Hypertension Clinical Trial
Official title:
Study On The Effect of Combined Use of a Connected Pillbox, Pre-filled Medication Trays, Automated Text Message/Phone Call Reminds, On Medication Adherence in Patients With Type II Diabetes Mellitus, Hypertension or Hyperlipidemia
Medication adherence is defined as the extent to which a patient takes his or her medication as prescribed by their healthcare provider. One third to one half of all patients in the United States do not take their medication as directed, resulting in nearly $100B in avoidable hospital costs per year. Recent efforts to improve medication adherence in patients with multiple comorbidities have turned to case management and disease management programs. Connected monitoring devices offer an alternative- or supplement- to frequent nurse visits and outreach. These devices enable frequent monitoring and intervention but can also generate large volumes of data that can be difficult for care teams to manage. The present study explores the use of one such device- a technology-enabled, connected pillbox. Given the continued emphasis on bending the cost curve in US healthcare, clinical validation of tools that may improve the management of costly chronic diseases, such as diabetes, is essential.
Randomized Control Trial Patients in the research treatment group receive pre-filled, 3x7
disposable trays that separate their medication by dose and time (e.g. morning, afternoon,
evening). These pre-filled trays are inserted into a connected, weekly pillbox that detects
when pills are removed from its wells. Using this information, TowerView Health system is
able to send automated text messages or phone reminders to patients to take forgotten or
ignored medication doses. Medication adherence data from deployed pillboxes populates a
software platform, which a research coordinator can access.
Patients who miss 3 consecutive doses or 5 doses out of 12 over a 4-day period trigger an
alert for the study research coordinator who can contact the patient via phone call. The
research coordinator follows a scripted motivational interview in his or her outreach to
determine the etiology of non-adherence. Patients reporting worrisome symptoms will be
instructed to contact their provider directly and/or go to the emergency room for immediate
attention. The investigator acknowledges that the current study actually involves multiple
interventions: 1. The pre-filled medication trays are provided by a pharmacist, which
overcomes medication access issues as well as the inconvenience of manually organizing
medications. 2. The electronic pillbox, which monitors adherence that triggers text message
or phone reminders in instances where patients forget or ignore medication doses 3. Research
coordinator alerts, which trigger outreach events that employ a motivational interview in
order to improve patient adherence.
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