Evaluation of acceptability and feasibility of using manual pill organizers and pill reminder apps for improving medication adherence among elderly population from rural Maharashtra.

Background: Approximately 40%-75% of elderly individuals suffering from chronic diseases are nonadherent to medications. Manual pill organizers (MPO) and pill reminder apps (PRAs) are simple interventions that can improve medication adherence. This was a mixed-methods study to understand the feasibility and acceptability of MPO and a locally developed PRA amongst elderly individuals from rural Maharashtra.

Materials And Methods: Sixty elderly individuals aged 60-80 years taking three or more oral medications with access to a smartphone were randomized to receive MPO, PRA, or MPO + PRA for 3 months (n = 30). The outcome measures included acceptability and feasibility using qualitative methods, and usability was measured using a system usability scale.

Results: Both MPO and PRA demonstrated good system usability and ease of independent use. The findings of the qualitative study highlighted reduced dependency on caregivers, reduced chance of missing a pill, and ease of carrying medicines during travel as benefits of MPO. User-friendliness, ability to take medication on time, and caregivers' satisfaction were reported benefits with PRA. Reported challenges included initial hesitancy, the additional workload of filling the MPO, alarm malfunctions, and dependency on family members for using PRA. Medication nonadherence due to forgetfulness significantly improved from 52% to 65% at baseline to 90%-100% at the end as reported using Medication Adherence Rating System-5. Participants in the combined group did not report any difficulty using the two interventions together.

Conclusion: The study demonstrates good feasibility and acceptability of MPOs and indigenously developed PRA either alone or in combination among the Indian rural elderly population. CTRI registration: CTRI/2024/01/061975 (Registered on- January 29, 2024).