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The effect of medical device dose-memory functions on patients’ adherence to treatment, confidence, and disease self-management

Authors Hall R, Willgoss T, Humphrey L, Kongsø JH

Received 23 January 2014

Accepted for publication 16 April 2014

Published 23 May 2014 Volume 2014:8 Pages 775—788


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Rebecca L Hall,1 Thomas Willgoss,1 Louise J Humphrey,1 Jens Harald Kongsø2

1Adelphi Values, Adelphi Mill, Bollington, Cheshire, UK; 2Novo Nordisk A/S, Novo Allé, Bagsværd, Denmark

Background: Adherence to treatment is an important issue in chronic disease management and an indicator of patients’ ability to self-manage their condition and treatment. Some drug-dispensing and drug-delivery devices have been designed to support patients’ medication-taking behavior by including dose-memory and combined dose-memory and dose-reminder functions, which electronically store, and visually display dose-history information, enabling the patient to review, monitor, and/or be actively reminded about their medication doses.
Purpose: This literature review explored the role and impact of these devices on patients’ treatment adherence, confidence with, and self-management of their condition and treatment.
Materials and methods: A search of MEDLINE, Embase, and PsycINFO was performed to identify articles published in English from 2003–2013 that studied the effect of devices with dose-memory and combined dose-memory and dose-reminder functions on treatment adherence and users’ (patients, health care professionals [HCPs], and caregivers) confidence, self-management behavior, and attitudes.
Results: The database searches yielded 940 abstracts from which 13 articles met the inclusion criteria and were retained. Devices with dose-memory and combined dose-memory and dose-reminder functions were found to improve self-reported and electronically monitored treatment adherence in chronic conditions such as asthma, diabetes, and HIV. The ability of the devices to provide dose-history information and active medication reminders was considered valuable in disease management by patients, caregivers, and HCPs. The devices were found to enhance patients’ confidence in, and motivation to manage their medication and condition, and help reduce forgotten or incorrect medication dosing.
Conclusion: The incorporation of dose-memory and combined dose-memory and dose-reminder functions in drug-delivery devices can improve patients’ adherence, confidence, and self-management behavior. They can target non-intentional barriers to adherence and can provide a means of improving disease control and clinical outcomes, thereby offering clinical and economic value. This review highlights the importance of conducting further qualitative and quantitative research to further understand the value and impact of these types of devices on patients’ long-term adherence to, and self-management of treatment.

Keywords: patient adherence, memory function, reminder function, self-management, drug-delivery devices

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