Technologies for Medication Adherence Monitoring and Technology Assessment Criteria: Narrative Review (Preprint)

Abstract

BACKGROUND Accurately measuring and monitoring patient medication adherence is a global challenge due to the absence of “gold standard” methods for adherence measurement. Recent attentions have turned towards the adoption of technologies for medication adherence monitoring as they provide the opportunity for continuous tracking of individual medication adherence behavior. Yet, current medication adherence monitoring technologies vary by their technical features and methods of adherence data capture, leading to differences in their respective advantages and limitations. Overall, there is a lack of appropriate criteria to guide the assessment of medication adherence monitoring technologies for optimal adoption and utilization. OBJECTIVE This study aimed to provide a concise overview and summary of current medication adherence monitoring technologies and propose a set of technology assessment criteria to aid in the development and adoption of these technologies. METHODS A literature search was conducted on PubMed, Scopus, CINAHL, and ProQuest Technology Collection (January 2010-June 2021) using the combination of keywords "medication adherence," "measurement technology," and "monitoring technology". The selection focused on studies related to medication adherence monitoring technology and its development and use. The technological features, methods of adherence data capture, and potential advantages and limitations of identified technology applications were extracted. Common, recurring elements were synthesized as potential technology assessment criteria. RESULTS Among 3865 articles retrieved, 98 remained for final review, which reported a variety of technology applications for monitoring medication adherence, including electronic pill bottles/boxes, ingestible sensors, electronic medication management systems, blister pack technology, patient self-report technology, video-based technology, and motion-sensor technology. The most commonly reported technologies included electronic pill bottles, electronic pillboxes, and ingestible sensors. Twenty-eight technology assessment criteria were identified and organized into five categories: Development Information, Technology Features, Medication Adherence Data Collection & Management, Feasibility & Implementation, and Acceptability and Usability. CONCLUSIONS This study summarized the technical features, data capture methods, and various advantages and limitations of medication adherence monitoring technology reported in the literature and proposed criteria for assessing medication adherence monitoring technologies. This collection of assessment criteria may be a useful tool to guide the development and selection of relevant technology, facilitating the optimal adoption and effective use of technology to improve medication adherence outcomes. Future studies are suggested to further validate the medication adherence monitoring technology assessment criteria and construct an appropriate technology evaluation framework.