Waterloo, Ontario—Smart packaging has been proposed as a way to increase medication adherence, especially in seniors taking multiple medications.

Now, a new survey finds that older adults are open to using smart packaging that electronically monitors when they take their medication. In some cases, the smart system can notify patients and their caregivers if there are problems.

The report in PLOS ONE points out that about half of the patients with chronic diseases in developed nations do not take their medications as ordered by the prescribers. This has led to the development of a variety of devices to help mitigate the problem, from at-home medication-dispensing devices to reminder applications.

"Many of these products are advertised as user-friendly and efficient, but not all are tested with seniors in mind. So how would we know if older adults are able to use them for their day-to-day medication intake and are there any factors that can impact their in-home utilization?" questioned lead author Sadaf Faisal, a PhD candidate at the University of Waterloo School of Pharmacy.

The study sought to examine the integration of a smart multidose blister package and better understand medication intake behavior of adults with chronic diseases using an integrated theoretical model comprised of the Technology Acceptance Model and the Theory of Planned Behavior and Capacity, Opportunity, Motivation and Behavior Model.

Researchers conducted an ethnographic-informed study with 10 older adults using the smart multidose blister package to manage their medications for 8 weeks. Data were collected quantitatively and qualitatively using in-home observations, photo-elicitation, field notes, semistructured interviews, system usability scale (SUS), and net promoter scale (NPS). Participants had an average age of 76 years, and 80% were female. They reported an average of five medical conditions and the use of an average of 11.1 medications. The mean SUS was 75.50, and the overall NPS score was 0.

The authors advise that their qualitative analysis identified three themes:

• Factors influencing medication intake behavior
• Facilitators to the product use
• Barriers to the product use.

The survey determined that the smart blister packaging was easy to use and accepted by the older adults. On the other hand, size and lack of portability appeared to be significant downsides. Participants also became frustrated if the product behaved inconsistently—for example, sending reminders one day but not another. Cost was a barrier to use, and participants said they would be less likely to consider smart technology if it was not covered by a drug plan or funded by the government.

"For technology to be effective, it has to be accepted by the end-users," Ms. Faisal stated. "Smart, technology-based adherence products have the potential to support patients, but health-care providers should assess older adults' medication intake behaviors and barriers and facilitators to using a product before recommending them."

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