title: Adherence to hydroxyurea medication by children with sickle cell disease (SCD) using an electronic device: a feasibility study.
abstract: Adherence to hydroxyurea (HU) is a significant modifying factor in sickle cell vaso-occlusive pain. We conducted a study using an electronic medication container-monitor-reminder device (GlowCap™) to track adherence and determine whether use of this device affected rates of HU adherence. Subjects were regular attendees to our clinic. They were given a 37-item questionnaire and were asked to use a GlowCap containing HU. When the device cap is opened, it makes a remote "medication taken" record. The device also provides usage reminder in the form of lights and alarm sounds if the cap opening is delayed. Nineteen subjects participated in the survey, and 17 in the intervention phase. Of the 17, 12 had reliable adherence data. Seventeen caregivers of patients and two patients completed the survey. Two most common barriers to adherence identified were lack of reminders and absence of medicine home delivery. The intervention component of this study, which used both the electronic (GlowCap) method and medication possession ratio showed that the median adherence rate for the 12 patients evaluated was 85 %. The GlowCap device accurately kept a record of adherence rates. This device may be an effective tool for increasing HU medication adherence.
authors.affiliation: Hurley Children's Hospital and Department of Pediatrics/Human Development, Michigan State University, College of Human Medicine, Flint, MI, 48503, USA. sinoue1@hurleymc.com.
authors.forename: Susumu
authors.initials: S
authors.lastname: Inoue
authors.affiliation: Department of Public Health, School of Health Sciences, University of Michigan-Flint, Flint, MI, USA.
authors.forename: Gergana
authors.initials: G
authors.lastname: Kodjebacheva
authors.affiliation: Hurley Children's Hospital and Department of Pediatrics/Human Development, Michigan State University, College of Human Medicine, Flint, MI, 48503, USA.
authors.forename: Tammy
authors.initials: T
authors.lastname: Scherrer
authors.affiliation: Diplomat Specialty Pharmacy, Flint, MI, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Rice
authors.affiliation: Diplomat Specialty Pharmacy, Flint, MI, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Grigorian
authors.affiliation: Department of Public Health, School of Health Sciences, University of Michigan-Flint, Flint, MI, USA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Blankenship
authors.affiliation: Hurley Children's Hospital and Department of Pediatrics/Human Development, Michigan State University, College of Human Medicine, Flint, MI, 48503, USA.
authors.forename: Nkechi
authors.initials: N
authors.lastname: Onwuzurike
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D055615:Electrical Equipment and Supplies / Q000592:standards; D005240:Feasibility Studies; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use*; D055118:Medication Adherence; D017010:Reminder Systems / Q000295:instrumentation*; D011795:Surveys and Questionnaires
chemical_list: D006918:Hydroxyurea
keywords: Hydroxyurea; Medication adherence; Sickle cell disease