Improving Medication Adherence in Isolated Patients With Cognitive Impairment Using Automated Telephone Reminders.

Background and purpose: Medication adherence is essential for effective medical treatment. However, it is challenging for cognitively impaired patients. We investigated whether an automated telephone reminder service improves medication adherence and reduces the decline of cognitive function in isolated patients with cognitive impairment.

Methods: This was a single-center, randomized clinical trial. We enrolled mild cognitive impairment (MCI) or Alzheimer's disease (AD) patients who lived alone or with a cognitively impaired spouse. We provided an automated telephone reminder service for taking medication to the intervention group for 6 months. The control group was provided with general guidelines for taking the medication every month. The participants underwent neuropsychological assessment at the beginning and end of the study. Statistical significance was tested using nonparametric Wilcoxon rank sum and Wilcoxon matched-pairs signed-rank tests.

Results: Thirty participants were allocated randomly to groups, and data for 29 participants were analyzed. The mean age was 79.6 (standard deviation, 6.0) years and 79.3% of the participants were female. There was no significant difference in medication adherence between the 2 groups. However, a subgroup analysis among participants with more than 70% response rates showed better medication adherence compared to the control group (intervention: 94.6%; control: 90.2%, p=0.0478). There was no significant difference in the change in cognitive function between the 2 groups.

Conclusions: If a patient's compliance is good, telephone reminders might be effective in improving medication adherence. It is necessary to develop reminder tools that can improve compliance for cognitively impaired patients.