The 24 women recruited for our study were over 18-years-old and had been using oral contraception pills. The device monitoring the pills taken from the push-through pilll package (Popit Inc). Base line adherence was measured by using the on-demand reminder system without the reminders.įigure 1. In this study, we studied the feasibility of a novel on-demand reminder system which consists of an electronic device (Figure 1) attached to a push-through pill package and a smartphone application in patients using oral contraceptives. However, the high cost of the devices and their bulkiness have restricted their use in large population studies. The electronic medication packaging devices provide accurate information of the time and date of the removal of the medication from the pill package. Patient reporting on their adherence has been shown to be of low accuracy. Surprisingly, the system could not decrease the number of missed doses. Įlectronic surveillance systems and on-demand text message alerts have been shown to improve the precision with which patients follow their prescription of oral antidiabetics in a six-month study period. In clinical support systems, constant repeated alerts have been shown to cause clinicians to override the alerts. Thus, it remains to be shown if longer duration studies will show alert fatigue for the constant daily reminders and decrease of adherence improvement. However, the median duration of the studies in Thakkar’s review was only three months. However, the daily text message reminders increase adherence to chronic disease medication from 50 to 67.8%. In 2015 Cochrane analysis of different methods to increase the adherence to oral contraceptives could not found any studies where simple daily text message reminders would increase adherence to contraceptive pills. This is thought to be due to young age, inability to establish a routine, pill unavailability, side-effects, loss of motivation and lack of involvement in the initial decision to begin oral contraception. Forgetting from one to three pills in a cycle is a frequent problem concerning 15-51% of oral contraceptive users. However, during the first year of oral contraceptive usage, nine percent of the users get pregnant because of poor adherence. Oral contraception pills are a special group of medical drugs since the users are motivated and understand the importance of the pills. It has been estimated that 50% of the patients use prescribed medical drugs as they were supposed to. Poor patient adherence is a major problem in medical drug use and in clinical drug trials. Key wordsīirth control, contraceptive methods, patient adherence, smartphone application, reminder system Introduction An on-demand alert system may prove to be more useful in a long-term use than typical daily alerts. All participants completed the pilot, drop off rate being 0%.Ĭonclusions: An on-demand reminder system seems to be well tolerated and can increase adherence to medication. The time window during which the participants took their pill decreased by 1 hour and 32 minutes (p<0.01). The risk to forget the daily pill was reduced to one seventh with the on-demand reminder (p<0.01). When the on-demand reminder system was turned on during the second month, 8% (2 women) of the women forgot one or more pills. Results: Without the alert system, 46% (11 women) forgot to take one or more pills during the first one-month period. Pill-taking time points were gathered to a cloud service and analysed. During the second month of the study, a smartphone application connected to the device was activated and alerted the user only if she was about to forget to take the daily pill. During the first month the device merely monitored pill consumption behaviour, without interacting with the patient. An electronic device attached to the push-through pill packages monitored pill-taking for two months. Materials and methods: 24 voluntary women using oral birth control pills participated in the study. Additionally, we studied the impact of such a reminder solution for improving the consistency in pill-taking timing. Purpose of the article: In this study, we studied the feasibility of an on-demand reminder system to increase patient adherence to oral birth control pills.
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