Smart medication dispenser increases adherence of type 2 diabetes patients

An innovative medication dispenser that automatically sends an SMS reminder to patients when they forget to take their medicine, improves adherence of type 2 diabetes patients not only in the short term but also on the long run. This was demonstrated in studies performed by NIVEL and bundled in a dissertation defended by Marcia Vervloet at May 22^nd at Tilburg University.

 
Many patients experience difficulties in taking their medication. As a result, patients do not optimally benefit from their treatment. In addition, it increases healthcare costs. Poor adherence can have different causes. Patients might forget their medication, but they might also intentionally skip a dose. Marcia Vervloet studied a technological solution for diabetes patients who forget to take their medication. For patients with diabetes it is very important to regularly take their medication to avoid fluctuations in their blood glucose level.
 
SMS for forgotten doses
“With Real Time Medication Monitoring (RTMM), patients are reminded of their medication intake”, says Marcia Vervloet. “This system uses an electronic medication dispenser that registers each opening. If the dispenser is not opened within an agreed time period, an SMS is automatically sent to the patient to remind him of the medication intake. Patients only receive an SMS when they forget to take a dose.” Vervloet studied the effect of RTMM among 161 patients from forty pharmacies. Patients selected for the study used oral antidiabetics for at least a year and had collected less than 80% of their diabetes medication at the pharmacy in the year preceding the study. They were divided over three groups. Two groups received the medication dispenser, one of which additionally received SMS reminders. The third group – the control group – did not receive the dispenser or reminders.
 
Long-term
Patients who received SMS reminders revealed higher adherence levels than the control group. Also in the long term, one and a half years after the SMS reminders had stopped, these higher levels remained. Furthermore, compared to patients who used the medication dispenser but were not reminded, they took more doses within the agreed time period.
Previous studies only investigated short-term effects of electronic reminders on adherence. Moreover, in these studies a reminder was sent regardless of whether the patient had taken the medication or not. This can lead to habituation and a consequent loss of effectiveness. Marcia Vervloet is the first to show long-term effectiveness of electronic reminders on adherence with the smart medication dispenser in diabetes patients.
 
Routine
“Patients especially forget their medication when their daily routine is interrupted, for example during weekends and holidays. These moments require more attention”, says Marcia Vervloet. “This smart medication dispenser can be an effective tool for healthcare professionals to support patients who tend to forget their medication or are inaccurate with their timing. But also to strengthen self-management. Not only for patients with diabetes, but for patients with other chronic diseases as well.”
 
Funding
Achmea Healthcare Foundation
Ministry of Education, Culture and Science
 
Cooperating partners
Mediq
Evalan
Pharmacoepidemiology & Pharmacotherapy, Utrecht University
Amsterdam School of Communication Research (ASCoR), University of Amsterdam