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Updated: Jul 3, 2026

Novel Apparatus and Method for Drug Reinforcement
Published on: August 20, 2010
A Novel Simulation-Based Approach to Teach Medication Adherence in Pharmacy Education
Alexcia S Carr1, Suheib A Omran1, Leticia R Moczygemba1
1The University of Texas at Austin College of Pharmacy, Health Outcomes Division, Austin, TX, USA.
Objective:
1) Using time-stamped data from a medication adherence app, examine changes in students' adherence to a medication regimen before and after using a grade for adherence as an incentive; 2) Assess changes in perceptions of medication adherence and use of reminder aids across 3 time points (baseline, week 1, and week 2).
Methods:
First-year student pharmacists (N = 103) enrolled in a Pharmacy Practice Lab completed two 1-week medication adherence simulations. Each week, students were prescribed a 5-medication regimen with timing and food requirements and instructed to log each dose taken in the app. Adherence was ungraded in the first week and graded in the second week. An 18-question survey assessed students' perceptions of barriers and beliefs related to adherence and the use of reminder aids at baseline and after each simulation. Paired t-tests, McNemar's test, and repeated-measures analysis of variance were used for data analysis.
Results:
Mean adherence scores increased significantly from 68.8% in week 1 (ungraded) to 88.7% in week 2 (graded). Use of reminder aids increased significantly from 52.5% in week 1 to 95.0% in week 2. Students' perceptions of adherence evolved, with significant changes to 11 survey items. Students demonstrated greater recognition of barriers to adherence, such as busy schedules or forgetfulness, and a shift in beliefs about the complexity of maintaining a medication regimen.
Conclusion:
Grading served as an incentive to improve adherence and increased the use of reminder aids. Students' understanding of barriers to adherence also improved. Finally, the simulation facilitated learning about how motivational strategies (eg, incentives, reminders) can influence medication-taking behaviors in real-world settings.
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