Electronic pill bottles to monitor and promote medication adherence for people with multiple sclerosis: A randomized, virtual clinical trial

• Published in: Journal of the neurological sciences 2021-09, Vol.428, p.117612-117612, Article 117612
• Main Authors: Rice, Dylan R., Kaplan, Tamara B., Hotan, Gladia C., Vogel, Andre C., Matiello, Marcelo, Gillani, Rebecca L., Hutto, Spencer K., Ham, Andrew S., Klawiter, Eric C., George, Ilena C., Galetta, Kristin, Mateen, Farrah J.
• Format: Article
• Language: English
• Subjects: Clinical trial; Disease modifying therapy; Medication adherence; mHealth; Multiple sclerosis
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2021.117612

We perform a randomized trial to test the impact of electronic pill bottles with audiovisual reminders on oral disease modifying therapy (DMT) adherence in people with MS (PwMS). Adults with multiple sclerosis (MS) taking an oral DMT were randomized 1:1 for 90 days to remote smartphone app- and pill bottle-based (a) adherence monitoring, or (b) adherence monitoring with audiovisual medication reminders. Optimal adherence was defined as the proportion of doses taken ±3 h of the scheduled time. Numbers of missed pills and pills taken early, on time, late, and extra were recorded. A multivariable regression model tested possible associations between optimal adherence and age, MS duration, cognitive functioning, and number of daily prescription pills. 85 participants (66 female; mean age 44.9 years) took dimethyl/diroximel fumarate (n = 49), fingolimod (n = 26), or teriflunomide (n = 10). Optimal adherence was on average higher in the monitoring with reminders arm (71.4%) than the monitoring only arm (61.6%; p = 0.033). In a multivariable model, optimal adherence was less likely in younger participants (p