CARE-acterRx

An entertaining, educational app that motivates patients to adhere to their medication and rewards them for doing so.

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Medication Adherence Track: CARE-acter_Rx_

The inspiration for this app comes from games like Pokemon Go, Farmville, and Tamagotchi. We all know that these games are addictive and extremely entertaining. In coming up with an idea to solve the problem of poor medication adherence, one of our first thoughts was that there has to be a strong motivating factor. In our app, CARE-acter_Rx_, this comes in the form of entertainment as well as reward.

What it is

CARE-acter_Rx_ is an app that tracks a patient's medication usage through the use of a button with Bluetooth capability. The button is placed on the medication packaging, and when the user pushes the button, it sends a notification to the app that they have taken their medication. The fun part is that when the user signs up for the app, they get to choose a character (hence the name of the app) that they will be "taking care of" as they go through their medication regimen. Then, the app begins sending notifications to the user to take their medication at times specified by the user. As the patient takes their medication, the character becomes happier and healthier, and if they don't take their medication, the character becomes sadder and sicker. When the patient goes into the app to see their progress, they will be presented with facts about what the medication is doing in their body, and how it is benefitting them to continue their regimen. In addition, the user will be able to earn financial rewards for their medication adherence. After they finish their regimen, or after a certain percentage or number of doses, the user will receive some sort of coupon or discount for future prescriptions or other items they want to purchase. Furthermore, the app will be a collaboration with CVS pharmacy, although the app has the potential to be expanded to various pharmacies. The app will collect a user's prescription information from the CVS database to make medication input easier for the user. Throughout the medication regimen, the patient will also be able to send feedback about their symptoms to their pharmacist or doctor. The pharmacist will then be able to determine if the medication is working as expected, and also whether the patient is adhering to their medication or not.

How we built it

First, we started with the concept. Then we brainstormed what elements of this app we wanted to include to make is as impactful and effective as possible. Next, we ran through a natural flow of user operations and created visuals that we hoped would correspond to what the app would look like. We compared a variety of app building sites to decide which one would be most compatible with our goals, and decided to use Meteor to build our app. Within this software, we used angular.js. We further utilized atom.io. Then we worked for hours and hours in developing an app to encompass the wide array of elements that make up our concept.

Challenges we ran into

The biggest challenge that we ran into was the fact that we started building the app with software that we had never used before. We had to learn all of the specifics of the software and work through a lot of debugging in order to begin developing this app. Furthermore, we ran into the challenge of time. Creating an app as complex as we envisioned it was going to be a challenge to do within 36 hours.

Accomplishments that we're proud of

We are most proud of our concept. We believe that this platform will be enticing to a large and varied population, and that an increase in medication adherence will result. We have begun the process of building this app, and with the help of CVS and more experienced coders, development will be accelerated and more complex visuals and user interactions will be possible. We are also very proud of the progress we have made so far in building the app with software that we had never used before. From the start we knew it would be a difficult undertaking, but we persevered through that.

What we learned

We learned a lot about why medication adherence is such a widespread issue as well as the broad impacts it has on society. Furthermore, we learned how to code within software we had never used before and how working within a timeframe can be an extremely challenging task.

What's next for CARE-acter_Rx_

CARE-acter_Rx_, as it currently stands, has the potential for exponential growth. The Bluetooth capable buttons can be altered to be more compatible with various medication packages and the buttons can be color coded to correspond to the patient's different prescriptions. Furthermore, a wide variety of reward systems can be used depending on the patient's medical issues. For instance, chronic conditions can have a token economy element to cater to long-term medication usage, thus maintaining motivation to use the app. There can also be a dynamic element to the character, in which the character grows as they take their medication, or perhaps where the patient can further customize their avatar as they reach different progress points. In addition, although the app is initially focused on collaboration with CVS, the benefit of this app to the health care industry as a whole is in the interest of all providers. Therefore, the goal is to expand to any pharmacy who is willing to participate.

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Updates

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// Pseudocode!!!!!

// Input variables from user: tabsPerDose dosePerDay daysTotalPrescribed

//initial calculations double tabsTaken = 0; double tabsTotal = (tabsPerDose * dosePerDay * daysTotalPrescribed); double tabsRemaining = (tabsTotal - tabsTaken) ; double progress = (tabsTaken / tabsTotal) ;

// when compliant button is clicked tabsTaken = (tabsTaken + tabsPerDose) ; tabsRemaining = (tabsTotal - tabsTaken) ; double progress = (tabsTaken / tabsTotal) ; //display congrats, amount/days left, fun fact //also display picture!

