98.6% Medication Compliance
At Patient Compliance & Medication Adherence, e-pill reports an impressive 98.6% Medication Compliance Rate for one of their products:
Can you achieve better medication adherence? How about a 98.6% Medication Compliance / Medication Adherence rate …
Pill Dispenser:MD.2: Monitored automatic pill dispenser. Alarms and dispenses up to 6 times per Day. Holds up to 1 month of medications (at 2 times per day). Will call caregiver’s cellphone if patient does not take medications on time. Greatly impoves Medication Adherence. As of 11/1/05 we have had 3,000,000 (3 million!) possible dispenses from MD.2s. 98.6% of those resulted in an actual dispense. The MD.2 Automatic Pill Dispenser has notified users it’s time for their medication and 98.6% of the time the button gets pushed and the medication dispensed
This page links to MD.2: Monitored automatic pill dispenser, which describes that appliance. While there are a batch of features, I will focus only on those pertinent to the 98.6% Medication Compliance Rate. As the excerpt points out, albeit in smaller print, Medication Compliance is defined as “the button [on the MD.2] gets pushed and the medication dispensed.”
On searching, I could find no further explication of the 98.6% compliance rate so I emailed the company with my query. The next morning, a helpful representative telephoned me and explained the statistic by describing how the machine operates. I’ve paraphrased the representative’s scenario, supplemented with information from the web site, below:
At the time the pills are to be given, the machine’s “Loud Voice Alarm including reminder text and flashing light” (the quotation and emphasis are from the web site) begin. The voice alarm loop persists continuously for up 90 minutes if the button that dispenses the pill – and turns off the voice alarm – is not pushed. At 60 minutes, the machine begins dialing up to five caretakers to alert them that the medications have not been taken. The compliance criterion is met if anyone pushes the button within 90 minutes.
Commentary
While I do not know enough about the MD.2 itself to review it here, it seems a legitimate concept with some appeal to those, like me, who are remote caregivers. I do think their promotion of a 98.6% Compliance Rate is ambiguous since many, especially but not exclusively lay people, may assume “medication compliance” means the patient takes the medication. It is easy to imagine someone – say, my mother – slamming the button to stop the voice alarm without taking the medication.
On the other hand, the closest we have in compliance to a gold standard of measurement is the use of electronic pill bottles that use opening the pill bottle at the right time as a proxy for taking a pill with compliance rates being calculated from that statistic. Of course, most pill bottles don’t keep making noise until the top is removed.
The fundamental problem the MD.2’s 98.6% compliance rate spotlights is the confusion caused by the lack of standard definitions for such basic terms as – well, compliance.
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