Electronic Smart Blister Packages to Monitor and Support Medication Adherence: A Usability Study

Abstract

Purpose An electronic version of the Dosepak ® (EDP) which records date and time of dosing events has been developed to monitor adherence to medication packaged in blisters. This study aimed to evaluate its usability and acceptance and to monitor dose-taking adherence for optimal implementation in future clinical trials and practice. Methods Healthy volunteers aged over 18 years were asked to dispense placebo tablets twice daily from EDPs equipped with a re-usable electronic module for a total duration of four weeks. Afterwards, subjects were asked to complete an online questionnaire and partake in a short one-on-one interview. The usability of the EDP was assessed using the System Usability Scale (SUS), while dose-taking adherence was monitored by EDP records, pill counting, and self-report. The short interview explored user experiences in more detail. Results Twenty subjects with median [IQR] age 41.5 [32–49.8] years, 55% female, 45% healthcare professionals, and 20% chronic medication users completed the study and found the EDP easy to use, with a mean [SD] SUS score of 78.0 [11.2]. Median [IQR] dose-taking adherence was 89% [82–95%] based on EDP records, 96.5% [89–100%] based on pill counting, 92% [91–96%] based on self-report, and the levels differed significantly (p < 0.05). Four themes emerged from the interviews: user preference, experience, patient burden, and ideas for improvement. Most participants preferred smaller sized blisters. They found the EDP simple to use and did not see any patient burden for its use in trials or clinical practice. Some reported forgetfulness and suggested reminders built into the blister or sent to their mobile phones. Adequate information or instruction should also be provided for older people and polypharmacy patients. Conclusion EDP had good perceived usability, was well accepted, and differed significantly from other adherence measurement methods. This study provides input to further guide scale-up of the blister packages.

Applications of Smart Material Sensors and Soft Electronics in Healthcare Wearables for Better User Compliance

“…Smart sensors can be used to monitor patient compliance using smart blisters and smart bottles [ 5 , 6 ]. Smart pill blisters monitor a patient’s intake using electronic circuits.…”

Poking and Prodding So They Take Their Pills

“…Ho et al trialed a 4-step medication delivery and phone follow-up outreach process that produced mixed results-an increase in medication adherence, but also an increase in need for repeat revascularization [5]. Smart blister packs which monitor day-to-day variability adherence in medications are easy to use and provide more objective data than pill counting and self-reporting by patients [6]. Tablets with embedded sensors that detect contact with gastric acid and transmit ingestion events to external monitors have been approved for other diseases like schizophrenia [7].…”