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
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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