ALICE pillbox app RCT
A Spanish tablet pillbox app improved self-reported adherence and reduced missed doses over 3 months in older adults on multiple medicines.
Source
A Spanish pillbox app for elderly patients taking multiple medications: randomized controlled trial
Study at a glance
- Design
- RCT — 3-month ALICE tablet reminder vs no app
- N
- N=99 · 48 control, 51 experimental
- Population
- Older multimorbid outpatients on multiple medications in Spanish primary care
- Outcome
- MMAS-4 adherence, missed doses, and medication errors at 3 months
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ALICE pillbox app RCT
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
99 patients analyzed (48 control, 51 experimental).
Data were obtained from 99 patients (48 and 51 in the control and experimental groups, respectively).
Treatment adherence increased 28.3% and missed doses fell 27.3%.
Specifically, treatment adherence (measured by the scale scores) increased by 28.3% and the rate of missed doses fell by 27.3%.
What they did
After co-design with patients and clinicians, investigators randomized older multimorbid outpatients to 3 months of ALICE tablet reminders versus no app, measuring MMAS-4 adherence, missed doses, and errors.
What they found
Adherence scores rose 28.3% and missed doses fell 27.3% with ALICE; among those with ≥2 prior errors, medication errors fell 41.2%. Clinical labs did not meaningfully improve in 3 months.
The limits
What it doesn't show
Short follow-up and self-report limits prove hard clinical benefit or generalizability beyond Spanish primary care.
Key terms
- ALICE
- Spanish tablet pillbox app with photo-based medication alerts.
- MMAS-4
- Four-item Morisky medication adherence scale.
- Polypharmacy
- Taking multiple medications, often five or more.
- Barthel Index
- Functional independence scale used in eligibility.
- Medication error
- Wrong dose/drug or related self-administration mistake.
- Multimorbidity
- Living with multiple chronic conditions.
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Primary study type?
Common questions
Who was eligible?
Adults >65 on multiple meds, Barthel >60, managing meds at home.
How many analyzed?
99 patients (48 control, 51 experimental).
Did labs improve?
No clinically relevant improvement in clinical status over 3 months.
Biggest adherence change?
MMAS-based adherence +28.3%; missed doses −27.3%.
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