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June 23, 2014Journal of Telemedicine and Telecare94 citationsOpen Access

Randomized controlled feasibility trial of two telemedicine medication reminder systems for older adults with heart failure

CGCarly M. GoldsteinEGEmily C. GathrightMDMary A. Dolansky

Key Result

Active medication reminders did not improve medication adherence compared to passive devices (79% vs 78%) in older adults with heart failure over 28 days.

Study Design

Type

RCT (n=60)

Randomization

2 × 2 design

Structured PICO

Do telemedicine medication reminder systems improve medication adherence in older adults with heart failure?

P
Population
60 older adults with heart failure (mean age 69 years, 35% female) followed for 28 days to assess medication adherence.
I
Intervention
Telemedicine medication reminder systems (electronic pill box or smartphone app with active reminding)
C
Comparator
Passive medication reminder devices (electronic pill box or smartphone app with silent/passive mode)
O
Outcome
Adherence to 4 medications over 28 days

Active telemedicine medication reminders (electronic pillbox or smartphone app) did not improve short-term medication adherence in older heart failure patients compared to passive devices.

Main Result

Absolute Event Rate: 79% vs 78%

Abstract

We conducted a feasibility study of a telehealth intervention (an electronic pill box) and an m-health intervention (an app on a smartphone) for improving medication adherence in older adults with heart failure. A secondary aim was to compare patient acceptance of the devices. The participants were 60 adults with HF (65% male). Their average age was 69 years and 83% were Caucasian. Patients were randomized using a 2 × 2 design to one of four groups: pillbox silent, pillbox reminding, smartphone silent, smartphone reminding. We examined adherence to 4 medications over 28 days. The overall adherence rate was 78% (SD 35). People with the telehealth device adhered 80% of the time and people with the smartphone adhered 76% of the time. Those who received reminders adhered 79% of the time, and those with passive medication reminder devices adhered 78% of the time, i.e. reminding did not improve adherence. Patients preferred the m-health approach. Future interventions may need to address other contributors to poor adherence such as motivation.

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Cite This Study

Goldstein et al. (2014) conducted an RCT in heart failure (n=60). Active medication reminders (electronic pill box or smartphone app) vs. Passive (silent) medication reminder devices was evaluated on Adherence to 4 medications over 28 days. Active medication reminders did not improve medication adherence compared to passive devices (79% vs 78%) in older adults with heart failure over 28 days.

synapsesocial.com/papers/6a20770c5401ca4f9e31786ahttps://doi.org/10.1177/1357633x14541039
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