Impact of Electronic Medication Reminder Caps on Patient Adherence and Blood Pressure

Abstract

Background: Medication adherence is widely recognized as an essential component of chronic disease management, yet only 50% of patients take their medication as prescribed. Newer technologies have the potential to improve medication adherence. Objective: To conduct a pilot study estimating the impact of a pharmacy-dispensed electronic reminder cap (SMARxT cap), which also records cap openings, on medication adherence and blood pressure (BP). Methods: After a 30-day run-in period, 28 individuals were randomized to receive a SMARxT or placebo cap on each BP medication. The primary outcome was adherence measured via (1) the medication possession ratio, (2) number of cap openings, and (3) self-report. The secondary outcome was the average of 2 BP readings at 6 months. Mean changes from baseline to 6 months were compared between the 2 groups. Results: The medication possession ratio increased 2.7% in the SMARxT cap group and decreased 1.1% in the control group (P = .13), and cap openings increased 11.9% in the SMARxT cap group and 9.9% in the control group (P = .83). Self-reported adherence increased 1.1 points in the SMARxT cap group and 0.8 points in the control group (P = .64). Systolic BP decreased 8.2 mm Hg in the SMARxT cap group and 2.8 mm Hg in the placebo cap group (P = .35), and diastolic BP decreased to 6.2 mm Hg in the SMARxT cap group and was unchanged in the placebo cap group (P = .06). Conclusions: Use of SMARxT cap showed nonsignificant improvement in medication adherence and BP lowering. This technology has potential to characterize and improve medication-taking behavior.

Keywords: blood pressure; electronic medication packaging; electronic reminder devices; hypertension; medication adherence.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Downey and Mr Klink have ownership interest in the electronic cap that was part of this study, and they are employed by Concordance Health Solutions. The other authors have no conflicts of interest to disclose.

© The Author(s) 2021.

Figures

Figure 1.

Image of SMARxT cap (left) and placebo cap (right) on a prescription medication bottle.

Figure 2.

Flow diagram of patient enrollment.

Figure 3.

Blood pressure results (n = 28). * P = .35 for the comparison of systolic blood pressure change from baseline to 6 months, calculated using an independent samples t test. ^ P = .06 for the comparison of diastolic blood pressure change from baseline to 6 months, calculated using an independent samples t test.