Sending cell phone pictures of medications before taking them may provide a simple but effective way to monitor compliance with prescribed treatment for methamphetamine addiction, reports a study in the September Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"Clinicians asking their patients to photograph themselves while taking medications may serve as another way of stressing the importance of medication taking," according to the new research by Gannt P. Galloway, Pharm.D., and colleagues of California Pacific Medical Center Research Institute, San Francisco.

Capsule Photographs Offer Useful and Cost-Effective Approach

The researchers provided camera-equipped cellular phones to 20 patients taking a prescription medication (modafinil) to treat methamphetamine dependence. Before taking their daily medication, patients were instructed to take a picture of the capsule in their hand, then e-mail the photo to the research center.

The cell phone pictures were compared with two other approaches to assessing medication compliance: a "medication event monitoring system" (MEMS), which is a special pill bottle that electronically records each time the bottle is opened; and pill counts, where researchers simply counted the patient's supply of capsules at each clinic visit.

The patients took 95 percent of their prescribed medication based on pill counts and 94 percent based on MEMS. In contrast, based on cell phone photos, the estimated adherence rate was 77 percent. Analysis of weekly data collected by all three methods suggested that the cell phone method tended to underestimate treatment compliance, compared to pill counts.

By comparison, the MEMS tended to overestimate compliance. "MEMS overestimation could be explained by subjects opening the bottle without taking a pill, while the photograph underestimation could be explained by subjects failing to send a photograph," Dr. Galloway and coauthors write.

Based on timestamps on the cell phone photos, patients who took their medication at a consistent time each day had higher treatment compliance rates. Compliance was unrelated to how long the patients used methamphetamine or to methamphetamine cravings.

Monitoring compliance with prescribed treatment is a challenging problem in medical treatment and research. The researchers thought that having patients snap and send cell phone photos might provide an alternative monitoring approach that was less expensive than MEMS but provided more information including what time the medication was taken than pill counts.

The patients in the study received small financial incentives for sending the cell phone photos. There were some problems related to providing patients with cell phones including lost phones and, at the beginning of the study, extra charges related to use of the phones for Internet browsing. These problems could be avoided by having patients use their own cell phones to take and send photos.

Within these limitations, the new study suggests that camera-equipped cell phones provide a useful and cost-effective approach for monitoring compliance with recommended treatment. Given the ubiquity of cell phone use, the devices could have other health care applications as well, Dr. Galloway and colleagues believe: "Innovative uses of cellular telephones offer researchers and clinicians new ways to improve clinical trials and practice."

Source: Lippincott Williams & Wilkins