A 'Smart' Pill Bottle's Reminder To Take Meds Isn't Enough, Research Shows : Shots - Health News Lots of people forget to take their medicine on time. Now firms are selling "smart" pill bottles that send patients reminders through the Internet. But maybe the real problem isn't forgetfulness.
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'Smart' Pill Bottles Aren't Always Enough To Help The Medicine Go Down

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'Smart' Pill Bottles Aren't Always Enough To Help The Medicine Go Down

'Smart' Pill Bottles Aren't Always Enough To Help The Medicine Go Down

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ROBERT SIEGEL, HOST:

What if we told you that there is a way to use technology to save between $100 and $300 billion a year in health care spending? Well, that's the estimated cost of people not taking the medications they're prescribed. A number of companies are selling so-called smart pill bottles to help patients remember to take their medication. But so far, there's little payoff. Lauren Silverman of member station KERA has the story.

LAUREN SILVERMAN, BYLINE: Dr. Niteesh Choudhry describes the problem of people not taking the medication they're prescribed as...

NITEESH CHOUDHRY: The final cascade of all of science.

SILVERMAN: The final cascade because researchers work years, even decades, to develop drugs, get them approved by the FDA. Then doctors spend more years studying those drugs.

CHOUDHRY: But then, in order for them to work, they really have to be taken.

SILVERMAN: Up to half the time, they're not taken as prescribed. The result - more than 100,000 preventable deaths. When you ask patients why they don't take their pills, they often say they forgot. So Choudhry set out to test some simple reminder devices on 50,000 patients. One of the devices was 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. And...

CHOUDHRY: Unfortunately, we found no effect whatsoever.

SILVERMAN: That's right. Folks who used the digital cap did no better than those who used a regular pill box. Maybe, Choudhry says, a clock alone isn't a powerful enough reminder.

(SOUNDBITE OF MUSIC)

SILVERMAN: Enter the army of smart pill bottles.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED WOMAN #1: Meet Pillsy, your new personal assistant for vitamins and medications.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED WOMAN #2: iRemember is a smart pill cap.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED WOMAN #3: GlowCaps are internet-connected pill caps.

SILVERMAN: More than a dozen companies have developed internet-connected bottles and caps that send emails and text message reminders. Thousands of patients with complex diseases are using one such connected pill bottle called AdhereTech. Josh Stein is CEO.

JOSH STEIN: Our system is automatically getting data sent from each and every bottle 24/7.

SILVERMAN: Data from sensors that measure when the cap is twisted off and exactly how much medication is removed. When it's time to take a pill, a blue reminder light pulses. Miss a dose - a flashing red light, then a chime.

(SOUNDBITE OF CHIME)

SILVERMAN: After that, the patient or a caregiver gets a message. Stein says it's the iPhone of pill bottles.

STEIN: Other devices will require patients to set up a device or download apps and integrate everything. We work with an average patient population that's 70 years old, so we said we need to build something that works right out of the box.

SILVERMAN: So how well do the fancier connected pill bottles work? Dr. Kevin Volpp, director of the University of Pennsylvania's Center for Health Incentives, wanted to find out. He selected more than a thousand heart failure patients to receive a different connected pill bottle plus money for taking medication on time. And you could have the bottle alert someone if you skipped a dose.

KEVIN VOLPP: The expectation was that we would see a large increase in medication adherence, and that would then translate into a significant reduction in hospital readmissions and lower health care costs.

SILVERMAN: And...

VOLPP: That unfortunately was not what we found.

SILVERMAN: Even with the glowing pill bottle, the cash, the alert, people weren't following through. Let's recap. We've looked at two large studies of pill bottle reminder systems - one pretty basic, the other higher-tech. Neither helped patients take their meds. So what's going on? Volpp says it could be the study design, the devices. Or maybe forgetfulness isn't the only problem.

VOLPP: Patients in many cases don't really like taking medicines every day. It reminds them of the illness, and they'd rather not be reminded of that.

SILVERMAN: Medication can also come with negative side effects and high costs. But Volpp is still optimistic about pill bottle technology paired with social interventions. In his study, the results were better for people who had their pill bottle automatically alert a friend if they missed a dose. Niteesh Choudhry at Harvard agrees technology will be part of the solution, especially for people with memory issues. But it won't be enough to change everyone's behavior.

CHOUDHRY: The real barriers to this idea of taking a pill or multiple pills every day and putting in your mouth may be way more complicated.

SILVERMAN: When it comes to getting people to take their medications, it looks like a smart bottle is no magic pill. Lauren Silverman, NPR News.

[EDITOR'S NOTE ON AUG. 23: A companion story to this report has been updated to correct and clarify some things written about AdhereTech. Click here to see what has been changed.]

(SOUNDBITE OF DJ MAKO SONG, "ASH")

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