A Spanish Pillbox App for Elderly Patients Taking Multiple Medications

Summary

Background: Non-adherence and medication errors are common among patients with complex drug regimens. Applications for smartphones and tablets are known to be effective for improving adherence but they have not been tested in elderly patients with such complex chronic conditions, their older age meaning they tend to have less experience with this type of technology.

Objective: to design, implement and evaluate a medication self-management application for elderly patients taking multiple medications called ALICE with the intention of improving adherence and safe medication use.

Methods: A single-blind randomized controlled trial was conducted with a control and an experimental group (N=99) in Spain in 2013. The characteristics of ALICE were specified based on the suggestions of 3 nominal groups with a total of 23 patients and a focus group with 7 professionals. ALICE was designed for Android and iOS and to allow the personalisation of prescriptions and medical advice, showing images of each of the medications (the packaging and the medication itself) together with alerts and multiple reminders for each alert. The randomly subjects in the control group received oral and written information on the safe use of their medications and the experimental group used ALICE for three months. Pre- and post- measures included: rate of missed doses and medication errors reported by patients, Morisky Medication Adherence 4 items Scale scores, level of independence, self-perceived health status and biochemical test results of the patients. In the experimental group, data were also collected on their previous experience with information and communication technologies, their rating of ALICE and their perception of the level of independence they had achieved. The inter-group intervention effects were calculated by univariate linear models and ANOVA, with the pre- to post-intervention differences as the dependent variables.

Conditions

• Diabetes
• Hypertension

Interventions

DEVICE

Pillbox app named ALICE

Participants in the experimental group were given a BQ tablet or an iPad with the ALICE app installed and personalised according to the medications they had been prescribed as listed in their medical record

OTHER

oral and written information

oral and written information about the most common errors of patients

Sponsors & Collaborators

• Basque Institute for Healthcare Innovation (O+berri), Bilbao, Spain

  collaborator UNKNOWN

• Andalusian Agency for Health Care Quality, Seville, Spain

  collaborator UNKNOWN

• Hospital Universitario Fundación Alcorcón

  collaborator OTHER

• Castilla-La Mancha Health Service

  collaborator OTHER

• Universidad Miguel Hernandez de Elche

  lead OTHER

Principal Investigators

• José J Mira, PhD · Universidad Miguel Hernández

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

65 Years

Max Age

90 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2012-06-30

Primary Completion

2013-05-31

Completion

2013-05-31

Countries

• Spain

Study Locations