Snapping Photos of Pills Provides Simple Way to Monitor Medication Compliance

Philadelphia, Pa. (August 16, 2011) – Sending cell phone pictures of medications before taking them may provide a simple but effective way to monitor compliance with prescribed treatment for methamphetamine addiction, reports a study in the September Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"Clinicians asking their patients to photograph themselves while taking medications may serve as another way of stressing the importance of medication taking," according to the new research by Gantt P. Galloway, Pharm.D., and colleagues of California Pacific Medical Center Research Institute, San Francisco.

Capsule Photographs Offer Useful and Cost-Effective ApproachThe researchers provided camera-equipped cellular phones to 20 patients taking a prescription medication (modafinil) to treat methamphetamine dependence. Before taking their daily medication, patients were instructed to take a picture of the capsule in their hand, then e-mail the photo to the research center.

The cell phone pictures were compared with two other approaches to assessing medication compliance: a "medication event monitoring system" (MEMS), which is a special pill bottle that electronically records each time the bottle is opened; and pill counts, where researchers simply counted the patient's supply of capsules at each clinic visit.

The patients took 95 percent of their prescribed medication based on pill counts and 94 percent based on MEMS. In contrast, based on cell phone photos, the estimated adherence rate was 77 percent. Analysis of weekly data collected by all three methods suggested that the cell phone method tended to underestimate treatment compliance, compared to pill counts.

By comparison, the MEMS tended to overestimate compliance. "MEMS overestimation could be explained by subjects opening the bottle without taking a pill, while the photograph underestimation could be explained by subjects failing to send a photograph," Dr. Galloway and coauthors write.

Based on timestamps on the cell phone photos, patients who took their medication at a consistent time each day had higher treatment compliance rates. Compliance was unrelated to how long the patients used methamphetamine or to methamphetamine cravings.

Monitoring compliance with prescribed treatment is a challenging problem in medical treatment and research. The researchers thought that having patients snap and send cell phone photos might provide an alternative monitoring approach that was less expensive than MEMS but provided more information—including what time the medication was taken—than pill counts.

The patients in the study received small financial incentives for sending the cell phone photos. There were some problems related to providing patients with cell phones—including lost phones and, at the beginning of the study, extra charges related to use of the phones for Internet browsing. These problems could be avoided by having patients use their own cell phones to take and send photos.

Within these limitations, the new study suggests that camera-equipped cell phones provide a useful and cost-effective approach for monitoring compliance with recommended treatment. Given the ubiquity of cell phone use, the devices could have other health care applications as well, Dr. Galloway and colleagues believe: "Innovative uses of cellular telephones offer researchers and clinicians new ways to improve clinical trials and practice."

###About Journal of Addiction MedicineThe mission of Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical specialty. Published quarterly and under the guidance of an esteemed Editorial Board, the Journal is designed for all physicians and other health professionals who desire to remain current through peer-reviewed content; including original research, scholarly reviews on high-impact topics, clinical case conferences, as well as other useful articles relating to the care of the patient with addiction-related disorders. Journal of Addiction Medicine is now also cited in PubMed, and has a steadily rising impact factor.

About American Society of Addiction MedicineAmerican Society of Addiction Medicine is a professional society representing close to 3,000 physicians dedicated to increasing access and improving quality of addiction treatment, educating physicians and the public, supporting research and prevention, and promoting the appropriate role of physicians in the care of patients with addictions.

About Lippincott Williams & Wilkins Lippincott Williams & Wilkins (LWW) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the LWW brand, as well as content-based sites and online corporate and customer services.

LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2010 annual revenues of €3.6 billion ($4.7 billion).

Register for reporter access to contact details

Journal of Addiction Medicine