SNLF - Traumatismes crânien

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Personalized mobile health reminders to improve medication adherence following acquired brain injury: A randomized pilot and feasibility trial

Peii Chen (West Orange, Usa), Marinos Pylarinos (West Orange, Usa), Amanda Azer (West Orange, Usa), Emma Kaplan (West Orange, Usa), Maria Mawhinney (West Orange, Usa), Grace Wells (West Orange, Usa), Jenny Masmela (West Orange, Usa)

Objective : At discharge from inpatient services, patients with acquired brain injury (ABI) are prescribed multiple medications to treat and prevent myriad sequelae. Polypharmacy can be challenging for these patients to manage, as varying degrees of cognitive and motor dysfunction impede medication adherence. To address this challenge, we examined the feasibility of providing automated text messages and personal video call reminders.

Material / Patients and Methods : Patients were screened using the following criteria: ≥18 years old, < 3 months post ABI, English as primary language, taking ≤ 8 medications daily, and able to open pill bottles that were tracked using the microelectromechanical systems (MEMS) technology. Participants received MEMS bottles and were randomized into three groups: standard (no reminder), automated text message, and video call. Feasibility was assessed based on enrollment rate, retention rate, and usability of digital reminders and MEMS bottles.

Results : 4031 patients were screened over 44 months, and 66 (1.6%) were enrolled. 41 (62%) completed baseline analysis, and 25 (38%) completed the 6-month study (11 in standard, 7 in text, and 7 in video call). Both study team and participants reported that automated text messaging was less time consuming and less intrusive than video calls. Some participants asked to retain MEMS bottles for continued use after the study.

Discussion - Conclusion : The low enrollment rate may be related to the study being conducted at a single site with a 3-person research staff. The potentially intrusive nature of video call reminders may have contributed to the low enrollment and retention rates. Our findings suggest a combination of automated reminders and digital tracking bottles may increase medication compliance, which requires further investigation.