Adherence & Retention

Hi Tom,

Thanks for your posting and the contact information for the recycled phones.

I think you make some excellent points. As I mentioned in my previous post, we had a lot of challenges with the IVR and SMS, mostly because we required specific actions from individuals. Namely, we asked them to answer a call or SMS with a PIN and a number. While simple, it was much more difficult than we thought. I wonder if the use of the recycled phone and the medication monitor speaker would have similar problems. Revised training techniques have greatly improved our yield, but I've found the passive data collection with the WIsepill to be much more reliable. As you point out, they are not perfect in that people may not use them or they may misuse them; however, the only action required of the individual is to open the lid to take his/her pills as would be required with any pill container. As with most situations, I think a variety of approaches are needed, and we need data and experience to decide which work the best.

I completely agree with your idea of dose removal control and would love to see ...

Hi Tom,

Thanks for your posting and the contact information for the recycled phones.

I think you make some excellent points. As I mentioned in my previous post, we had a lot of challenges with the IVR and SMS, mostly because we required specific actions from individuals. Namely, we asked them to answer a call or SMS with a PIN and a number. While simple, it was much more difficult than we thought. I wonder if the use of the recycled phone and the medication monitor speaker would have similar problems. Revised training techniques have greatly improved our yield, but I've found the passive data collection with the WIsepill to be much more reliable. As you point out, they are not perfect in that people may not use them or they may misuse them; however, the only action required of the individual is to open the lid to take his/her pills as would be required with any pill container. As with most situations, I think a variety of approaches are needed, and we need data and experience to decide which work the best.

I completely agree with your idea of dose removal control and would love to see this addition to the Wisepill or similar device in the future. They are not compatible with the commonly used blister packs, so again I think we need some options.

I also really appreciate your website www.medicationmonitors.net, which gives a great overview of the many devices that are coming out in this space.

Regards,
Jessica

Jessica,

In regard to your question about using a speaker in the monitor and a cell phone to transmit a PIN and a number: This should be quite simple. My preferred approach would employ DTMF tones. These are the same tones which are sent when you enter a number on the keypad in a phone. DTMF stands for Dual Tone Multi-Frequency. Each tone is actually the sum of waveforms with two frequencies. Since each distinct tone corresponds to a digit or special character (# or *) sending numbers is quite easy if the monitor incorporates a DTMF generator. A DTMF decoder at the receiving end (e.g. in the clinic) would decode the tones into their corresponding digits. Alphabetic information can also be sent using two DTMF tones for each letter; and there is at least one such protocol in use in another context. Since DTMF is widely used, the DTMF generator and decoder are readily available, although the DTMF generator which would be incorporated in the monitor is somewhat expensive at around $3 to $4.

Thanks for the additional information, Donald. Are you aware of any groups using DTMF in the field currently?

Regards,
Jessica

Jessica,

I am not aware of anyone using DTMF in this particular context. But, I certainly don't know all that is going on.

I actually have applied this strategy at the <a href="http://r-e-h-a-b.org/">rehab</a> facility I work for. Sometimes people are afraid to make new changes, but I guess that today's fast paced society requires change to happen more often.