title: Determining the feasibility of objective adherence measurement with blister packaging smart technology.
abstract: OBJECTIVE
  The results of a feasibility study of blister-pack smart technology for monitoring medication adherence are reported.
  
  
  METHODS
  Research in the area of objective therapy compliance measurement has led to the development of microprocessor-driven systems that record the time a unit dose is removed from blister packaging. One device under development is the Smart Blister-a label imprinted with event-detection circuitry that can be affixed to standard commercial blister cards. In the first trial of the device in actual clinical practice, 115 community-dwelling Dutch patients receiving valsartan maintenance therapy (160 mg once daily) were given 14-day blister packages equipped with the Smart Blister. On the return of empty blister cards to the 20 participating community pharmacies, the stored information was scanned and downloaded for data analysis and patient counseling purposes.
  
  
  RESULTS
  A total of 245 Smart Blister-equipped packages were used by valsartan recipients during the eight-month study. The device was largely effective in recording patient and blister-card identification data and other desired information. However, in 17% of cases, the Smart Blister system registered multiple tablet-removal events at the same time, presumably indicating unintentional breakage of nearby conductive circuits and the need for design refinements. The Smart Blister-equipped medication cards were generally well received by patients and pharmacies.
  
  
  CONCLUSIONS
  An evaluation of the functionality and robustness of the Smart Blister in a real-world clinical practice situation yielded some promising results, but the findings also indicated a need for design refinements and additional performance testing of the device.
authors.affiliation: Department of Clinical Pharmacy, Radboud University Nijmegen Medical Centre, the Netherlands. h.vanonzenoort@akf.umcn.nl
authors.forename: Hein A
authors.initials: HA
authors.lastname: van Onzenoort
authors.forename: Cees
authors.initials: C
authors.lastname: Neef
authors.forename: Willem W
authors.initials: WW
authors.lastname: Verberk
authors.forename: H Peter
authors.initials: HP
authors.lastname: van Iperen
authors.forename: Peter W
authors.initials: PW
authors.lastname: de Leeuw
authors.forename: Paul-Hugo M
authors.initials: PH
authors.lastname: van der Kuy
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage; D004348:Drug Labeling; D016903:Drug Monitoring / Q000592:standards*; D004349:Drug Packaging / Q000592:standards*; D004867:Equipment Design; D005240:Feasibility Studies; D006801:Humans; D009426:Netherlands; D010349:Patient Compliance; D010594:Pharmacies; D015203:Reproducibility of Results; D013678:Technology, Pharmaceutical / Q000592:standards*; D013777:Tetrazoles / Q000008:administration & dosage; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000068756:Valsartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine