Patterns of effective medication adherence: The role of wireless interventions

Medication non-adherence is a key and growing public health concern. About half of the annual prescriptions dispensed in the United States are not taken as prescribed. Most of the studies focus on improving medication adherence using interventions, including interventions based on wireless and mobile technologies. However, these studies measure only average medication adherence. This is helpful in understanding the high and low level of adherence between patients. However, the patterns of adherence are likely to have significant impact on the effectiveness of medications and outcomes. In this paper, we apply wireless based interventions to improve the patterns of effective medication adherence. The interventions include simple reminders, persistent reminders, and context aware reminders. As part of performance evaluation, we study if the change in adherence pattern due to reminders lead to higher or lower effective adherence. Our results show that (1) reminders can improve the pattern and average value of medication adherence, but may lead to undesirable drug events; (2) context-aware reminders can improve both the pattern and average value of adherence without increasing the undesirable drug events. The results have significant implications for medication adherence and interventions for healthcare system and researchers studying adherence and interventions.