Patch nonwear accounts for more than half of apparent nonadherence in a digital medicine system

The study analyzed data from 997 days from 20 patients taking aripiprazole through the digital medicine system Abilify MyCite. Of 322 days without detected medication ingestion, 53.7% had insufficient patch contact with the body. When all no-detection days were counted as nonadherence, the apparent nonadherence rate was 32.3%, but when accounting for adequate patch wear, it decreased to 18.1%. The actual nonadherence rate ranges between 14.9% and 32.3%, as adherence during patch-off periods cannot be observed. The study found that medication ingestion was more likely on days when patients followed their usual daily activity pattern and when they spent more time at home during the habitual dose period. Device wear was critical for proper interpretation of adherence outcomes.