Are caregivers ready for digital? Caregiver preferences for health technology tools to monitor medication adherence among patients with serious mental illness

Abstract

Background Adherence to antipsychotic medication is critical for bipolar disorder (BPD), major depression (MDD) and schizophrenia (SCZ) patients. Digital tools have emerged to monitor medication adherence along with tracking general health. Evidence on physician or patient preferences for such tools exists but is limited among caregivers. The study objective was to assess preferences and willingness-to-pay (WTP) for medication adherence monitoring tools among caregivers of SMI patients. Methods A web-based survey was administered to caregivers of adult SMI patients. Twelve discrete choice questions comparing adherence monitoring tools that varied across two attribute bundles: (1) tool attributes including source of medication adherence information, frequency of information updates, access to adherence information, and physical activity, mood, and rest tracking, and (2) caregiver monthly out-of-pocket cost attribute were administered to caregiver respondents. Attributes were parameterized for both digital and non-digital tools. Random utility models were used to estimate caregivers’ preferences and WTP. Results Among 184 study-eligible caregivers, 57, 61 and 66 participants cared for BPD, MDD, and SCZ patients, respectively. Caregivers highly preferred (odds ratio (OR): 7.34, 95% confidence interval (CI): 5.00–10.79) a tool that tracked medication ingestion using a pill embedded with an ingestible event market (IEM) sensor and tracked patients’ physical activity, mood, and rest than a non-digital pill organizer. Additionally, caregivers were willing to pay $255 per month (95% CI: $123–$387) more for this tool compared to a pill organizer. Conclusion Caregivers of SMI patients highly preferred and were willing to pay more for digital tools that not only measures medication ingestion but also tracks general health.

Canadian perspectives of digital mental health supports: Findings from a national survey conducted during the COVID-19 pandemic

“…While recent federal efforts have resulted in affordable broadband access to 94% of Canadians, 57 , 58 which may reduce the potential bias of a web-based survey, other digital divide factors, such as a lack of digital literacy, may hinder participation and must be considered. Another source of bias is the low response rate; however, this rate is consistent with other web-panel studies 57 , 59 – 64 and is expected for population surveys of this length administered on the web and without financial incentive. 65 Lastly, the cross-sectional design provides a snapshot of the experience and needs of the population, especially with the dynamic nature of jurisdictional pandemic responses and their impact on Canadians.…”

Digital health interventions to improve adherence to oral antipsychotics among patients with schizophrenia: a scoping review

“…Caregivers of individuals with schizophrenia preferred digital adherence monitoring tools over non-digital ones. They preferred a pill embedded with an ingestible event monitoring (IEM) sensor system because it tracked patients' medication ingestion, physical activity, quality of rest and self-reported mood 87. Besides, caregivers emphasised the need for wearable devices, such as smartwatches, to monitor the patient’s condition and inform the physicians of the data captured 79…”

Bibliometric analysis and evidence of clinical efficacy and safety of digital pills

“…In this regard, the study of Forma et al ( Forma et al, 2022 ) involved an online survey on willingness to pay for adherence monitoring tools among individuals ( n = 184) caring for patients with serious mental disorders. A high preference for the use of digital pills, which monitor not only the use of medicines but also the physical activity of patients, the quality of rest, and mood, has been identified.…”