Comparing medication adherence using a smartphone application and electronic monitoring among patients with acute coronary syndrome.
Nicholas A Giordano, Kathryn A Riman, Rachel French and 4 others
PMID 34247788WHAT IT FOUND
In the same ACS patients, electronic pill bottles recorded lower adherence than a photo-taking app.
The methods disagreed, so low electronic bottle adherence may mean the bottle was not opened, not that the patient skipped aspirin.
Key findings
01For the same patients, the electronic pill bottle measured lower adherence than the smartphone photo app.
02Whether patients reported using a reminder system did not explain the difference between the two measures.
03The app appeared to be used more often than the electronic bottle.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a small secondary analysis of only the intervention arm of a pilot trial, so it cannot show that either method improves adherence. Participants were not blinded and received financial incentives tied to uploading app photos, which may have favoured app use. Some electronic bottle data were missing because of device failure or non-return, reducing the analysed sample. The study did not directly ask whether patients used pill boxes, over-the-counter aspirin, or other containers, so disagreement between measures could not be fully explained. App adherence was based on photo check-ins, not directly observed medication taking.
Declared interests
The supplied text does not include a funding or conflict-of-interest declaration. It states the app was created by Wellth Inc., and the electronic monitoring devices were CleverCaps or MEMS.
The easy way to misread this
Do not conclude that the smartphone app improves medication adherence or is more accurate than the electronic bottle. The app recorded higher adherence, but this study compared measurement methods, not treatment effects, and the difference may reflect patients not opening the electronic bottle or being paid to take photos.