CPDD 72nd Annual Meeting • Scottsdale, Arizona - The College on ...

197
USING PILL PHOTOS TAKEN WITH A CELL PHONE TO
ASSESS ADHERENCE IN A CLINICAL TRIAL.
K Flower, J Guillén, J Coyle, John Mendelson, G P Galloway; Addiction
Pharmacology, California Pacific Medical Center Research Institute, San
Francisco, CA
Aims: Medication non-adherence is a common and serious problem that compromises
clinical trials, reduces therapeutic efficacy and increases costs.
Determining adherence can be difficult. Clinical trials often use MEMS
(Medication Event Monitoring System) to assess adherence, though this technology
often produces apparent over-adherence. Photos taken on cell phones
(CP) are time-stamped and easily emailed. This study compared adherence measured
by pill counts (PC), MEMS and cell phone pill photos (CPPP).
Methods: CPs with cameras were provided to 20 subjects enrolled in an 8 week
clinical trial of modafinil for methamphetamine addiction. Participants documented
every modafinil administration by placing the pill in their hand and photographing
it immediately prior to ingestion, with a $3 compensation for each
photo sent to the lab. A 10-day supply of medication was dispensed weekly; pills
remaining in returned MEMS devices were counted manually. PCs were compared
to MEMS and CPPP estimates of adherence.
Results: Overall adherence estimated by PC was (94.9 ± 13.5 %), for MEMS
(93.6 ± 15.0%), and for CPPP (76.9 ± 14.6%). For individual weeks, CPPP and
MEMS agreed with PC with similar frequency (Fisher’s Exact Test, 2 tailed (FET
2T): OR 1.11, p= .79). When measures disagreed with PC, MEMS over-reported
adherence more than CPPP (FET 2T: OR 3.88, p