NPR: ‘Smart’ Pill Bottles Aren’t Always Enough To Help The Medicine Go Down

What if I told you there was a way to use technology to save an estimated $100 billion to $300 billion dollars a year in health care spending in the U.S.? That’s the estimated cost incurred because people don’t take the medications they’re prescribed. A number of companies are now selling wireless “smart” pill bottles, Internet-linked devices aimed at reminding people to take their pills. But recent research suggests that actually changing that behavior may take more than an electronic nudge. All agree it’s a worthy goal. Dr. Niteesh Choudhry, an internist at Harvard Medical School, describes the problem of not taking medication as “the final cascade of all of science.” Researchers work years, sometimes decades, he says, to develop highly effective drugs, get them approved by the FDA and into the hands of doctors who then study when to prescribe them to sick people. But for the drugs to work, they have to be taken. And up to half the time, they’re not taken as prescribed, Choudhry says. The result is at least 100,000 preventable deaths each year. When you ask patients why they don’t take their medicine they usually say they forgot, Choudhry says. So he recently set out to test some simple reminder devices. He enrolled 50,000 patients who were taking daily cardiovascular medications or antidepressants in a randomized trial and gave them one of three tools: a pill bottle with toggles to mark whether they’d taken their medication that day; a standard, daily pillbox (with a compartment or compartments for each day); or a digital cap that functions like a stopwatch. It starts counting each time you open it so you can see how long it’s been since you last took a pill. Choudhry expected a slight improvement in pill-taking among those who used the bottle with the digital cap. “Unfortunately we found no effect whatsoever,” he says, in comparison to adults who used a regular pillbox. Read more about Kevin Volpp’s study and results at NPR and at MimsToday.