Background Accurate measurement and monitoring of patient medication adherence is a global challenge because of the absence of gold standard methods for adherence measurement. Recent attention has been directed toward the adoption of technologies for medication adherence monitoring, as they provide the opportunity for continuous tracking of individual medication adherence behavior. However, current medication adherence monitoring technologies vary according to their technical features and data capture methods, leading to differences in their respective advantages and limitations. Overall, appropriate criteria to guide the assessment of medication adherence monitoring technologies for optimal adoption and use are lacking. Objective This study aims to provide a narrative review of current medication adherence monitoring technologies and propose a set of technology assessment criteria to support technology development and adoption. Methods A literature search was conducted on PubMed, Scopus, CINAHL, and ProQuest Technology Collection (2010-present) using the combination of keywords medication adherence, measurement technology, and monitoring technology. The selection focused on studies related to medication adherence monitoring technology and its development and use. The technological features, data capture methods, and potential advantages and limitations of the identified technology applications were extracted. Methods for using data for adherence monitoring were also identified. Common recurring elements were synthesized as potential technology assessment criteria. Results Of the 3865 articles retrieved, 98 (2.54%) were included in the final review, which reported a variety of technology applications for monitoring medication adherence, including electronic pill bottles or boxes, ingestible sensors, electronic medication management systems, blister pack technology, patient self-report technology, video-based technology, and motion sensor technology. Technical features varied by technology type, with common expectations for using these technologies to accurately monitor medication adherence and increase adoption in patients’ daily lives owing to their unobtrusiveness and convenience of use. Most technologies were able to provide real-time monitoring of medication-taking behaviors but relied on proxy measures of medication adherence. Successful implementation of these technologies in clinical settings has rarely been reported. In all, 28 technology assessment criteria were identified and organized into the following five categories: development information, technology features, adherence to data collection and management, feasibility and implementation, and acceptability and usability. Conclusions This narrative review summarizes the technical features, data capture methods, and various advantages and limitations of medication adherence monitoring technology reported in the literature and the proposed criteria for assessing medication adherence monitoring technologies. This collection of assessment criteria can be a useful tool to guide the development and selection of relevant technologies, facilitating the optimal adoption and effective use of technology to improve medication adherence outcomes. Future studies are needed to further validate the medication adherence monitoring technology assessment criteria and construct an appropriate technology assessment framework.
BACKGROUND Accurately measuring and monitoring patient medication adherence is a global challenge due to the absence of “gold standard” methods for adherence measurement. Recent attentions have turned towards the adoption of technologies for medication adherence monitoring as they provide the opportunity for continuous tracking of individual medication adherence behavior. Yet, current medication adherence monitoring technologies vary by their technical features and methods of adherence data capture, leading to differences in their respective advantages and limitations. Overall, there is a lack of appropriate criteria to guide the assessment of medication adherence monitoring technologies for optimal adoption and utilization. OBJECTIVE This study aimed to provide a concise overview and summary of current medication adherence monitoring technologies and propose a set of technology assessment criteria to aid in the development and adoption of these technologies. METHODS A literature search was conducted on PubMed, Scopus, CINAHL, and ProQuest Technology Collection (January 2010-June 2021) using the combination of keywords "medication adherence," "measurement technology," and "monitoring technology". The selection focused on studies related to medication adherence monitoring technology and its development and use. The technological features, methods of adherence data capture, and potential advantages and limitations of identified technology applications were extracted. Common, recurring elements were synthesized as potential technology assessment criteria. RESULTS Among 3865 articles retrieved, 98 remained for final review, which reported a variety of technology applications for monitoring medication adherence, including electronic pill bottles/boxes, ingestible sensors, electronic medication management systems, blister pack technology, patient self-report technology, video-based technology, and motion-sensor technology. The most commonly reported technologies included electronic pill bottles, electronic pillboxes, and ingestible sensors. Twenty-eight technology assessment criteria were identified and organized into five categories: Development Information, Technology Features, Medication Adherence Data Collection & Management, Feasibility & Implementation, and Acceptability and Usability. CONCLUSIONS This study summarized the technical features, data capture methods, and various advantages and limitations of medication adherence monitoring technology reported in the literature and proposed criteria for assessing medication adherence monitoring technologies. This collection of assessment criteria may be a useful tool to guide the development and selection of relevant technology, facilitating the optimal adoption and effective use of technology to improve medication adherence outcomes. Future studies are suggested to further validate the medication adherence monitoring technology assessment criteria and construct an appropriate technology evaluation framework.
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