com
Citation: Synchronyx. Beyond the Pill Count: Real-Time Dose-Level Monitoring to Identify Demographic Disparities in Medication Adherence Barriers. Poster presented at: Pharmacy Quality Alliance (PQA) Annual Meeting; May 13, 2026; Baltimore, MD.
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Beyond the Pill Count: Real-Time Dose-Level Monitoring to Identify Demographic Disparities in Medication Adherence Barriers
New real-world evidence from Synchronyx presented at the PQA 2026 Annual Meeting. Enter your details below to receive the full PDF.
