A randomized controlled trial of a smart pillbox to improve medication adherence among middle-aged and older adults with polypharmacy
10.12206/j.issn.2097-2024.202604008
- VernacularTitle:智能药箱改善中老年多重用药患者服药依从性的随机对照研究
- Author:
Fei YU
1
;
Hongjun ZHANG
2
;
Zhaoyuan LIU
3
Author Information
1. Liaoning Institute of Basic Medical Sciences, Shenyang 110101, China;School of Smart Elderly Care and Health Management, Liaoning Vocational College of Medicine, Shenyang 110101, China.
2. Department of General Surgery, Liaoning Corps Hospital of Chinese People’s Armed Police Forces, Shenyang 110034, China.
3. School of Pharmacy, Naval Medical University, Shanghai 200433, China.
- Publication Type:Pharmacyadministration
- Keywords:
smart medication box;
polypharmacy;
real-world study;
medication adherence
- From:
Journal of Pharmaceutical Practice and Service
2026;44(10):534-538
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of smart medication boxes on medication adherence among middle-aged and older patients with polypharmacy in real world. Methods A single-center randomized controlled trial was conducted in 147 middle-aged and older patients with polypharmacy under long-term follow-up management at a tertiary hospital from June，2020 to May，2023. Participants were randomly assigned to the intervention group （n=73） or the control group （n=74）. The intervention group received smart medication box-based reminders and monitoring, while the control group received routine medication guidance. Follow-up assessments were performed in baseline, 6 months, and 12 months. Medication adherence was evaluated by self-report and pill count, and the composite endpoint of death and rehospitalization was recorded. Repeated-measures analysis was used to compare changes in adherence between groups, and logistic regression was used to analyze the primary outcome. Results At 6 months, pill count-based adherence was significantly higher in the intervention group than in the control group [94.6% （95% CI: 92.8%-96.7%） vs 90.3% （95% CI: 88.5%-92.3%）, P=0.002]. At 12 months, pill count-based adherence remained higher in the intervention group [95.3%（95% CI: 93.9%-97.0%）vs 88.4%（95% CI: 87.2%-90.8%）, P=0.001]. Self-reported adherence was also significantly higher in the intervention group at 12 months （P=0.019）. After adjustment for nursing level and health-related quality of life, no significant difference was observed between groups in the composite endpoint of death and rehospitalization. Conclusion Smart medication boxes could effectively improve objective medication adherence in middle-aged and older patients with polypharmacy and might help optimize long-term medication management. Their effect on major clinical outcomes still requires further validation.
