International Journal of Hematology

DOI: 10.1007/s12185-016-2027-x Pages: 200-207

Adherence to hydroxyurea medication by children with sickle cell disease (SCD) using an electronic device: a feasibility study

1. Hurley Children’s Hospital and Department of Pediatrics/Human Development, Michigan State University, College of Human Medicine

2. University of Michigan-Flint, Department of Public Health, School of Health Sciences

3. Diplomat Specialty Pharmacy

Correspondence to:
Susumu Inoue
Tel: (810) 262-9283



Adherence to hydroxyurea (HU) is a significant modifying factor in sickle cell vaso-occlusive pain. We conducted a study using an electronic medication container-monitor-reminder device (GlowCap™) to track adherence and determine whether use of this device affected rates of HU adherence. Subjects were regular attendees to our clinic. They were given a 37-item questionnaire and were asked to use a GlowCap containing HU. When the device cap is opened, it makes a remote “medication taken” record. The device also provides usage reminder in the form of lights and alarm sounds if the cap opening is delayed. Nineteen subjects participated in the survey, and 17 in the intervention phase. Of the 17, 12 had reliable adherence data. Seventeen caregivers of patients and two patients completed the survey. Two most common barriers to adherence identified were lack of reminders and absence of medicine home delivery. The intervention component of this study, which used both the electronic (GlowCap) method and medication possession ratio showed that the median adherence rate for the 12 patients evaluated was 85 %. The GlowCap device accurately kept a record of adherence rates. This device may be an effective tool for increasing HU medication adherence.

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