Impact of Bubble Packaging on Adherence to Long-Term Oral Medications Used to Prevent Cardiovascular Disease

Background: Adherence to long-term pharmacotherapy is problematic in the United States. Bubble packaging of medications has been touted to improve patients’ use of medications. Scant research has assessed bubble packaging’s impact on adherence to multiple medications. Objective: To compare medication adherence between patients receiving medications to address cardiovascular disease risk factors in bubble packages to those receiving medications in pill bottles. Methods: This retrospective cohort study utilized prescription dispensing records from an independent pharmacy. Patients receiving statins, β-blockers, angiotensin-converting enzyme inhibitors, or oral hypoglycemic agents were identified and grouped into those who received medications in bubble packages and those received medications in pill bottles. Adherence was assessed with medication possession ratios. Patients were classified as adherent if their medication possession ratio was 80% or more. Results: Receiving medications in bubble packaging was significantly associated with greater adherence compared to pill bottles ( P < .001). In adjusted models, greater numbers of medications filled ( P = .024) and increasing patient age ( P = .018) were significantly associated with low adherence, while bubble packaging was not ( P = .13). Stratified analyses revealed that bubble packaging was significantly associated with greater adherence when 4 or fewer medications are filled ( P = .012) and for patients between 18 and 44 years of age ( P = .023). Conclusion: Bubble packages can improve medication adherence. However, they may not resolve complex issues contributing to the problem of nonadherence, especially for older patients and those prescribed multiple medications.

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Lessons Learned from Development of a Mobile App for Cardiovascular Health Awareness

Sustainability ◽

10.3390/su13115985 ◽

2021 ◽

Vol 13 (11) ◽

pp. 5985

Author(s):

Bryan Weichelt ◽

Jeffrey VanWormer ◽

Yin Xu ◽

Chris Kadolph ◽

Simon Lin

Keyword(s):

Cardiovascular Disease ◽

Health Information ◽

Healthcare System ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

The United States ◽

Mobile App ◽

Lessons Learned ◽

Health Concern ◽

Development Processes

Cardiovascular disease (CVD) is a major public health concern in the United States. In response to the federally sponsored Million Hearts Risk Check Challenge, a team of programmers, software developers, health-information technologists, and clinicians in an integrated healthcare system in Wisconsin collaborated to develop Heart Health MobileTM (HHM), designed to improve awareness of cardiovascular disease risk and promote risk factor control among users. This paper outlines the development processes and highlights key lessons learned for mobile health applications. An agile project management methodology was used to dedicate adequate resources and employ adaptive planning and iterative development processes with a self-organized, cross-functional team. The initial HHM iOS app was developed and tested, and after additional modifications, gamified and HTML 5 versions of the app were released. The development of an iOS app is low in cost and sustainable by a healthcare system. Future app modifications to enhance data security and link self-reported cardiovascular risk assessment data to patient medical records may improve performance, patient relevance, and clinician acceptance of HHM in the primary-care setting. Legal and institutional barriers regarding the capture and analyses of protected health information must be mitigated to fully capture, analyze, and report patient health outcomes for future studies.

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