New research shows smart pill bottles may not be the cure for medication adherence, but researchers are still holding out hope that new technology, paired with behavioral interventions, can make an impact.
The use of electronic pill bottles that tracked when patients took medication, combined with monetary incentives and support from friends, family and engagement advisers, offered no significant improvement in medication adherence for patients that were recovering from a heart attack, according to a new study published in JAMA Internal Medicine.
“What we found was a little bit surprising and a little bit disappointing,” Kevin Volpp, M.D., Ph.D., director of the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania and lead author of the study, said in an accompanying interview. He added that there was no significant difference between the two groups when it came to inpatient rehospitalizations, ED visits, medication adherence or total costs.
The study comes at a time when hospitals and payers are looking for new approaches to medication adherence through the use of technology. Rush University recently began using smart pills equipped with a small sensor to improve adherence for patients with diabetes and high blood pressure.
But researchers said there were indications that earlier enrollment could play a factor in the success of the interventions. Because participants were identified through five different health plans, it took 40 days on average to enroll them in the program because of the delay in insurance claims.
David Asch, M.D., executive director of the Center for Health Care Innovation at the University of Pennsylvania, said he’s “not going to buy” the possibility that this approach doesn’t work based on a single study. One of the most important lessons of the research, he said, is the subtle distinction between various engagement strategies and how effective those are. Future research should focus on interventions that start at the time of discharge and incorporate different variations of smart pill bottles.
“I think we learned enough about what went wrong in the study that may help us in designing better studies and better interventions in the future,” he said.