Early Application of Adherence Technology in Bipolar Disorder

Poor medication adherence increases the risk of relapse, hospitalization, and suicide in patients with bipolar disorder.

The search for unobtrusive, easy-to-implement adherence aides for this population is perpetual.

One recent study published in Patient Preference and Adherence tested the feasibility and patient acceptance of a technology-assisted adherence approach.

For this preliminary study, researchers from the Case Western Reserve University School of Medicine worked with MedicaSafe, a New York-based company that develops innovative medication technology.

They enrolled 5 participants aged 62 years, on average, who had been diagnosed with bipolar disorder for an average of 21 years. Four of the 5 patients received 1 medication indicated to treat bipolar disorder.

The patients used a multicomponent, technology-enabled adherence enhancement system for 15 days.

This system included:

· An automated pill cap with remote monitoring sensor.

· A multimedia adherence enhancement program.

· A treatment incentive program allowing patients to accrue points that could be redeemed for cash.

The researchers prospectively assessed the system’s preliminary feasibility. They also evaluated patient satisfaction, changes in adherence, disease state knowledge, and bipolar symptoms associated with its use.

Three of the 5 participants completed the full 15-day period and reported that the system was easy to use. Additionally, patients’ mean treatment knowledge increased 40% with its use.

Because the sensor is designed to fit a standard pharmacy bottle, it could be challenging to use on large mail-order pill containers or multiday pill minders, the researchers noted. This is significant because most bipolar patients take more than 1 medication and often receive them through mail-order pharmacies.

Other limitations included small study sample size, short-term study duration, and sub-optimal method of affixing the pill sensor to pharmacy bottles.

Despite the system’s challenges, the researchers deemed it feasible for use among bipolar patients. The results also provided some direction for technology-assisted adherence approaches in bipolar disorder.