Suitability for elderly with heart disease of a QR code-based feedback of drug intake: Overcoming limitations of current medication adherence telemonitoring systems. (15th March 2021)

• Record Type: Journal Article
• Authors: Capranzano, Piera; Francaviglia, Bruno; Sardone, Andrea; Agnello, Federica; Valenti, Noemi; Frazzetto, Marco; Legnazzi, Marco; Occhipinti, Giovanni; Scalia, Lorenzo; Calvi, Valeria; Capodanno, Davide; Tamburino, Corrado
• Is Part Of: International journal of cardiology. Volume 327(2021)
• Page Start: 209
• Page End: 216
• Publication Date: 2021-03-15
• Subjects: Mobile health -- Medication adherence -- Telemonitoring -- Quick response code -- Elderly; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2020.12.008
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Current medication adherence telemonitoring systems have several limitations prompting the need for simpler, low-cost and widely applicable tools. To meet these needs, we propose a novel method consisting in sending a digital feedback of medication intake by just reading a pre-defined Quick Response (QR) code attached on the pills box. Methods: To assess the potential clinical applicability of the proposed QR code-based task, its feasibility was tested among elderly with heart diseases. The primary endpoint was the learning success defined as a correct execution of all QR code-based digital task steps within 10 min. Study outcomes were compared between patients 65–75 years old (younger cohort) and those aged >75 years (older cohort) admitted to the Cardiology ward of a tertiary center. Results: A total of 262 patients were included: 128 (48.9%) were younger and 134 (51.1%) older. Despite a baseline low smartphone use in the overall population (41.2%), patients learning success of the digital task was as high as 75.6%, with lower rates among older vs. younger (67.9% vs. 83.6%, p = 0.005). After adjustment no significant independent association between age and success in learning the QR code-based task was found. Differently, increasing age was a negative independent predictor of smartphone use. The learning time was overall small, but longer in the older group (126 ± 100 vs. 100 ± 60 s, p = 0.03). Conclusions: The QR code-based digital task was highly feasible for elderly with heart diseases suggesting its potential large-scale clinical application and encouraging the investigation of QR code-based systems for medication adherence telemonitoring. Highlights: Implementation of the low-cost and widely available QR code technology may improve medication adherence telemonitoring. The QR code could be applied to generate real-time feedback of medication intake. The QR code reading is suitable for elderly with heart diseases, suggesting its potentially high clinical applicability. Age is an independent predictor of smartphone use, but has no impact on learning the technology. Clinical rehabilitation programs should be implemented to increase the digital literacy of elderly patients.