Electronic Monitoring Devices

Electronic monitoring devices, such as electronic caps (e.g., Medication Event Monitoring System [MEMS] caps), can be used to register the date and time a pillbox is opened. Computerized software is used to record the number and timing of openings. Although sometimes described as state-of-the-art measures of adherence, these devices are not always reliable. For example, patients may open the pillbox but not remove a pill, or they may discard the pill after removing it. In addition, data are lacking about the importance of the precise information obtained. For example, taking doses of a medication 10 hours rather than 12 hours apart may not be clinically significant. Moreover, these devices cannot be used to monitor the intake of liquid medications. Data also suggest that a significant proportion of patients refuse to use or incorrectly use these devices (Shell-mer and Zelikovsky 2007). Although electronic monitoring holds promise, it is not currently in routine clinical use.

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