Development and Feasibility Testing of a Smartphone Intervention to Improve Adherence to Antipsychotic Medications

Julie Kreyenbuhl, Elizabeth J. Record, Seth Himelhoch, Melanie Charlotte, Jessica Palmer-Bacon, Lisa B. Dixon, Deborah R. Medoff, Lan Li

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Approximately 60% of individuals with schizophrenia do not take their antipsychotic medications as prescribed, and nonadherence is associated with exacerbation of psychotic symptoms, increased hospital and emergency room use, and increased healthcare costs. Behavioral-tailoring strategies that incorporate medication taking into the daily routine and use environmental supports have shown promise as adherence-enhancing interventions. Informed by the Information-Motivation-Behavioral (IMB) Skills Model and using the iterative process of user-centered design, we collaborated with individuals with schizophrenia and psychiatrists to develop an interactive smartphone application and web-based clinician interface, MedActive, for improving adherence to oral antipsychotic treatment. MedActive facilitates the active involvement of individuals with schizophrenia in managing their antipsychotic medication regimen by providing automated reminders for medication administration and tailored motivational feedback to encourage adherence, and by displaying user-friendly results of daily ecological momentary assessments (EMAs) of medication adherence, positive psychotic symptoms, and medication side effects for individuals and their psychiatrists. In a 2-week open trial completed by 7 individuals with schizophrenia and their psychiatrists, MedActive was determined to be both feasible and acceptable, with patient participants responding to 80% of all scheduled EMAs and providing positive evaluations of their use of the application. Psychiatrist participants were interested in viewing the information provided on the MedActive clinician interface, but cited practical barriers to regularly accessing it and integrating into their daily practice.

Original languageEnglish
Pages (from-to)152-167
Number of pages16
JournalClinical Schizophrenia and Related Psychoses
Volume13
Issue number1
DOIs
StatePublished - Mar 2019

Bibliographical note

Publisher Copyright:
© 2019 Walsh Medical Media, LLC. All rights reserved.

Keywords

  • Adherence
  • Antipsychotic
  • Mobile
  • Schizophrenia
  • Smartphone
  • Technology

ASJC Scopus subject areas

  • Psychiatry and Mental health

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