Commercial Smart Virtual Assistants to support medication adherence in chronic patients: a preliminary usability study

Low medication adherence is identified as one of the main issues for increased morbidity and mortality in chronic patients. Smart Virtual Assistants (SVA) devices are becoming increasingly common in households, enabling the possibility of using vocal commands to interact with active solutions to non-adherence. Thus, the aim of this study was to evaluate the usability of commercially available SVA devices to support medication adherence in chronic patients. A skill was developed for the most common commercially available SVA environment (Amazon Alexa), together with a cloud database and a connected online dashboard. Each enrolled participant answered the eHealth Literacy Scale (IT-eHEALS) questionnaire and to a question on perceived adherence, then the prescribed medications were inserted into the online dashboard and linked to their SVA device account at home, thus automatically setting reminders at the proper time and 25 minutes later. A 30-minute interval after each reminder was allowed to vocally confirm to the SVA the medicine intake. After seven days, participants participated in a semi-structured interview including the System Usability Scale (SUS) questionnaire. Eleven subjects (7M, 4F, median age 52 (IQR = 13.5) years old) participated in the study. IT-eHEALS scores ranged from 20 to 40. Overall, low adherence to therapy was identified before the experiment. Post-experiment SUS questionnaire resulted in median score of 77.5 (IQR = 11.25). Participants were very satisfied with the usability of the developed skill. The high SUS score demonstrates how SVA devices could be perceived as effective, interactive and easy-to-use tools to support medication adherence. Further studies are required to improve the developed skill and quantify its ability to effectively increase adherence in chronic patients.