Improving medication adherence in home care using a bidirectional medication assistance system

Medication adherence is essential for the success of home care. However, it is hard to achieve in reality. In this paper, we propose a bidirectional medication assistance system that is composed of a sensor-enabled pill box and a photo message system. While most of the existing medication assistance systems enhance medication adherence by properly alerting the patients; our bidirectional system does it by the enhancement of information sharing and communications between patients and medical staff. The medication dosage states of a patient are detected by a hall-effect sensor attached to the lid of an off-the-shelf pill box. The sensor data is transferred over a ZigBee network located in the patient’s home and is stored in a cloud database through a 3G mobile network. Since the raw sensor data might contain erroneous open-close events of the pill box, we developed a data filtering function to eliminate the false-positive events. With the data filtering function, we improved the accuracy of medication monitoring from 60% to 85% during our three-month experiment involving seven patients. In addition, we evaluated the effectiveness of the photo message system that home visiting nurses can use to communicate with the patient. The missed medication ratio was improved from 15% to 4% after the photo message system was installed. The effectiveness of the photo message system continued for two months after the initiation. We also interviewed 15 medical staff about the effectiveness of the medication monitoring with the sensor-enabled pill box and the photo message system.

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