Siu Henry Yu-Hin, Mangin Dee, Howard Michelle, Price David, Chan David
Stonechurch Family Health Centre, 1475 Upper Ottawa St, Hamilton, ON L8W 3J6 Canada.
Department of Family Medicine, McMaster University, Hamilton, Canada.
Pilot Feasibility Stud. 2017 Feb 1;3:5. doi: 10.1186/s40814-016-0118-3. eCollection 2017.
Medication non-adherence, polypharmacy, and adverse drug events are major healthcare issues leading to significant morbidity, mortality, and healthcare expenditures. Currently, there are no methods to systematically track medication usage in community-dwelling seniors. The eDosette prototype was created to make medication use patterns visible via the Internet. This study aims to demonstrate feasibility, usability, and acceptability of the eDosette in community-dwelling seniors in primary care.
A 2-week feasibility study involving a convenience sample of 10 patients from an academic family medicine teaching unit in Hamilton, Ontario, Canada, was conducted over a 6-month period between April and October 2015. The eDosette transmitted hourly electronic data via the Internet on each participant's pattern of medication use; this data was converted into an individualized medication administration record (MAR). Based on the MARs from the 10 participants, the frequency of missed medication doses, the time of dose administration, and each participant's adherence rate for their prescribed medications could be determined. A medication adherence survey and a patient usability and acceptability survey were administered to all the participants of the study.
The eDosette was able to record a participant's medication use and transmit this data electronically via the Internet with sufficient quality to create participant-specific MARs. A total of 418 doses were captured by the eDosette throughout the study; only 5% ( = 22 doses) were missing information or had poor image quality. Analysis of the MARs revealed that 19% ( = 79 doses) were taken outside a 2-h window of the average dose administration time, and two doses were completely missed by all participants during this feasibility study. Participant feedback found the eDosette easy and acceptable to use. Participant feedback also identified hardware and software issues that require attention prior to a larger study.
The eDosette is a feasible and novel technology that can be successfully installed into the homes of community-dwelling seniors to help in monitoring actual medication use patterns. This study provided details for further device development and evidence to support the need for a larger pilot study on the eDosette's impact on medication adherence.
药物治疗不依从、多重用药和药物不良事件是导致严重发病率、死亡率和医疗保健支出的主要医疗问题。目前，尚无系统跟踪社区老年人用药情况的方法。电子药盒原型的创建是为了通过互联网使用药模式可见。本研究旨在证明电子药盒在初级保健中社区老年人中的可行性、可用性和可接受性。
2015年4月至10月的6个月期间，在加拿大安大略省汉密尔顿的一个学术家庭医学教学单位对10名患者的便利样本进行了为期2周的可行性研究。电子药盒通过互联网每小时传输一次关于每位参与者用药模式的电子数据；这些数据被转换为个性化的用药管理记录（MAR）。根据10名参与者的MAR，可以确定漏服药物剂量的频率、给药时间以及每位参与者对其处方药的依从率。对该研究的所有参与者进行了用药依从性调查以及患者可用性和可接受性调查。
电子药盒能够记录参与者的用药情况，并通过互联网以足够的质量电子传输此数据，以创建针对参与者的MAR。在整个研究过程中，电子药盒共捕获了418剂药物；只有5%（即22剂）缺少信息或图像质量不佳。对MAR的分析显示，19%（即79剂）是在平均给药时间的2小时窗口之外服用的，并且在这项可行性研究期间，所有参与者完全漏服了两剂。参与者反馈发现电子药盒使用起来简单且可接受。参与者反馈还确定了在进行更大规模研究之前需要关注的硬件和软件问题。
电子药盒是一种可行的新技术，可以成功安装到社区老年人的家中，以帮助监测实际用药模式。本研究为进一步的设备开发提供了详细信息，并提供了证据支持对电子药盒对用药依从性影响进行更大规模试点研究的必要性。
