E-Pillboxes Improve Medication Adherence, Study Finds

Text messaging alone was as ineffective as no reminders at all among TB patients

By Mary Elizabeth Dallas

Tuesday, September 15, 2015

TUESDAY, Sept. 15, 2015 (HealthDay News) -- Electronic reminders may help people with tuberculosis take their medication properly, a new study suggests.

Tuberculosis (TB) patients are less likely to miss doses when they receive alerts from an electronic pillbox, researchers report in the Sept. 15 issue of PLOS Medicine. Electronic pillboxes use visual, audio and/or vibration cues to signal when it's time to take medication.

TB is a bacterial infection that mainly strikes the lungs. The traditional method of ensuring medical adherence in TB patients is to watch people take their medicine, but the study authors said this isn't doable in remote areas such as rural China.

"Innovative approaches to enable patients to adhere to TB treatment are needed. Widespread use of medication monitors in national TB control programs can benefit from the development of a low-cost and reliable medication monitor as well as evidence that its use can improve clinical outcomes," study co-author Katherine Fielding, of the London School of Hygiene & Tropical Medicine, said in a journal news release.

The study involved more than 4,100 people with tuberculosis in 36 districts in the Chinese provinces of Heilongjiang, Jiangsu, Hunan and Chongqing. Researchers randomly selected patients to receive one of four approaches to help them follow through on treatment.

One group received text messages with medication reminders. Another group received alerts from an e-pillbox, while a third group received both electronic-pillbox alerts and text messages. A fourth group received no reminders at all, the study authors said.

More than one in five patients without reminders missed doses of their medication in about 30 percent of the months analyzed, according to the study.

Those who received reminders from an electronic pillbox didn't take their medication properly in 17 percent of the months. The patients who received both text messages and electronic-pillbox reminders missed doses only about 14 percent of the months, the study found.

However, those who only received text messages took their medication no more reliably than those who received no reminders, the researchers pointed out.

Writing in an accompanying article, John Metcalfe, of the University of California, San Francisco, and colleagues said: "If replicated, [this study] will have important implications for global TB treatment in moving away from witnessed dosing, which is not universally feasible, towards a more personalized adherence model of patient-provider communication in which intervention is delivered where, when, and in whom it is needed to efficiently prevent adverse treatment outcome."

SOURCE: PLOS Medicine, news release, Sept. 15, 2015

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