Serious mental illness is a chronic condition that requires long-term pharmacological treatment. Adherence to oral antipsychotic medication has specific nuances that affects patients and physicians alike. For patients with serious mental illness, nonadherence increases their risk of hospitalization and relapse. Nonadherence is a formidable barrier for physicians in accurately assessing medication efficacy and helping patients achieve their fullest potential. A digital adherence system approved by the Food and Drug Administration can provide near–real time aripiprazole ingestion information. The system records ingestions through an embedded ingestible sensor in oral aripiprazole, which sends a transient local signal to a patch worn on the patient’s torso that is then stored on a paired smartphone app. With patient permission, these data can be viewed remotely by their physician, along with a patient’s mood, activity, and time spent resting. Such data are able to do the following: reveal broad patterns of medication adherence behavior to the patient as well as their physician; help physicians and patients understand and create more realistic expectations for adherence; promote discussion of treatment options; and minimize therapeutic appointment time devoted to determining actual adherence, thereby maximizing the time available to address each patient’s distinctive reasons for their adherence pattern. Crucially, extra time created during appointments can be used to strengthen the therapeutic relationship, which may translate into both improvements in adherence and patient attitude toward their medication. Future investigations are needed to examine how this technology impacts the development of training and best practice guidelines for its use. Otherwise, the potential benefits of this technology may be lost, or worse, inadequate and inappropriate use may harm the therapeutic relationship.

UNSTRUCTURED Serious mental illness (SMI) is a chronic condition that require long term pharmacological treatment. Adherence to oral antipsychotic medication has specific nuances that plague patients and physicians alike. For SMI patients, nonadherence increases their risk of hospitalization and relapse. Nonadherence is a formidable barrier to physicians in accurately assessing medication efficacy and helping a patient achieve their fullest potential. A digital adherence system approved by the FDA can provide near real-time Aripiprazole ingestion information. The system records ingestions through an embedded ingestible sensor in oral Aripiprazole , which sends a transient local signal to a patch worn on the patient’s torso that is then stored on a paired smartphone App. With patient permission this data can be viewed remotely by their physician, along with a patient’s mood, activity, and time spent resting. Such data can: reveal broad patterns of medication adherence behavior to the patient themselves as well as their physician; may help physicians and patients understand and create more realistic expectations for adherence, expanding discussion of treatment options; as well as minimizing therapeutic appointment time devoted to determining actual adherence, thereby maximizing the time available to address each patient’s distinctive reasons for being (non)adherent. Crucially, extra time created during appointments can be used to strengthen the therapeutic relationship, which may translate into both improvement in adherence and patient attitude to their medication. Future investigations are needed to examine how this technology impacts the physician-patient relationship to develop training and provide best practice guidelines for its use. Otherwise potential benefits of this technological advance may be lost, or worse still, inadequate and inappropriate use may harm the therapeutic relationship.