//when noncompliant button is clicked tabsTaken = (tabsTaken - tabsPerDose) ; tabsRemaining = (tabsTotal - tabsTaken) ; double progress = (tabsTaken / tabsTotal) ;

// display some sort of message saying what to do (keep taking meds or whatever) // this will be either from the internet or from a pharmacist // if that isn't kosher, this can display the contact info for the pharmacist or // physician so that the patient can ask what they should do now that they missed // a dose //and display picture!

//note that our "compliant button" corresponds to the patient taking the dose (clicking button) AND it occuring at the appropriate time

//expected doses calculated by prescription info //user will set first time and desired dose (can update as appropriate) //Next notification will occur if time is past expected time + some buffer

timeBtwnDoses = (24 / dosePerDay) nextDoseTime = current.time + timeBtwnDoses double bufferTime = 1

//If buttonPressed within plus or minus a buffer (say 1 hour) of expected, either no notification //or a fun fact. If not, then a push reminder.

//load images or whatever and assign variables to them

//load images or whatever and assign variables to them (pandai)

panda0 (image that is all full of buggies) panda1 panda2 panda3 panda4 panda5 panda6 (bug free!!)

// not sure how you're fitting this in but... functionInput (progress): avatar = null (define some variable avatar that is not local in the if/else loop thing) if (progress <= 0.16) { avatar = panda0; //panda is full of germs! } else if (progress > 0.16 && progress <= 0.33) { avatar = panda1; //fewer germs! } else if (progress > 0.33 && progress <= 0.50) { avatar = panda2; } else if (progress > 0.50 && progress <= 0.67) { avatar = panda3; } else if (progress > 0.67 && progress <= 0.83) { avatar = panda4; } else if (progress > 0.83 && progress <= 0.99) { avatar = panda5; } else { avatar = panda6; // panda is germ free! } display avatar

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posted an update —

Resource:

 

'Smart' Pill Bottles Aren't Always Enough To Help The Medicine Go Down

http://www.npr.org/sections/health-shots/2017/08/22/538153337/smart-pill-bottles-arent-enough-to-help-the-medicine-go-down

→ It reminds them that they are sick.  Solution: positive reinforcement.

 

Creating the app:

https://developer.chrome.com/apps/first_app

 

https://www.meteor.com/tutorials/blaze/creating-an-app

https://ionicframework.com/



Inspiration:

  • Tamagotchi / neopets (see neopets website for ideas)
  • Talking Tom
  • Selfie button (bluetooth or wifi tracking adherence → must also have option to manually override so that life can happen, and the app can adapt without consequence)
  • Farmville
  • Amazon dash button
  • Smart pill bottle/case (see above article)



  1. Input dosage and schedule into app
  2. Avatar
  3. Record their adherence (buttons and manual input)
  4. Positive reinforcement, reminders, option to send progress to provider
    1. Avatar progressively happier (or worse)
    2. Coupons / ExtraBucks
      1. Chronic or single-course treatment

    3. Farmville / token economy game

      1. This is more for chronic conditions
      2. Decorate avatar?

 

Structure of objects:

 

  1. Personal Info
    1. Name - a string
    2. Email - a string
    3. Cell phone number - ten digit integer
    4. DOB - mm/dd/yyyy
    5. Primary pharmacy - either a string or a choice from a pull down menu

  2. Desired method(s) of notification

    1. Text - no/yes/frequency
    2. Email - no/yes/frequency
    3. Push notifications - no/yes/frequency
    4. Browser extension - no/yes/frequency

  3. Avatar n

    1. Type of avatar - Cat, tree, etc

  4. Medications

    1. Med A
      1. Provider
        1. Name
        2. Contact info for provider - string

      2. Med class - choice from several classes (pre programed into choices of meds) (class 1, class 2, class 3)

        1. Class 1 (antibiotic)
          1. chronic /non-chronic (nonchronic) (this will call the appropriate function managing behavior of avatar)
          2. Detail in avatar (bugs that change number)

        2. Class 2 (diabetes)

          1. chronic/nonchronic (chronic)
          2. Detail in avatar (something with blood sugar)

        3. Class 3 (statin)

          1. chronic/nonchronic (chronic)

      3. Which pharmacy

        1. Choices or a string

      4. Treatment regimen

        1. pill/shot
        2. Frequency of dosage

    2. Med B
    3. Med C

 

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