title: The effect of medical device dose-memory functions on patients' adherence to treatment, confidence, and disease self-management.
abstract: BACKGROUND
  Adherence to treatment is an important issue in chronic disease management and an indicator of patients' ability to self-manage their condition and treatment. Some drug-dispensing and drug-delivery devices have been designed to support patients' medication-taking behavior by including dose-memory and combined dose-memory and dose-reminder functions, which electronically store, and visually display dose-history information, enabling the patient to review, monitor, and/or be actively reminded about their medication doses.
  
  
  OBJECTIVE
  This literature review explored the role and impact of these devices on patients' treatment adherence, confidence with, and self-management of their condition and treatment.
  
  
  METHODS
  A search of MEDLINE, Embase, and PsycINFO was performed to identify articles published in English from 2003-2013 that studied the effect of devices with dose-memory and combined dose-memory and dose-reminder functions on treatment adherence and users' (patients, health care professionals [HCPs], and caregivers) confidence, self-management behavior, and attitudes.
  
  
  RESULTS
  The database searches yielded 940 abstracts from which 13 articles met the inclusion criteria and were retained. Devices with dose-memory and combined dose-memory and dose-reminder functions were found to improve self-reported and electronically monitored treatment adherence in chronic conditions such as asthma, diabetes, and HIV. The ability of the devices to provide dose-history information and active medication reminders was considered valuable in disease management by patients, caregivers, and HCPs. The devices were found to enhance patients' confidence in, and motivation to manage their medication and condition, and help reduce forgotten or incorrect medication dosing.
  
  
  CONCLUSIONS
  The incorporation of dose-memory and combined dose-memory and dose-reminder functions in drug-delivery devices can improve patients' adherence, confidence, and self-management behavior. They can target non-intentional barriers to adherence and can provide a means of improving disease control and clinical outcomes, thereby offering clinical and economic value. This review highlights the importance of conducting further qualitative and quantitative research to further understand the value and impact of these types of devices on patients' long-term adherence to, and self-management of treatment.
authors.affiliation: Adelphi Values, Adelphi Mill, Bollington, Cheshire, UK.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Hall
authors.affiliation: Adelphi Values, Adelphi Mill, Bollington, Cheshire, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Willgoss
authors.affiliation: Adelphi Values, Adelphi Mill, Bollington, Cheshire, UK.
authors.forename: Louise J
authors.initials: LJ
authors.lastname: Humphrey
authors.affiliation: Novo Nordisk A/S, Novo Allé, Bagsværd, Denmark.
authors.forename: Jens Harald
authors.initials: JH
authors.lastname: Kongsø
keywords: drug-delivery devices; memory function; patient adherence; reminder function; self-management