Corbett Cynthia F, Combs Elizabeth M, Chandarana Peyton S, Stringfellow Isabel, Worthy Karen, Nguyen Thien, Wright Pamela J, O'Kane Jason M
College of Nursing, University of South Carolina, Columbia, SC, United States.
Center for Advancing Chronic Care Outcomes through Research and Innovation, College of Nursing, University of South Carolina, Columbia, SC, United States.
JMIR Form Res. 2021 Jul 13;5(7):e27327. doi: 10.2196/27327.
Medication nonadherence is a global public health challenge that results in suboptimal health outcomes and increases health care costs. Forgetting to take medicines is one of the most common reasons for unintentional medication nonadherence. Research findings indicate that voice-activated virtual home assistants, such as Amazon Echo and Google Home devices, may be useful in promoting medication adherence.
This study aims to create a medication adherence app (skill), MedBuddy, for Amazon Echo devices and measure the use, usability, and usefulness of this medication-taking reminder skill.
A single-group, mixed methods, cohort feasibility study was conducted with women who took oral contraceptives (N=25). Participants were undergraduate students (age: mean 21.8 years, SD 6.2) at an urban university in the Southeast United States. Participants were given an Amazon Echo Dot with MedBuddy-a new medication reminder skill for Echo devices created by our team-attached to their study account, which they used for 60 days. Participants self-reported their baseline and poststudy medication adherence. MedBuddy use was objectively evaluated by tracking participants' interactions with MedBuddy through Amazon Alexa. The usability and usefulness of MedBuddy were evaluated through a poststudy interview in which participants responded to both quantitative and qualitative questions.
Participants' interactions with MedBuddy, as tracked through Amazon Alexa, only occurred on half of the study days (mean 50.97, SD 29.5). At study end, participants reported missing their medication less in the past 1 and 6 months compared with baseline (χ=0.9 and χ=0.4, respectively; McNemar test: P<.001 for both). However, there was no significant difference in participants' reported adherence to consistently taking medication within the same 2-hour time frame every day in the past 1 or 6 months at the end of the study compared with baseline (χ=3.5 and χ=0.4, respectively; McNemar test: P=.63 and P=.07, respectively). Overall feedback about usability was positive, and participants provided constructive feedback about the skill's features that could be improved. Participants' evaluation of MedBuddy's usefulness was overwhelmingly positive-most (15/23, 65%) said that they would continue using MedBuddy as a medication reminder if provided with the opportunity and that they would recommend it to others. MedBuddy features that participants enjoyed were an external prompt separate from their phone, the ability to hear the reminder prompt from a separate room, multiple reminders, and verbal responses to prompts.
The findings of this feasibility study indicate that the MedBuddy medication reminder skill may be useful in promoting medication adherence. However, the skill could benefit from further usability enhancements.
药物治疗依从性不佳是一项全球性的公共卫生挑战，会导致健康结果不理想，并增加医疗成本。忘记服药是无意性药物治疗依从性不佳的最常见原因之一。研究结果表明，语音激活的虚拟家庭助手，如亚马逊Echo和谷歌Home设备，可能有助于提高药物治疗依从性。
本研究旨在为亚马逊Echo设备创建一款药物治疗依从性应用程序（技能）MedBuddy，并评估这款服药提醒技能的使用情况、可用性和有用性。
对服用口服避孕药的女性（N = 25）进行了一项单组、混合方法的队列可行性研究。参与者是美国东南部一所城市大学的本科生（年龄：平均21.8岁，标准差6.2）。为参与者提供了一个附带MedBuddy（我们团队为Echo设备创建的一种新的药物提醒技能）的亚马逊Echo Dot，并将其关联到他们的研究账户，他们使用该设备60天。参与者自行报告其基线和研究后的药物治疗依从性。通过亚马逊Alexa跟踪参与者与MedBuddy的交互，客观评估MedBuddy的使用情况。通过研究后的访谈评估MedBuddy的可用性和有用性，参与者在访谈中回答定量和定性问题。
通过亚马逊Alexa跟踪发现，参与者与MedBuddy的交互仅在一半的研究日发生（平均50.97，标准差29.5）。在研究结束时，参与者报告在过去1个月和6个月中忘记服药的情况比基线时有所减少（χ分别为0.9和0.4；McNemar检验：两者P <.001）。然而，在研究结束时，与基线相比，参与者报告在过去1个月或6个月中每天在相同的2小时时间范围内持续服药的依从性没有显著差异（χ分别为3.5和0.4；McNemar检验：P分别为0.63和0.07）。关于可用性的总体反馈是积极的，参与者对该技能可改进的功能提供了建设性反馈。参与者对MedBuddy有用性的评价绝大多数是积极的——大多数人（15/23，65%）表示如果有机会，他们会继续使用MedBuddy作为服药提醒，并且会推荐给其他人。参与者喜欢的MedBuddy功能包括独立于手机的外部提醒、能在单独房间听到提醒提示、多次提醒以及对提示的语音回复。
这项可行性研究的结果表明，MedBuddy服药提醒技能可能有助于提高药物治疗依从性。然而，该技能可从进一步提高可用性中受益。
