Electronic Medication Adherence Reporting and Feedback During Care Transitions (Massachusetts)

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Patients often have issues with their medications posthospitalization. Adverse drug events are common because of a variety of factors, including misunderstanding of the prescribed medication regimen and nonadherence with that regimen. This project will randomly select patients admitted to the medicine service of a large, urban hospital on five or more chronic medications and with a plan to be discharged to the community. Patients will be provided with an electronic pillbox with prefilled weekly medication trays that can alert them when it is time to take their medications, alert family members if there is an issue, and produce a report of medication-taking habits for patients’ primary care providers.

The project will then evaluate the effects of this smart pillbox intervention on both patients’ ability to take their medications safely and on the control of chronic conditions such as high blood pressure. Several measures of the intervention’s implementation will be collected, including the use of medication adherence reports by patients, caregivers, and providers. The evaluation will also include asking patients about their experiences using the smart pillbox.

The specific aims of the project are as follows:

  • Implement a smart pillbox intervention for patients discharged from the hospital to the community
  • Evaluate the effects of the intervention on postdischarge medication discrepancies, medication adherence, and chronic disease management
  • Determine barriers and facilitators of implementation of the intervention 

This project will be established as a cluster-randomized controlled trial. Patients who meet trial criteria will be identified shortly after admission, asked to provide informed written consent, and to complete a brief questionnaire. They will then receive the smart pillbox, a standard pillbox, or usual care, as appropriate. Patients in the smart pillbox intervention arm will continue to receive biweekly medication trays for 6 months.

The project team hopes to advance the field of medication safety by quantifying the benefits of an electronic adherence intervention for patients who have transitioned from the hospital to their homes.

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