A Low-Cost IoT Smart Pill Box with Physical Intake Verification: Design and Evaluation in Real-Life Use

Medication non-adherence undermines the treatment of chronic diseases, and reminder applications cannot show whether a dose was taken. This paper reports a 52-day field evaluation of a low-cost smart pill box that registers each intake event with an infrared sensor and a reed switch, time-stamps it with a battery-backed clock, queues events locally during network outages and forwards them to a Laravel server that alerts the patient, a caregiver and a physician by staged e-mails. One user with multiple sclerosis, who is also an author, used the device with three scheduled doses per day. Of 155 planned doses, 90 were taken (58.1%); excluding an 8-day period in which the device was deliberately switched off, adherence was 68.7% (95% CI 59–78%) and differed between phases (83.3%, 47.6% and 73.2%). Taken doses were registered at a median deviation of 0 min, 94.4% within five minutes of the alarm; e-mail reminders were followed by intake in 4 of 69 cases. All 90 events recorded after installation matched a planned dose, all 103 device packets were consistent with the database, the median device-to-server delay was 2 s, and the notification chain fired at its thresholds in every case. Deep sleep extended the runtime on a 10,000 mAh power bank by 2.6-fold (from 14 h to 36 h). The sensors register intake events but do not verify ingestion. The record was consistent, and the local alarm was a strong trigger for intake; consolidated caregiver notifications and peripheral power control are the next steps.