What's so smart about smart bottles?
When it comes to promoting and tracking patient adherence, smart bottles are far more advanced than traditional prescription vials. These devices are precise and can monitor adherence over the duration of therapy. Before smart bottles, our best means of measuring adherence were rooted in patient reports, pills counts, and refill history. We know these methods are inherently flawed as they rely on patient recall and honesty. And who has the time to do pill counts? Smart bottles take us 2 steps forward in terms of monitoring adherence (and intervening on nonadherence).
The earliest smart bottles recorded a dose each time the cap was removed. Newer bottles use features such as scales, dose unit removal, and even something called capacitance. Listed below are some of the features that should be evaluated when considering smart bottle usage in your pharmacy.
The first is one that most bottle companies today like to tout. That’s understandable. If a patient isn’t willing to take steps on their own to maintain adherence, why would they take steps to set up a device that is intended to do the same thing? Earlier devices would require the patient to download an app, connect the device to a wifi network, or connect the device to a plug-in hub. Fortunately, as technology has advanced, most companies have integrated cellular connectivity directly into their bottles, meaning the patient does not have to do anything.
Another capability that can impact the 'requires-nothing' goal of the smart bottle is the battery life of these devices. Most bottle companies recognize that their bottle better last at least a month, and some have been able to go much longer than that. The issue with battery life is that as it declines, the burden on the patient goes up. Each time the battery life is depleted, the patient has to either recharge it or swap bottles. And if swapping, they may even be required to return their 'dead' bottle for refurbishment. So the longer the battery life, the better.
The types of alerts utilized by these bottles run the gamut—patients typically see some combination of light and auditory notifications on the bottle when it’s time for their dose and if they’ve missed a dose. Patients and caregivers, in most cases, can usually have text messages, emails, and automated phone calls configured for missed dose alerts as well. Pharmacies most often rely on alerts within the manufacturer’s portal, which may or may not include a corresponding email notifying the pharmacy staff that they have missed dose alerts within the portal.
There are many direct-to-consumer devices and mobile applications available to promote medication adherence. Recognizing patients may want to track their own adherence, smart bottle manufacturers often offer a patient app. Within these apps, patients can visualize their successful doses and missed doses, and in some cases, see their own personal medication adherence score.
In addition to not requiring the patient to do anything, it is also considered important for smart bottles to be fairly inconspicuous. Some adherence devices are rather bulky and hard to transport, thus eliminating some of their adherence-promoting benefits. Fortunately, most manufacturers’ products allow your standard amber vial to be used or they provide their own bottles that look similar to a standard vial.
Last, since these devices are storing and transmitting protected health information, its important that they be FDA-approved and HIPAA-compliant if your pharmacy is going to get involved.
For more information on smart bottles, read here about the business side of pharmacies offering these products to patients.