Dement Neurocogn Disord.  2022 Oct;21(4):117-125. 10.12779/dnd.2022.21.4.117.

Improving Medication Adherence in Isolated Patients With Cognitive Impairment Using Automated Telephone Reminders

• Kim MJ
• Song JY
• Jang Jw
• Lee SY
• Jhoo JH
• Byeon GH
• Kim Y

• KMID: 2536275
• DOI: http://doi.org/10.12779/dnd.2022.21.4.117

Abstract

Background and Purpose
Medication adherence is essential for effective medical treatment. However, it is challenging for cognitively impaired patients. We investigated whether an automated telephone reminder service improves medication adherence and reduces the decline of cognitive function in isolated patients with cognitive impairment.
Methods
This was a single-center, randomized clinical trial. We enrolled mild cognitive impairment (MCI) or Alzheimer’s disease (AD) patients who lived alone or with a cognitively impaired spouse. We provided an automated telephone reminder service for taking medication to the intervention group for 6 months. The control group was provided with general guidelines for taking the medication every month. The participants underwent neuropsychological assessment at the beginning and end of the study. Statistical significance was tested using nonparametric Wilcoxon rank sum and Wilcoxon matched-pairs signed-rank tests.
Results
Thirty participants were allocated randomly to groups, and data for 29 participants were analyzed. The mean age was 79.6 (standard deviation, 6.0) years and 79.3% of the participants were female. There was no significant difference in medication adherence between the 2 groups. However, a subgroup analysis among participants with more than 70% response rates showed better medication adherence compared to the control group (intervention: 94.6%; control: 90.2%, p=0.0478). There was no significant difference in the change in cognitive function between the 2 groups.
Conclusions
If a patient’s compliance is good, telephone reminders might be effective in improving medication adherence. It is necessary to develop reminder tools that can improve compliance for cognitively impaired patients.

Keyword

Alzheimer Disease; Medication Adherence; Reminder Systems; Telemedicine