Remind study

An exploratory study of the acceptability and perceived value of electronic multi-compartment medication devices to inform a subsequent RCT of their effect on medication adherence.

Background

The aims were to:

• conduct an exploratory study of the perceived advantages and disadvantages of electronic multi-compartment medication devices (eMMDs) to patients, carers and professional stakeholders
• identify candidate conditions, outcomes and devices to include in a subsequent phase II pilot randomised controlled trial (RCT)
• explore likely recruitment approaches and rates

Method

A comprehensive literature search on the use of eMMDs was conducted to determine what evidence there was for their effectiveness. 

An exploratory study was carried out using mixed methods. 

Focus groups were carried out with professionals, patients and lay carers (supplemented by interviews as necessary). 

A quantitative survey of pharmacists was carried out to determine the likely number of patients using MMDs and taking medications for conditions which might have readily measurable outcomes to determine adherence.

Results

Community pharmacists (n=11), general practitioners (n=9), community nurses (n=12) and social care managers (n=8) were recruited from the National Health Service (NHS) and local authority services. Patients (n=15) who were current conventional or electronic multi-compartment medication device users or had medication adherence problems were recruited from community pharmacies. 3 informal carers participated.

Electronic multi-compartment medication devices which prompt the patient to take medication may be beneficial for selected individuals, particularly those with cognitive impairment, but who are not seriously impaired, provided they have a good level of dexterity. They may also assist individuals where it is important that medication is taken at fixed time intervals. These are likely to be people who are being supported to live alone.

No single device suited everybody; smaller/lighter devices were preferred but their usefulness was limited by the small number/size of storage compartments. Removing medications was often challenging. Transportability was an important factor for patients and carers.

A carer's alert if medication is not taken was problematic with multiple barriers to implementation and no consensus as to who should receive the alert.

There was a lack of enthusiasm among professionals, particularly among pharmacists, due to concerns about responsibility and funding for devices as well as ensuring devices met regulatory standards for storage and labelling.

Papers

Views of patients and professionals about electronic multicompartment medication devices: a qualitative study (BMJ Open, 2016)

A systematic review of electronic multi‐compartment medication devices with reminder systems for improving adherence to self‐administered medications (International Journal of Pharmacy Practice, 2016)