Digital pill caps, financial incentives fail med adherence

Neither smart technology like digital pill caps, nor financial incentives, significantly improved patients’ medication adherence, a study shows.

Researchers from the University of Pennsylvania Perelman School of Medicine sought to determine whether the use of smart technology and financial rewards could improve medication adherence in patients who had survived acute myocardial infarction (AMI) and delay subsequent vascular events.

Investigators conducted a randomized clinical trial of 1,509 patients, ages 18-80, from 2013 to 2016. All patients were prescribed at least two of four medications (antiplatelet agents, aspirin, beta-blockers or statins). The patients were randomized to receive digital pill bottles with lottery incentives along with social support for medication adherence (1,003 patients) or to usual care (506 patients).

There were no differences in the mean medication adherence between the controls (0.42 [0.39]) and the intervention group (0.46 [0.39]) (difference, 0.04; 95% CI, -0.01 to 0.09; P=0.10). Additionally, there was no difference between the control group and the intervention group for mean medical costs in the 12 months after enrollment.

“Adherence to medications prescribed after myocardial infarction is low. Wireless technology and behavioral approaches have shown promise in improving health behaviors. A compound intervention integrating wireless pill bottles, lottery-based incentives and social support did not significantly improve medication adherence or vascular readmission outcomes for AMI survivors,” the authors wrote.

The findings were published in the August issue of JAMA Internal Medicine.

Reference: Volpp KG, Troxel AB, Mehta SJ. JAMA Internal Med. 2017;177(8):1093-1101.