A liquid- and capsule-compatible hydroxyurea electronic monitor to identify non-adherent youth with sickle cell disease

Prescription and claims data indicate that hydroxyurea (HU) adherence is low among youth with sickle cell disease (SCD). Electronic monitors (EM) are a gold standard measure, yet existing models have significant drawbacks that limit their use in youth with SCD. We developed a small, cellular-connected EM that is compatible with both liquid and capsule HU formulation bottles. In testing this EM among a sample of adolescents and young adults and caregivers of young children with SCD, we found that the EM is feasible and acceptable among youth with SCD and caregivers of young children with SCD in the short-term. We also found that the EM are useful for determining HU adherence and gained user insights that may improve their use longer-term. Future studies should examine the EM ability to determine which youth with SCD could most benefit from HU adherence intervention and treatment escalation in those with optimized adherence.