Personal experiences of electronic measurement of

Authors: Julie A Chambers Ronan E O’Carroll Martin Dennis Cathie Sudlow Marie Johnston

Publish Date: 2015/04/15

Volume: 31, Issue: 5, Pages: 167-174

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Abstract

The Medication Event Monitoring System MEMS which records date and time of pillbottle openings was used to measure adherence to antihypertensive medication in a randomized controlled trial RCT of a brief psychological intervention with 58 stroke survivors Patients were asked to describe and rate their experiences of using the MEMS pill bottleMEMS adherence was related to both pill count and selfreported adherence Medication Adherence Report Scale Most patients found the MEMS acceptable and easy to use although some found it cumbersome and/or experienced difficulties with the cap Nearly half 48  reported at least one instance where MEMS data did not reflect their pilltaking behavior eg taking a tablet out the day before to take on a flight 55  of patients indicated that the MEMS helped them remember their medication suggesting a mere measurement effectElectronic pill monitoring has many flaws including practical difficulties and data inaccuracies There was evidence of a measurement effect indicating that MEMS should be used in both intervention and control arms when used to measure adherence within RCTs We also observed that the MEMS pill bottle is not suitable for measuring adherence in patients who use their own ‘days of the week’ box for sorting medication as we found poorer adherence at followup in this group Despite these limitations we conclude that electronic monitoring presents the best method currently available for objective measurement of adherence especially where detailed timing information is required Accuracy may be improved by the concurrent use of other measures eg pill count selfreportThis project was funded by a grant from the Scottish Government Department of Health Chief Scientist Office reference number CZH/4/569 We would like to thank the doctors and nurses at the Western General Hospital stroke clinic and ward for their help in recruitment and the participants for giving up their time to take part

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