Facilitating medication adherence and eliminating therapeutic inertia using wireless technology

Abstract

Effective and efficient management of chronic illness remains a significant clinical problem. To improve chronic illness management, two obstacles that must be overcome are patient non-adherence to medication regimens and provider therapeutic inertia (failure to respond in timely manner to clinical data). Using an iterative approach, behavioral theory was used to develop a mobile health (mHealth) medication and blood pressure self-management system that was patient and provider centered. Electronic medication trays provided reminder signals and smart phone text messages reminded patients to measure blood pressures using a Bluetooth-enabled monitor. Patients received mobile phone-delivered personalized motivational and reinforcement messages based upon adherence levels to these regimens. Two 3-month proof of concept randomized control trials were conducted with 2 patient groups; 1) Hispanics with uncontrolled essential hypertension (n=6), and 2) patients with hypertension after kidney transplantation. (n=6). Hispanic patients who received the mHealth intervention all exhibited significant improvements in both medication adherence and reductions in resting and 24-hour blood pressures during the trial and at 3-month follow-up, as compared to the control group.