Usability of digital medicine systems in patients with schizophrenia or schizoaffective disorder

To assess the usability and performance of digital medication management systems (DMS) for patients with stable ambulatory schizophrenia and schizoaffective disorder.

This prospective, interventional study comprised a screening phase (up to 4 weeks), training phase (3 weeks: system use under the support), and independent phase (5 weeks under the minimized support) with a follow-up period of 2 weeks. Based on the DSM-5 criteria, patients with a diagnosis of schizophrenia or schizoaffective disorder, taking an atypical antipsychotic as their primary medication, and having access to a smartphone were included in this study.

A total of 30 patients participated in the study. The main characteristics of the patients were as follows: age, 43.5 ± 11.4 years; male percentage, 40% (n = 12); duration of antipsychotic drug use, 14.2 ± 11.7 years; educational period, 13.3 ± 2.1 years; chlorpromazine (CP) equivalent dose, 369.6 ± 253.6 mg/day; and Brief Psychiatric Rating Scale (BPRS), 23.6 ± 4.8. The patients applied patches with the sensor of the DMS embedded in (hereinafter, a wearable sensors) for 93.2% of the study period. The patients could apply the patch independently and successfully and synchronize it with a smartphone application that allowed them to monitor their medication intake in 15.2 ± 8.1 days (median, 9.0; interquartile range (IQR), 1.0-15.0 days after initiation). Thirty-eight adverse events that were reported in 17 patients were classified as mild or moderate, and were related to wearable sensor use.

It was concluded that most patients completed the task for the DMS with minimal assistance early in the study and continued to apply wearable sensors throughout the study period. Moreover, the results confirmed the feasibility of DMS in clinical practical use in stable schizophrenia.