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Increasing Medication Adherence Among Heart Attack Patients

Despite the proven benefits of certain medications after a heart attack, and the high mortality rate of coronary artery disease (CAD) in the United States, only about half of heart attack patients still take the medication prescribed to them one year later.

With this in mind, Penn Medicine launched a Your Big Idea Challenge to crowdsource ideas from people across the country for ways to increase medication adherence among heart attack patients.

Over the course of four weeks, 109 ideas for tools, techniques and programs to help patients take their medication after a heart attack were submitted. In addition, more than 165 ratings and 30 comments were logged on the Your Big Idea platform. The winning ideas are representative of the most popular solution themes: technology, usability and convenience, and the ability to track adherence. They were also the top-rated among the challenge committee.

Winning ideas

Pill Caddy: Any Move Assures Daily Compliance - The Pill Caddy provides multiple slots for any size bottle and indicates exactly when a bottle has been moved by sensing a change in pressure/weight or by the disruption of a light beam built into each pill bottle slot. Optionally, the pharmacist could “tag” each bottle with a RFID-like sensor to use with the Pill Caddy. It can also record and display the date and time when a pill bottle is removed from the Pill Caddy. The key: make it as easy as possible to put the bottles, direct from the pharmacy, into and take out. No programming required, no trays to fill, no app to download and set up.

Smartphone, App, Echo, etc. - Use your smart phone app to remind you the time to take the medication. If you have an Amazon Echo, you could also utilize this equipment to remind you to take your medication. Even email apps such as Outlook Express could be utilized to remind you it is time to take your medication. The lighted bottle caps that you gave me were very helpful in reminding me to take my medications. In fact, I am still using it even if I am not connected to your system.

Pre-Packaged Meds - When a patient leaves the hospital, give them prepackaged (individually wrapped, with all the meds for morning, afternoon and evening printed on the package) meds that they just tear off and take at the appropriate time. Rather than each med in a separate bottle that the patient has to administer, all his meds, for each time of the day would be prepackaged for the first 30-90 days. That would put them in the habit of taking the correct meds at the correct time. They could then purchase the packs from the hospital pharmacy as an added income stream for the hospital.

Technology App - Multi function phone app: Time of day to take meds reminders, refill reminders (count down of qty remaining, refill reminders in advance of 0), interaction with UPenn via wireless (like Glowcaps), ability to download stats to UPenn on schedule or on demand from anywhere patient is located, ability to take incoming communications from UPenn staff if meds are missed (text, voice), tracking stats guide (grid, chart), Ability to learn about study progress (group stats, long term results), incentives for compliance -- accumulate points for prizes (everybody can win something if on plan).

Automated Cell Phone App/Telephone Call - App that sends cell phone a reminder to take meds. Or an automated telephone reminder that needs to be answered in order to acknowledge the person received the message. This acknowledgment should be for both apps.

Cell Phone or Fitbit Alarm Reminders - The glow caps were good, but hard to adhere to when traveling. It is very easy to set up reminder alarms on your cell phone or Fitbit. I have a Fitbit Alta and you can set as many alarms as you like that vibrate on your wrist. It doesn't just vibrate once, but multiple times and is hard to ignore. You could set the alarm to go off once a day, twice a day or three times a day as needed depending on your meds. Great reminders, especially when you travel and are on a different time zone or busy from your normal routine.

Medication Reminder and Alert Wristwatch - A wristwatch (or band) able to be programmed to give a voice and/or sound reminder to take medication. It may have the capacity to specify the medication and dosage at specific times. It will remind again every 5 minutes until the patient confirms by activating a voice command or pushes a button that the medication has been taken. The watch can also have a medical alert capability in the event the patient has an medical event. Numerous other medical monitors and alerts can be programmed in such a watch.

Autopill - Have a computerized message sent to your phone daily to remind you of your medication. You can also answer a simple question to be eligible for prizes.

Nagging Mate - An App that can be used on a smart phone, alarm clock or Alexis. The user would select the time(s) and message(s). (Take pills/exercise/time for a walk/other.) User, easily, selects time and message. Snooze capabilities (Remind me in 5/10 minutes) are, also, an option. The alarm should be continuous and annoying so the user is forced to take an action (snooze or accept).

Reminder Alarm – Small programmable wrist apparatus that can be programmed with 2-4 different alarms to remind you as to when to take your meds-- elderly need something that is with them at all times. They need to have sound-- vibration-- and possibly flashing light as reminders. They should be programmable so they are changeable during travel--vibration in event of hearing impairment and light in case of numbness or lack of feeling-- any of which should be able to be deactivated. Any program that has a control setup should have a WORKING PHONE # that is accessible at all times--this was a problem with last program.

The “Meds Minder” App - App for smart phones or tablets. Patients along with a nurse or medical assistant, would load all medication info into the App. Such as dose, time taken, frequency,etc. This App would sync with the devices calendar & alerts.The App would alert the patient when medications needed to be taken. It would also track the patients supply, & email the pharmacy when the medication supply was low. The App would also alert the patient when the email was sent & when medication was available to be picked up from their pharmacy. It could also alert doctor when patient hasn't taken meds.

Cell Phone - I have been on my meds since 2/14/14 my cell phone has a setting for alarm times, since almost everyone has a cell phone they are perfect for reminding everyone to take their meds at the correct time. I have not missed one dose since my heart attack.

Similar to a Fitbit - My idea for the challenge is: Similar to the fit bit bracelet but you can wear it where ever you go and it could be waterproof also. Log in type of med with the time to set an alarm off to remind you to take your meds. For example heart meds will light up a red heart with the time name of meds dosage. But so easy to read and a reminder on your wrist plus if at hospital can't remember what meds to tell the nurse, well it will be on your bracelet.