Clinical Study using e-pill CADEX Alarm Technology with Schizophrenic Clients to Improve Treatment Compliance

Schizophrenia & Schizoaffective Disorders: Researchers have found compliance rates of less than 50% for medication and psychosocial therapeutic treatments for people diagnosed with schizophrenia. Compliance rates decline as the number of medication doses per day increases, and also decline for people with memory and other cognitive difficulties. Individuals with schizophrenia often have severe memory impairment and cognitive distortions that can interfere with medication compliance. Medication regimens, as well as other aspects of the overall treatment plan, can be complicated and require multiple doses across a day. The e-pill CADEX (manufactured by e-pill Medication Reminders, Boston (Wellesley), MA) has features such as various alarms for medications and appointments, brief textual reminders (for example, on how to take a medication), and Medic Alert information that make it uniquely suited to be used as an adjunct to treatment for this population. This type of technology has been recommended by providers and in peer-reviewed journal articles, but has not been formally tested. No similar technology has been tested for this population. If successful, this intervention has the potential to have a major impact on the treatment of schizophrenia. Most importantly, it is available in rural and frontier areas where access to providers and intensive treatment plans are limited or nonexistent. Its' use can be easily integrated into evidence-based practice guidelines and programs with little impact on the program’s original implementation.

Researcher: Elizabeth S. EnglandKennedy

Behavioral Health Research Center of the Southwest (BHRCS) / (505) 228-5610

Diabetes Studies / Medication Compliance / Patient Adherence

e-pill CADEX and other e-pill Medication Reminders used in clinical studies:

The Price of Non-Compliance

The least compliant diabetes patients were more than twice as likely to be hospitalized compared to those who were most compliant, and their total health-care costs were nearly double. The study notes that people who use their diabetes medications as directed are less likely to develop the short-term and long-term health problems that can require expensive care. For diabetes, every additional dollar spent on medication saved $7 in medical costs. The combined drug and medical costs for the most-compliant diabetes patients average $4,570, which is almost 50 percent below the $8,867 cost for the least-compliant group.

Human Resource Executive, May 2, 2006 Tom Starner

From the Medco Study on Diabetic Non-Compliance, 2005, Dr. Robert Epstein

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Prescription Drug Compliance a Significant Challenge for Many Patients

Nearly two-thirds (64%) of 2,507 US adults report that they have simply forgotten to take their medication, with 11 percent saying that this has happened "often" or "very often."

Harris Interactive/The Wall Street Journal March 29, 2005 Online Survey Link

A nurse short message service by cellular phone in type-2 diabetic patients for six months

The web-based intervention using SMS messaging improved levels of HbA1c and 2HPMG in type-2 diabetic patients for the six-month duration of the trial.

Journal of Clinical Nursing, June, 2007, Vol. 16 No. 6, pp 1082-1087 Hee-Seung Kim, Ph.D., RN; Hye-Sun Jeong PhD, RN Control group pre-test-post-test design

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Long-term clinical and economic outcomes of a community pharmacy diabetes care program

This study was designed to assess the persistence of outcomes for up to 5 years following the initiation of the The Asheville Project, a program of community-based pharmaceutical care services (PCS) for patients with diabetes. Mean A1c decreased at all follow-ups, with more than 50% of patients demonstrating improvements at each time. The number of patients with optimal A1c values (< 7%) also increased at each follow-up. More than 50% showed improvements in lipid levels at every measurement. Costs shifted from inpatient and outpatient physician services to prescriptions, which increased significantly at every follow-up. Total mean direct medical costs decreased by $1,200 to $1,872 per patient per year compared with baseline. Patients with diabetes who received ongoing PCS maintained improvement in A1c over time, and employers experienced a decline in mean total direct medical costs.

Journal of the American Pharmaceutical Association 2003 Mar-Apr;43(2):173-84

Barry A. Bunting and Carole W. Cranor, DB Christensen ( Comparative Study)

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