Technological Innovations in Medication Packaging to Improve Patient Adherence: A Systematic Review
Year: 2015
Type: dissertation
Study design: Systematic Review
Abstract: Importance: Nonadherence to medications affects over one in four patients in the US, reaching\nas high as 50% for many chronic drug regimens. One strategy to combat nonadherence may be\nimproved use of electronic medication packaging (EMP) devices built into the containers\nthrough which pills, inhalers, or other products are dispensed.\nObjective: To investigate whether EMP devices are effective in reducing medication\nnonadherence, identify common features of successful EMP devices, and assess the potential for\nthis tool to reduce adverse outcomes related to nonadherence.\nEvidence Acquisition: Peer-reviewed research testing the effectiveness of electronic medication\npackaging was identified using a systematic literature search. The results describing the impact\nof the interventions on adherence as well as other key findings were extracted, and each study\nwas formally assessed for bias using the guidelines outlined in the Cochrane Handbook for\nSystematic Reviews of Interventions. Finally, the devices described in each study were\nevaluated qualitatively in order to determine common features of EMP devices that may affect\nadherence outcomes.\nResults: A total of 37 studies met review criteria: 10 patient-interface-only “simple”\ninterventions and 29 studies of “complex” interventions (2 qualified for both categories) in\nwhich the EMP devices were linked to care delivery by a physician, pharmacist, or other\ncaregiver. Few studies of simple EMP interventions (3/10, 30%) improved medication\nadherence. By contrast, complex EMP interventions demonstrated improved adherence in a\nmajority of studies (20/29, 69%). My qualitative review identified 5 prominent characteristics of\nEMP interventions: recording dosing events and storing a record of adherence, audiovisual\nreminders to cue dosing, digital displays, real-time monitoring, and providing patients with\nadherence performance feedback. Recording dosing events, digital displays, and providing\nfeedback were most frequently found in studies that led to improved medication adherence.\nConclusion and Relevance: This systematic review found that EMP devices can significantly\nimprove medication adherence, particularly those that are integrated into the care delivery\nsystem and that are designed to record dosing events to give the opportunity for feedback. Well designed\nEMP devices can help physicians and patients seeking strategies to promote medication\nadherence.
Author: Kyle D. Checchi
Language: English
Subfield: Family Practice
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2132115200