BACKGROUND
Heart failure affects 6.2 million Americans and is a leading cause of hospitalization. Despite effective pharmacologic options, adherence is suboptimal. Digital pill systems (DPS) which use an ingestible radiofrequency emitter to directly measure medication ingestions in real-time represent a strategy for measuring and responding to nonadherence in the context of heart failure pharmacotherapy.
OBJECTIVE
To explore responses and perceived barriers to using the DPS to monitor pharmacotherapy adherence among patients with heart failure.
METHODS
Individual, semi-structured qualitative interviews and quantitative assessments were conducted between April and August 2022. Twenty patients with heart failure who were admitted to the general medical or cardiology service at an urban quaternary care hospital participated. Participants completed a qualitative interview exploring responses to the technology and perceived barriers to DPS use, and a quantitative assessment on heart failure history, existing medication adherence strategies, and attitudes towards technology. Qualitative data were analyzed using applied thematic analysis and NVivo software.
RESULTS
Most participants (60%) reported a willingness to use the DPS to measure heart failure medication adherence. Overall, the DPS was viewed as useful for increasing accountability and reinforcing adherence behavior. Perceived barriers included technological issues, lack of need, additional costs, and privacy concerns. Most were open to sharing adherence data with providers to bolster clinical care and decision-making. Reminder messages following detected nonadherence were perceived as a key feature, and customization was desired. Suggested improvements primarily related to the design and usability of the Reader.
CONCLUSIONS
Overall, individuals with heart failure perceived the DPS to be an acceptable and useful tool for measuring medication adherence. The DPS links technology to clinical medicine and can be integrated into treatment plans to optimize adherence management and inform behavioral interventions to boost adherence among heart failure patients.