Promises, Challenges of Digital Medication Adherence Monitoring Revealed

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Data are collected only after patient consent is given. <i>Image provided courtesy of Otsuka America Pharmaceutical, Inc.</i>
Data are collected only after patient consent is given. Image provided courtesy of Otsuka America Pharmaceutical, Inc.

In November 2017, the US Food and Drug Administration approved a new pill for paranoia featuring a sensor that monitors medication adherence. Researchers suggest that this technology may help improve both adherence and patient outcomes, according to an editorial published in the New England Journal of Medicine.1

The pill — Abilify MyCite® — sends messages to a wearable and removable patch and allows patients and their caregivers to assess whether the medication has been taken by means of data monitoring on a Web portal.

Although initial concerns regarding this technology centered on the ethics of remote patient monitoring, adherence data from the pill are obtained only after patient consent is given. Additionally, the patient can remove the patch at any time to cease adherence monitoring.

Currently, the sensor technology used in Abilify MyCite is being investigated in conjunction with medications that treat other chronic physical and mental conditions. This technology, termed the digital health feedback system (DHFS), was also recently shown to improve blood pressure control more than usual care among patients with poorly controlled hypertension.2

Based on these results, DHFS appears to not only improve adherence to medications, but the technology may also help improve treatment measures and overall outcomes. However, more research with a greater number of participants is needed to discover definite associations between the pill sensor technology and improved treatment outcomes.

Obstacles to implement this technology do exist, particularly for medications that do not provide relief of disease-related symptoms. People with hypertension, for instance, may not notice effects of treatment and may have little motivation to participate with DHFS technology. This is particularly true for patients with resistance to being told to adhere to their medications. In addition, digital monitoring of adherence does not have the ability to assess the psychological factors behind nonadherence, which are possibly more important to address.

In addition to using DHFS technology, an effective adherence motivator may include “giving doctors and patients the time to explore the beliefs and attributions informing medication behaviors.”

References

  1. Rosenbaum L. Swallowing a spy — the potential uses of digital adherence monitoring. N Engl J Med. 2018;378(2):101-103.
  2. Frias J, Virdi N, Raja P, Kim Y, Savage G, Osterberg L. Effectiveness of digital medicines to improve clinical outcomes in patients with uncontrolled hypertension and type 2 diabetes: prospective, open-label, cluster-randomized pilot clinical trial. J Med Internet Res. 2017;19:e246.

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