Design and development of an IoT-enabled smart pill box prototype with a smartphone app-based medication reminder
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Abstract
Non-adherence to medication regimens remains a significant concern in healthcare, negatively impacting patient outcomes and increasing costs. This pilot study investigated using Internet of Things (IoT) and microcontroller technologies to enhance adherence through a smartphone-app-driven smart pill box. The prototype integrated an IoT-enabled microcontroller with a custom app designed to send real-time medication reminders and log pill box usage. Ten participants with chronic conditions requiring daily medication evaluated the device over four weeks. Adherence rates, self-reported before the trial, were compared to those monitored during the trial. Results indicated a marked improvement in adherence, increasing from 78% at baseline to 92% during the study. Additionally, 90% of participants rated the system as user-friendly and expressed willingness to continue its use. The study highlights the potential of this IoT-enabled smart pill box to address medication non-adherence effectively. However, further research with larger sample sizes is necessary to confirm its broader applicability across diverse populations and medical conditions. These findings suggest that integrating IoT and microcontroller technologies into adherence interventions could significantly benefit chronic disease management and healthcare outcomes. This innovative approach holds promise for addressing the widespread challenge of medication non-adherence, but larger and more demographically diverse studies are needed to validate its long-term effectiveness and generalizability.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Gu Y, Zalkikar A, Liu M, Kelly L, Hall A, Daly K, et al. Predicting medication adherence using ensemble learning and deep learning models with large scale healthcare data. Sci Rep. 2021;11(1):18961. DOI: https://doi.org/10.1038/s41598-021-98387-w
Ravens-Sieberer U, Kaman A, Erhart M, Otto C, Devine J, Löffler C, et al. Quality of life and mental health in children and adolescents during the first year of the COVID-19 pandemic: results of a two-wave nationwide population-based study. Eur Child Adolesc Psychiatry. 2023;32(4):575-88. DOI: https://doi.org/10.1007/s00787-021-01889-1
Gil-Guillen VF, Balsa A, Bernárdez B, Valdés y Llorca C, Márquez-Contreras E, de la Haba-Rodríguez J, et al. Medication non-adherence in rheumatology, oncology and cardiology: a review of the literature of risk factors and potential interventions. Int J Environ Res Public Health. 2022;19(19):12036. DOI: https://doi.org/10.3390/ijerph191912036
Abdulsalim S, Unnikrishnan MK, Manu MK, Alrasheedy AA, Godman B, Morisky DE. Structured pharmacist-led intervention programme to improve medication adherence in COPD patients: a randomized controlled study. Res Social Adm Pharm. 2018;14(10):909-14. DOI: https://doi.org/10.1016/j.sapharm.2017.10.008
Jeminiwa R, Hohmann L, Qian J, Garza K, Hansen R, Fox BI. Impact of eHealth on medication adherence among patients with asthma: a systematic review and meta-analysis. Respir Med. 2019;149:59-68. DOI: https://doi.org/10.1016/j.rmed.2019.02.011
Car J, Tan WS, Huang Z, Sloot P, Franklin BD. eHealth in the future of medications management: personalisation, monitoring and adherence. BMC Med. 2017;15(1):73. DOI: https://doi.org/10.1186/s12916-017-0838-0
Mistry N, Keepanasseril A, Wilczynski NL, Nieuwlaat R, Ravall M, Haynes RB, et al. Technology-mediated interventions for enhancing medication adherence. J Am Med Inform Assoc. 2015;22(e1):e177-93. DOI: https://doi.org/10.1093/jamia/ocu047
Chun-Yun Kang G. Technology-based interventions to improve adherence to antihypertensive medications–an evidence-based review. Digit Health. 2022;8:1-16. DOI: https://doi.org/10.1177/20552076221089725
Wagan SA, Koo J, Siddiqui IF, Attique M, Shin DR, Qureshi NMF. Internet of medical things and trending converged technologies: a comprehensive review on real-time applications. J King Saud Univ - Comput Inf Sci. 2022;34(10):9228-51. DOI: https://doi.org/10.1016/j.jksuci.2022.09.005
Baker SB, Xiang W, Atkinson I. Internet of things for smart healthcare: technologies, challenges, and opportunities. IEEE Access. 2017;5:26521-44. DOI: https://doi.org/10.1109/ACCESS.2017.2775180
Alahi MEE, Sukkuea A, Tina FW, Nag A, Kurdthongmee W, Suwannarat K, et al. Integration of IoT-enabled technologies and artificial intelligence (AI) for smart city scenario: recent advancements and future trends. Sensors. 2023;23(11):5206. DOI: https://doi.org/10.3390/s23115206
Arshed M, Mahmud AB, Minhat HS, Ying LP, Umer MF. Effectiveness of mHealth interventions in medication adherence among patients with cardiovascular diseases: a systematic review. Diseases. 2023;11(1):41. DOI: https://doi.org/10.3390/diseases11010041
Atolagbe ET, Sivanandy P, Ingle PV. Effectiveness of educational intervention in improving medication adherence among patients with diabetes in Klang Valley, Malaysia. Front Clin Diabetes Healthc. 2023;4:1-11. DOI: https://doi.org/10.3389/fcdhc.2023.1132489
