A simple, novel method for assessing medication adherence: capsule photographs taken with cellular telephones.
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Date
2011-08-16
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Abstract
OBJECTIVES Medication nonadherence is an important factor in clinical practice and research methodology Although many methods of measuring adherence have been investigated there is as yet no gold standard We compared the usefulness and accuracy of a novel measure of adherence photographs taken by cellular telephones with 2 incumbents capsule count and the Medication Event Monitoring System MEMS METHOD Twenty subjects participated in a clinical trial of the efficacy of modafinil for the treatment of methamphetamine dependence Subjects were issued cell phones and medication in MEMS Cap equipped bottles and were instructed to take 1 capsule a day for 8 weeks recording adherence with both systems Pill counts were recorded at weekly inpatient visits Subjects were paid for participation and for each capsule photograph and the returned medication bottle with MEMS Cap RESULTS Capsule count indicated adherence proportion of prescribed medication taken was 94 9 When compared with capsule count the novel method was found to underestimate adherence whereas MEMS overestimated adherence By using the dosing time data collected we determined that subjects who dosed at a consistent time daily were more likely to adhere to the prescribed regimen We also detected discrepancies in the timestamps recorded by MEMS CONCLUSIONS Capsule photographs are a useful measure of adherence allowing more accurate time measures and more frequent adherence assessment than MEMS or capsule count Given the ubiquity of cellular telephone use and the relative ease of this adherence measurement method we believe it is a useful and cost effective approach
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Keywords
At risk for a particular disease or infection, Client, Access to information or data, Low adherence to treatments, Usability, Pilot, Treatment adherence, Disease management, Surveillance, Data collection and reporting, Image