Mobile health (mHealth) based medication adherence measurement - a pilot trial using electronic blisters in diabetes patients.

AIMS: The aim of the present study was to evaluate a mobile health (mHealth) based remote medication adherence measurement system (mAMS) in elderly patients with increased cardiovascular risk treated for diabetes, high cholesterol and hypertension. Cardiovascular risk was defined as the presence of at least two out of the three risk factors: type 2 diabetes, hypercholesterolaemia and hypertension. METHODS: For treatment of diabetes, hypercholesterolaemia and hypertension, four predefined routinely used drugs were selected. Drug adherence was investigated in a controlled randomized doctor blinded study with crossover design. The mAMS was used to measure and improve objectively the adherence by means of closed-loop interactions. RESULTS: The mean age of the 53 patients (30 female) was 69.4 ± 4.8 years. A total of 1654 electronic blisters were handed out. A statistically significant difference (P = 0.04) between the monitoring and the control phase was observed for the diabetes medication only. In a post-study questionnaire twenty-nine patients appreciated that their physician knew if and when they had taken their medications and 13 asked for more or automated communication with their physicians. Only one subject withdrew from the study because of technical complexity. CONCLUSIONS: The results indicate that mHealth based adherence management is feasible and well accepted by patients with increased cardiovascular risk. It may help to increase adherence, even in patients with high baseline adherence and, subsequently, lead to improved control of indicators including blood pressure and cholesterol concentrations. Electronic blisters can be used in a multi-medication regimen but need to be carefully designed for day-to-day application.

Design and evaluation of a multimodal mHealth based medication management system for patient self administration.

The intake of prescribed medication presents a challenge, in particular for elderly people and in cases where a variety of medications have to be taken in accordance to a complex schedule. To support patients with this task, an mHealth-concept was developed and evaluated in the course of a clinical trial. The system used a multimodal user interface concept, i.e. both RFID tags and barcodes to identify and document the intake of medications. Results of the clinical study with 20 patients indicate that the multimodal mHealth concept utilizing barcode and RFID tags enabled easy-to-use medication management. Although further clinical evaluation is needed to assess whether such a tool can also enhance adherence, the system shows the potential for targeting the problem of medication management with mHealth methods.

Feasibility of mHealth and Near Field Communication technology based medication adherence monitoring.

Poor patients' adherence to intake of prescribed medication has been identified as a serious problem in the treatment of chronically ill patients. Technical solutions are needed to measure and - if necessary - to increase the patients' adherence. A telemonitoring solution was developed to record a patient's medication intake based on smart blisters and mobile phones with NFC functionality. The components allowed recording of drug type, timestamp, and dosage of pills taken. The system's usability and technical feasibility was evaluated in the course of an application study. Over a period of 13 months 59 patients suffering from diabetes were monitored. 1,760 blisters were handed out to these patients and 14,843 takeout events were recorded and transmitted via mobile phone. Results indicate the feasibility of this concept to monitor adherence. Although the system still needs to be optimized for routine use it shows the potential for targeting the problem of poor patient adherence by NFC enabled devices.