Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2025 May 1;57(3):150-158.
doi: 10.4103/ijp.ijp_960_24. Epub 2025 Jul 9.

Evaluation of acceptability and feasibility of using manual pill organizers and pill reminder apps for improving medication adherence among elderly population from rural Maharashtra

Radhika K Nimkar  1 , Rajesh W Balkhande, Rakesh S Patil, Dhiraj M Agarwal, Aditi A Apte
Affiliations
Randomized Controlled Trial

Evaluation of acceptability and feasibility of using manual pill organizers and pill reminder apps for improving medication adherence among elderly population from rural Maharashtra

Radhika K Nimkar et al. Indian J Pharmacol. .

Abstract

Background: Approximately 40%-75% of elderly individuals suffering from chronic diseases are nonadherent to medications. Manual pill organizers (MPO) and pill reminder apps (PRAs) are simple interventions that can improve medication adherence. This was a mixed-methods study to understand the feasibility and acceptability of MPO and a locally developed PRA amongst elderly individuals from rural Maharashtra.

Materials and methods: Sixty elderly individuals aged 60-80 years taking three or more oral medications with access to a smartphone were randomized to receive MPO, PRA, or MPO + PRA for 3 months (n = 30). The outcome measures included acceptability and feasibility using qualitative methods, and usability was measured using a system usability scale.

Results: Both MPO and PRA demonstrated good system usability and ease of independent use. The findings of the qualitative study highlighted reduced dependency on caregivers, reduced chance of missing a pill, and ease of carrying medicines during travel as benefits of MPO. User-friendliness, ability to take medication on time, and caregivers' satisfaction were reported benefits with PRA. Reported challenges included initial hesitancy, the additional workload of filling the MPO, alarm malfunctions, and dependency on family members for using PRA. Medication nonadherence due to forgetfulness significantly improved from 52% to 65% at baseline to 90%-100% at the end as reported using Medication Adherence Rating System-5. Participants in the combined group did not report any difficulty using the two interventions together.

Conclusion: The study demonstrates good feasibility and acceptability of MPOs and indigenously developed PRA either alone or in combination among the Indian rural elderly population. CTRI registration: CTRI/2024/01/061975 (Registered on- January 29, 2024).

Keywords: Compliance; geriatric; mobile app; pillbox; usability.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Study flow chart. MPO = Manual pill organizer, PRA = Pill reminder app
See this image and copyright information in PMC

References

    1. Sabaté E. World Health Organization; 2003. Adherence to Long-Term Therapies: Evidence for Action. Available from: https://iris.who.int/bitstream/handle/10665/42682/9241545992.pdf?sequenc... . [Last accessed on 2024 Dec 23] - PubMed
    1. Wroe AL. Intentional and unintentional nonadherence: A study of decision making. J Behav Med. 2002;25:355–72. - PubMed
    1. Hughes CM. Medication non-adherence in the elderly: How big is the problem? Drugs Aging. 2004;21:793–811. - PubMed
    1. Doggrell SA. Adherence to medicines in the older-aged with chronic conditions: Does intervention by an allied health professional help? Drugs Aging. 2010;27:239–54. - PubMed
    1. Col N, Fanale JE, Kronholm P. The role of medication noncompliance and adverse drug reactions in hospitalizations of the elderly. Arch Intern Med. 1990;150:841–5. - PubMed

Publication types