Impact of push-through-packages with electronic devices for accurate drug taking

Abstract

Improved compliance is an issue in medical care and a previous study showed noncompliance measured via a survey and by counting unused drug. However, it is difficult to assess the frequency and timing of noncompliance in real time. In order to address these issues, we developed paper-made electronic devices with press through packages (PTPs) which recorded the time and frequency when users opened the PTPs. Using these devices, we studied the actual practice of self-administration of a hypertension drug (once a day). The data of 37 subjects using PTPs with electronic devices showed a discrepancy between actual compliance and subject-reported compliance. Only one subject (2.8%) had 100% compliance. There were 11 (30%) subjects in the highest level compliance group and 8 (22%) in the lowest. In contrast, 35 subjects (95%) reported perfect compliance by their own evaluation. Using innovative devices, it is possible to observe time, frequency, missed doses, and misuse in self administration. From an analysis of the correlation between subject background and noncompliance, all subjects had an equal possibility of noncompliance. This is the first report of actual patient compliance with real evidence of timing and frequency. The innovative electronic devices are particularly necessary for accurate control of drug therapy and cost-effective therapy with expensive druguse.