TY - JOUR
T1 - Development and Feasibility Testing of a Smartphone Intervention to Improve Adherence to Antipsychotic Medications
AU - Kreyenbuhl, Julie
AU - Record, Elizabeth J.
AU - Himelhoch, Seth
AU - Charlotte, Melanie
AU - Palmer-Bacon, Jessica
AU - Dixon, Lisa B.
AU - Medoff, Deborah R.
AU - Li, Lan
N1 - Publisher Copyright:
© 2019 Walsh Medical Media, LLC. All rights reserved.
PY - 2019/3
Y1 - 2019/3
N2 - 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.
AB - 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.
KW - Adherence
KW - Antipsychotic
KW - Mobile
KW - Schizophrenia
KW - Smartphone
KW - Technology
UR - http://www.scopus.com/inward/record.url?scp=85062620318&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062620318&partnerID=8YFLogxK
U2 - 10.3371/CSRP.KRRE.070816
DO - 10.3371/CSRP.KRRE.070816
M3 - Article
C2 - 27454213
AN - SCOPUS:85062620318
SN - 1935-1232
VL - 13
SP - 152
EP - 167
JO - Clinical Schizophrenia and Related Psychoses
JF - Clinical Schizophrenia and Related Psychoses
IS - 1
ER -