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Randomized Controlled Trial
. 2013 Sep;76 Suppl 1(Suppl 1):47-55.
doi: 10.1111/bcp.12184.

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

Helmut Brath  1 , Jürgen Morak, Thomas Kästenbauer, Robert Modre-Osprian, Hermine Strohner-Kästenbauer, Mark Schwarz, Willem Kort, Günter Schreier
Affiliations
Randomized Controlled Trial

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

Helmut Brath et al. Br J Clin Pharmacol. 2013 Sep.

Abstract

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.

Keywords: adherence; diabetes; e-blister; mHealth; telemedicine.

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Figures

Figure 1
Figure 1
Architecture of mHealth based medication adherence measurement system; NFC enabled mobile phone acts as data gateway to transmit the blister data to a remote telemonitoring service, where it can be seen by a physician
Figure 2
Figure 2
Gesture of touching the blister with the mobile phone to read out the event data
Figure 3
Figure 3
Time flow of study phases in group 1 and group 2
Figure 4
Figure 4
Distribution of time delays between detection and the corresponding transmission of a pill break-out event
See this image and copyright information in PMC

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