title: A collaborative awareness system for chronic disease medication adherence applied to HIV infection.
abstract: Electronic reminder systems have been available for decades, yet medication adherence remains poor. Most systems rely on simple alarms and do not address other determinants of health-related behavior. This paper describes a collaborative awareness system for chronic disease medication adherence that relies on patient self-reflection and clinician support. Visualizations of adherence performance, including estimated plasma concentration graphs and a dynamic, personalized, disease-state simulation, are available to the patient (cell phone and internet media display) and clinician (computer) in real-time. The clinician can send asynchronous video messages of advice and encouragement to the patient regularly. A pilot was conducted with four HIV positive patients for four weeks. Three patients who started with suboptimal adherence improved (93.0% to 99.1%, 83.0% to 96.3%, and 63.9% to 81.3%). One patient who started with optimal medication adherence (>95%) maintained this level. All four patients appreciated the rich feedback and wanted to continue using the system.
authors.affiliation: MIT Media Lab, Cambridge, MA 02139, USA. jom@mit.edu
authors.forename: John O
authors.initials: JO
authors.lastname: Moore
authors.forename: Helene
authors.initials: H
authors.lastname: Hardy
authors.forename: Paul R
authors.initials: PR
authors.lastname: Skolnik
authors.forename: Franklin H
authors.initials: FH
authors.lastname: Moss
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage*; D001676:Biofeedback, Psychology / Q000379:methods*; D004360:Drug Therapy, Computer-Assisted / Q000379:methods*; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D055118:Medication Adherence; D017216:Telemedicine / Q000379:methods*; D014584:User-Computer Interface
chemical_list: D019380:Anti-HIV Agents