Medication Monitoring Feasible in Patients With SCD

Adolescents and emerging adults with sickle cell disease (SCD) were successful in using Medication Event Monitoring System (MEMS) bottles to track oral adherence to their medication, which suggests future use may be beneficial, according to a study published in Patient Preference and Adherence.

Medication management | Image Credit: © siripimon2525 - stock.adobe.com

Patients in their teens to early twenties are at particular risk for adherence that is not optimal for treating their disease. Medication bottles with technology to record the date and time of each opening, known as electronic adherence monitoring devices, could be a way to combat suboptimal adherence; MEMS bottles are an example of this technology. This study aimed to evaluate the feasibility of using the MEMS bottle and the barriers to its use in patients with SCD aged 13 to 21 years.

All participants transferred their medication into the MEMS bottle for the 18-week study period. All participants spoke English, were aged 13 to 21 years, and had an active prescription for hydroxyurea or defarasirox when the study began. Patients with any neurocognitive disability were excluded. Patients or their parents submitted a self-report of demographic characteristics. Data from the MEMS bottle were downloaded at the end of the study when bottles were turned in. Initiation, sustained use, and bottle provision were used as descriptive statistics. An open-ended survey about barriers and facilitators to using MEMS was also done.

There were 18 participants included in this study, all of whom were non-Hispanic Black/African American. There were 11 male participants and the mean (SD) age was 17.8 (2.6) years; 14 took hydroxyurea for their SCD. The mean (SD) time taking their medication was 4.4 (3.8) years. Nine patients reported an annual family income of $10,000 or less, and 10 had public insurance, compared with 4 on private insurance and 3 on a combination.

A total of 61.1% of patients sustained the use of their MEMS bottle by the end of the study. Patients took a median of 26.2% of doses in the study period. Medication changes, specifically medication holds due to labs (11.1%), running out of medication (22.2%), dose changes (5.6%), forgetting to take medication (22.2%), and transitioning from pediatric (5.6%), were the most cited cause of barriers. Setting up a timer, tip sheets, reminder calls, mobile apps, and reminders to replace medication in the bottle were among the facilitators of using the MEMS bottle.

There were some limitations to this study. The sample size for this study was small and other adherence assessments were not used. Associations between adherence and demographic characteristics were not evaluated. Data on barriers and facilitators were limited due to the open-ended nature of the survey.

The researchers concluded that MEMS has the potential to help patients with SCD track adherence to their medication. Using this in conjunction with other tools and strategies could help to improve adherence in this population.

Reference

Hildenbrand AK, Kidwell KM, McGrady ME, Mara CA, Quinn CT, Crosby LE. Feasibility of electronic medication monitoring among adolescents and emerging adults with sickle cell disease. Patient Prefer Adherence. 2023;17:3167-3171. doi:10.2147/PPA.s431595