Smart Medication Management, Current Technologies, and Future Directions

Medication non-adherence is a major healthcare challenge with irreversible consequences in terms of healthcare costs and quality of care. While recent years have seen some effort in developing sensor-based technologies to detect medication adherence and provide interventions, the community lacks a comprehensive study on the clinical utility, reliability, and effectiveness of such medication intake monitoring solutions. Furthermore, many opportunities inspired machine learning algorithms have largely remained unexplored. In an effort to highlight these knowledge gaps, in this paper, we take an interdisciplinary approach to (1) review and compare existing engineering products for medication intake monitoring; (2) discuss clinical applications where such technologies have demonstrated to be effective; (3) explore research gaps and shed light on unmet needs and future research opportunities in the area of medication management from both clinical and technology development points of view. The results of this paper may open several new avenues in the area of technology-based medication.

[1]  M. Burnier,et al.  Electronic compliance monitoring in resistant hypertension: the basis for rational therapeutic decisions , 2001, Journal of hypertension.

[2]  Kathleen Dracup,et al.  A text messaging intervention to promote medication adherence for patients with coronary heart disease: a randomized controlled trial. , 2014, Patient education and counseling.

[3]  Constantin F. Aliferis,et al.  Modeling Clinical Judgment and Implicit Guideline Compliance in the Diagnosisof Melanomas Using Machine Learning , 2005, AMIA.

[4]  Bo-Yeong Kang,et al.  Predictors of Medication Adherence in Elderly Patients with Chronic Diseases Using Support Vector Machine Models , 2013, Healthcare informatics research.

[5]  Misha Pavel,et al.  A Statistical Reasoning System for Medication Prompting , 2007, UbiComp.

[6]  J. Tu,et al.  Adherence With Statin Therapy in Elderly Patients With and Without Acute Coronary Syndromes , 2002 .

[7]  C. Jones Medication adherence study looks at types of interventions. , 2014, Managed care.

[8]  K. Lohr,et al.  Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States , 2012, Annals of Internal Medicine.

[9]  L. Osterberg,et al.  Adherence to medication. , 2005, The New England journal of medicine.

[10]  Nuria Oliver,et al.  MoviPill: improving medication compliance for elders using a mobile persuasive social game , 2010, UbiComp.

[11]  G. Rutherford,et al.  Mobile phone text messaging for promoting adherence to antiretroviral therapy in patients with HIV infection. , 2012, The Cochrane database of systematic reviews.

[12]  Ping Li,et al.  Prevalence, Predictors, and Outcomes of Primary Nonadherence After Acute Myocardial Infarction , 2008, Circulation.

[13]  Xiaoxiao Jiang,et al.  Use of mobile phone text messaging to deliver an individualized smoking behaviour intervention in Chinese adolescents , 2013, Journal of telemedicine and telecare.

[14]  Anind K. Dey,et al.  Real-time feedback for improving medication taking , 2014, CHI.

[15]  R. Reves,et al.  Feasibility of an Ingestible Sensor-Based System for Monitoring Adherence to Tuberculosis Therapy , 2013, PloS one.

[16]  Richard Beasley,et al.  An audiovisual reminder function improves adherence with inhaled corticosteroid therapy in asthma. , 2007, The Journal of allergy and clinical immunology.

[17]  Günter Schreier,et al.  Mobile health (mHealth) based medication adherence measurement – a pilot trial using electronic blisters in diabetes patients , 2013, British journal of clinical pharmacology.

[18]  Yufei Yuan,et al.  Can wireless text messaging improve adherence to preventive activities? Results of a randomised controlled trial , 2009, Int. J. Medical Informatics.

[19]  S. Himelhoch,et al.  Acceptability of Mobile Phone Technology for Medication Adherence Interventions among HIV-Positive Patients at an Urban Clinic , 2013, AIDS research and treatment.

[20]  J. Cramer A Systematic Review of Adherence With Medications for Diabetes , 2004 .

[21]  H. Kim,et al.  Application of Support Vector Machine for Prediction of Medication Adherence in Heart Failure Patients , 2010, Healthcare informatics research.

[22]  Katie A. Devine,et al.  Electronic monitoring and feedback to improve adherence in pediatric asthma. , 2012, Journal of pediatric psychology.

[23]  A. Greene,et al.  Patients’ Engagement With “Sweet Talk” – A Text Messaging Support System for Young People With Diabetes , 2008, Journal of medical Internet research.

[24]  A R Feinstein,et al.  On white-coat effects and the electronic monitoring of compliance. , 1990, Archives of internal medicine.

[25]  P. S. Khurana,et al.  Mobilizing Your Medications: An Automated Medication Reminder Application for Mobile Phones and Hypertension Medication Adherence in a High-Risk Urban Population , 2013, Journal of diabetes science and technology.

[26]  Kathleen A. Fairman,et al.  Evaluating Medication Adherence: Which Measure Is Right for Your Program? , 2000 .

[27]  T. Lüscher,et al.  Adherence to medication. , 1990, Journal of human hypertension.

[28]  Günter Schreier,et al.  Feasibility of mHealth and Near Field Communication technology based medication adherence monitoring , 2012, 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[29]  P. Sly,et al.  Adherence with Preventive Medication in Childhood Asthma , 2011, Pulmonary medicine.

[30]  Monica Cain,et al.  Predicting Voluntary Participation in a Public Health Program Using a Neural Network , 2008, Int. J. Heal. Inf. Syst. Informatics.

[31]  M. Chisholm-Burns,et al.  The 'cost' of medication nonadherence: consequences we cannot afford to accept. , 2012, Journal of the American Pharmacists Association : JAPhA.

[32]  V. Ostojić,et al.  Improving asthma control through telemedicine: a study of short-message service. , 2005, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[33]  Guillaume-Alexandre Bilodeau,et al.  Monitoring of Medication Intake Using a Camera System , 2011, Journal of Medical Systems.

[34]  D. Kroetz,et al.  Adherence-resistance relationships to combination HIV antiretroviral therapy , 2007, Current HIV/AIDS reports.

[35]  H. Bosworth,et al.  Medication adherence: emerging use of technology , 2011, Current opinion in cardiology.

[36]  Cristian Pop-Eleches,et al.  Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders , 2011, AIDS.

[37]  G. Davı̀,et al.  Medication prescription and adherence disparities in non valvular atrial fibrillation patients: an Italian portrait from the ARAPACIS study , 2014, Internal and Emergency Medicine.

[38]  Marcel L. Bouvy,et al.  SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored , 2012, Int. J. Medical Informatics.

[39]  Andreas Bock,et al.  Medication Adherence Assessment: High Accuracy of the New Ingestible Sensor System in Kidney Transplants , 2013, Transplantation.

[40]  Nasser Kehtarnavaz,et al.  A medication adherence monitoring system for pill bottles based on a wearable inertial sensor , 2014, 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.