Shariful Islam SM, Mishra V, Siddiqui MU, Moses JC, Adibi S, Nguyen L, et al. Smartphone apps for diabetes medication adherence: systematic review. JMIR Diabetes. 2022;7(2):e33264. DOI: https://doi.org/10.2196/33264
Georgieva N, Tenev V, Kamusheva M, Petrova G. Diabetes mellitus—digital solutions to improve medication adherence: scoping review. Diabetology. 2023;4(4):465-80. DOI: https://doi.org/10.3390/diabetology4040040
Smith JC, Seage CH, Lane E, James DH. Using the theoretical domains framework to determine the barriers and facilitators to medication adherence in Parkinson’s disease. Explor Res Clin Soc Pharm. 2023;11:100309. DOI: https://doi.org/10.1016/j.rcsop.2023.100309
Islam T, Hassan R, Romy SR, Dellal D, Bin TRA. Enhancing medication adherence with IoT technology. Eur J Electr Eng Comput Sci. 2023;7(5):7-13. DOI: https://doi.org/10.24018/ejece.2023.7.5.557
Hui CY, McKinstry B, Fulton O, Buchner M, Pinnock H. Patients’ and clinicians’ visions of a future internet-of-things system to support asthma self-management: mixed methods study. J Med Internet Res. 2021;23(4):e22432. DOI: https://doi.org/10.2196/22432
Mohammed BG, Hasan DS. Smart healthcare monitoring system using IoT. Int J Interact Mob Technol. 2023;17(1):141-52. DOI: https://doi.org/10.3991/ijim.v17i01.34675
Antoun W, Abdo A, Al-Yaman S, Kassem A, Hamad M, El-Moucary C. Smart Medicine Dispenser (SMD). 2018 IEEE 4th Middle East Conference on Biomedical Engineering (MECBME); 2018 Mar 28-30; Tunis, Tunisia. USA: IEEE; 2018. p. 20-3. DOI: https://doi.org/10.1109/MECBME.2018.8402399
Kassem A, Antoun W, Hamad M, El-Moucary C. A comprehensive approach for a smart medication dispenser. Int J Comput Digit Syst. 2019;8(2):131-41. DOI: https://doi.org/10.12785/ijcds/080205
Chan AHY, Harrison J, Black PN, Mitchell EA, Foster JM. Using electronic monitoring devices to measure inhaler adherence: a practical guide for clinicians. J Allergy Clin Immunol Pract. 2015;3(3):335-49.e1-5. DOI: https://doi.org/10.1016/j.jaip.2015.01.024
Kim SK, Park SY, Hwang HR, Moon SH, Park JW. Effectiveness of mobile health intervention in medication adherence: a systematic review and meta-analysis. J Med Syst. 2025;49(1):13. DOI: https://doi.org/10.1007/s10916-024-02135-2
Ghozali MT. Assessing ChatGPT’s accuracy and reliability in asthma general knowledge: implications for artificial intelligence use in public health education. J Asthma. 2025;62(6):975-83. DOI: https://doi.org/10.1080/02770903.2025.2450482
Vervloet M, van Dijk L, Santen-Reestman J, van Vlijmen B, van Wingerden P, Bouvy ML, et al. SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored. Int J Med Inform. 2012;81(9):594-604. DOI: https://doi.org/10.1016/j.ijmedinf.2012.05.005
Regan AK, Bloomfield L, Peters I, Effler PV. Randomized controlled trial of text message reminders for increasing influenza vaccination. Ann Fam Med. 2017;15(6):507-14. DOI: https://doi.org/10.1370/afm.2120
Li C, Wang J, Wang S, Zhang Y. A review of IoT applications in healthcare. Neurocomputing. 2024;565:127017. DOI: https://doi.org/10.1016/j.neucom.2023.127017
Leving MT, van Boven JFM, Bosnic-Anticevich SZ, van Cooten J, Correia de Sousa J, Cvetkovski B, et al. Suboptimal peak inspiratory flow and critical inhalation errors are associated with higher COPD-related healthcare costs. Int J Chron Obstruct Pulmon Dis. 2022;17:2401-15. DOI: https://doi.org/10.2147/COPD.S380736
Haitaamar Z, Sulaiman A, Bendoukha SA, Rodrigues D. Lower inclination orbit concept for direct-communication-to-satellite internet-of-things using lean satellite standard in near-equatorial regions. Appl Sci. 2023;13(9):5654. DOI: https://doi.org/10.3390/app13095654
Sharma A, Kaur J, Singh I. Internet of Things (IoT) in pharmaceutical manufacturing, warehousing, and supply chain management. SN Comput Sci. 2020;1(4):232. DOI: https://doi.org/10.1007/s42979-020-00248-2
Ahmad HS, Yang AI, Basil GW, Welch WC, Wang MY, Yoon JW. Towards personalized and value-based spine care: objective patient monitoring with smartphone activity data. J Spine Surg. 2022;8(1):87-92. DOI: https://doi.org/10.21037/jss-21-67
Jacob C, Sanchez-Vazquez A, Ivory C. Social, organizational, and technological factors impacting clinicians’ adoption of mobile health tools: systematic literature review. JMIR Mhealth Uhealth. 2020;8(2):e15935. DOI: https://doi.org/10.2196/15935
Reiss F, Meyrose AK, Otto C, Lampert T, Klasen F, Ravens-Sieberer U. Socioeconomic status, stressful life situations and mental health problems in children and adolescents: results of the German BELLA cohort-study. PLoS One. 2019;14(3):e0213700. DOI: https://doi.org/10.1371/journal.pone.0213700
Yoosefi Lebni J, Mohammadi Gharehghani MA, Soofizad G, Khosravi B, Ziapour A, Irandoost SF. Challenges and opportunities confronting female-headed households in Iran: a qualitative study. BMC Womens Health. 2020;20(1):183. DOI: https://doi.org/10.1186/s12905-020-01046-x
Ravens-Sieberer U, Kaman A, Erhart M, Devine J, Schlack R, Otto C. Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. Eur Child Adolesc Psychiatry. 2022;31(6):879-89. DOI: https://doi.org/10.1007/s00787-021-01726-5
