Sajatovic Martha, Davis Michael S, Cassidy Kristin A, Nestor Joseph, Sams Johnny, Fuentes-Casiano Edna
Department of Psychiatry and Neurological and Behavioral Outcomes Center, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, Cleveland, OH, USA.
MedicaSafe, New York, NY, USA.
Patient Prefer Adherence. 2015 Jun 8;9:753-8. doi: 10.2147/PPA.S81724. eCollection 2015.
As poor medication adherence is common in bipolar disorder (BD), technology-assisted approaches may help to monitor and enhance adherence. This study evaluated preliminary feasibility, patient satisfaction and effects on adherence, BD knowledge, and BD symptoms associated with the use of a multicomponent technology-assisted adherence enhancement system.
This prospective study tested the system in five BD patients over a 15-day period. System components included: 1) an automated pill cap with remote monitoring sensor; 2) a multimedia adherence enhancement program; and 3) a treatment incentive program. This study evaluated system usability, patient satisfaction and effects on adherence (Morisky scale), knowledge (treatment knowledge test [TKT]), and symptoms (internal state scale [ISS]).
Mean age of the sample was 62 years, 4/5 (80%) Caucasian, and 4/5 (80%) single/divorced or widowed. Most participants (4/5, 80%) were on a single BD medication. Participants had BD for an average of 21 years. Challenges included attaching the pill sensor to standard pharmacy bottles for individuals using very large pill containers or those with multiday pill boxes. Three of five (60%) individuals completed the full 15-day period. Usability scores were high overall. Mean Morisky scores improved. Means on all four subscales of the ISS were all in the direction of improvement. On the TKT, there was a 40% increase in mean scores.
A multicomponent technology-assisted BD adherence enhancement system is feasible. Challenges include accommodating multiple types of pill containers and monitoring multiple drugs simultaneously. The system can also generate adherence information that is potentially useful for treatment planning.
由于双相情感障碍（BD）患者药物依从性差的情况很常见，技术辅助方法可能有助于监测和提高依从性。本研究评估了使用多组件技术辅助依从性增强系统的初步可行性、患者满意度以及对依从性、BD知识和BD症状的影响。
这项前瞻性研究在5名BD患者中对该系统进行了为期15天的测试。系统组件包括：1）带有远程监测传感器的自动药瓶盖；2）多媒体依从性增强程序；3）治疗激励程序。本研究评估了系统的可用性、患者满意度以及对依从性（Morisky量表）、知识（治疗知识测试 [TKT]）和症状（内部状态量表 [ISS]）的影响。
样本的平均年龄为62岁，4/5（80%）为白种人，4/5（80%）为单身/离婚或丧偶。大多数参与者（4/5，80%）仅服用一种BD药物。参与者患BD的平均时间为21年。挑战包括将药丸传感器安装到使用非常大的药丸容器的个人或使用多日药丸盒的人的标准药瓶上。五名参与者中有三名（60%）完成了完整的15天疗程。总体可用性得分较高。平均Morisky得分有所提高。ISS所有四个子量表的平均分均呈改善趋势。在TKT上，平均得分提高了40%。
多组件技术辅助的BD依从性增强系统是可行的。挑战包括适应多种类型的药丸容器以及同时监测多种药物。该系统还可以生成对治疗计划可能有用的依从性信息。
