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Real-Time Electronic Adherence Monitoring is Feasible, Comparable to Unannounced Pill Counts, and Acceptable

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Abstract

Second generation electronic medication adherence monitors provide real-time data on pill bottle opening behavior. Feasibility, validity, and acceptability, however, have not been established. Med-eMonitor is a multi-compartment adherence device with reminder and education capacity that transmits data through a telephone connection. Monthly adherence levels were measured for 52 participants over approximately 3 months using the Med-eMonitor (unadjusted and adjusted for participant confirmed dosing) and unannounced pill counts. HIV RNA was assessed before and after the 3-month period. Acceptability of Med-eMonitor was determined. Over 92% of Med-eMonitor data was transmitted daily. Unannounced pill counts significantly correlated with adjusted Med-eMonitor adherence (r = 0.29, P = 0.04). HIV RNA significantly correlated with unannounced pill counts (r = −0.34, P = 0.02), and trended toward a significant correlation with unadjusted Med-eMonitor adherence (r = −0.26; P = 0.07). Most, but not all, participants liked using the Med-eMonitor. Med-eMonitor allows for real-time adherence monitoring and potentially intervention, which may be critical for prolonging treatment success.

Resumen

La segunda generación de monitores electrónicos de adherencia a la medicación proporcionan datos en tiempo real sobre el comportamiento de la apertura de la píldora botella. Viabilidad, validez y aceptación, sin embargo, no se han establecido. Med-eMonitor es un dispositivo de la adhesión de varios compartimentos con capacidad de recordatorio y la educación que transmite datos a través de una conexión telefónica. Los niveles de cumplimiento mensual se realizaron mediciones de 52 participantes para aproximadamente tres meses con el Med-eMonitor (no ajustados y ajustados para que el participante confirmado de dosificación) y píldora no anunciadas recuentos. ARN del VIH se evaluó antes y después del período de tres meses. La aceptabilidad de Med-eMonitor se determinó. Más del 92% de los datos de Med-eMonitor se transmitió diariamente. Píldora no anunciadas recuentos correlacionó significativamente con la adhesión ajustado Med-eMonitor (r = 0,29, P = 0,04). ARN del VIH se correlacionó significativamente con la píldora no anunciadas recuentos (r = −0.34, P = 0,02), y una tendencia hacia una correlación significativa con la adhesión sin ajustar Med-eMonitor ARN (r = −0,26, P = 0,07). La mayoría, pero no todos, los participantes le gustaba usar el Med-eMonitor. Med-eMonitor permite supervisar el cumplimiento en tiempo real y potencial de intervención, que puede ser crítico para prolongar el éxito del tratamiento.

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Acknowledgments

The authors thank the National Institute of Mental Health (SBIR MH077502; RO1MH54907, K23MH087228, K01AI062435, K24MH87227) and the UCSF Clinical Translational Research Institute (UL1RR024131) for funding this research. They also thank Randy Dulin, Bruce Kehr, David Guzman, and all study participants. The manufactures of Med-eMonitor had no role in the analysis or preparation of the manuscript and the authors have no financial interest in Med-eMonitor.

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Authors and Affiliations

  1. Harvard Institute for Global Health, 104 Mt Auburn St, 3rd floor, Cambridge, MA, 02138, USA

    Jessica E. Haberer & David R. Bangsberg

  2. Massachusetts General Hospital, Boston, MA, USA

    Jessica E. Haberer, Gregory K. Robbins, Kathleen Ragland & David R. Bangsberg

  3. Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard, Charlestown, MA, USA

    Jessica E. Haberer & David R. Bangsberg

  4. Internet Solutions for Kids, Santa Ana, CA, USA

    Michele Ybarra

  5. University of California, San Francisco, CA, USA

    Alexandra Monk, Sheri D. Weiser & Mallory O. Johnson

Authors
  1. Jessica E. Haberer
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  2. Gregory K. Robbins
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  3. Michele Ybarra
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  4. Alexandra Monk
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  5. Kathleen Ragland
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  6. Sheri D. Weiser
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  7. Mallory O. Johnson
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  8. David R. Bangsberg
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Correspondence to Jessica E. Haberer.

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Haberer, J.E., Robbins, G.K., Ybarra, M. et al. Real-Time Electronic Adherence Monitoring is Feasible, Comparable to Unannounced Pill Counts, and Acceptable. AIDS Behav 16, 375–382 (2012). https://doi.org/10.1007/s10461-011-9933-y

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  • DOI: https://doi.org/10.1007/s10461-011-9933-y

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