E-Pill Bottle Reminder Alarms to Improve Adherence

Crossroads North Center for Quality Improvement and Innovation (CQII)


Pill bottle reminder alarms (e-pill) for youth patients new to the clinic and those with inconsistent medication routines, with the provision of clinic instructions on use of the e-pill devices and added support via an adherence video teach-back tool.

Change Ideas

  • Clinic purchased pill bottle reminder devices with no cost to patient.
  • Provided instruction on use during clinic visits.
  • Determined the mode of communication with client along with dates or frequency of check in to monitor clients’ progress or troubleshoot any problems.


There is some evidence that shows that medication reminder devices improve HIV medication adherence and biomarker outcomes1, 2 This e-pill bottle reminder intervention served as medication reminders among youth ages 13-24 years who were new to Crossroads North or who had ineffective medication routine. These medication reminder devices (TimeCap) were provided to youth which were coupled with Gilead’s 2-minute “Help Stop the Virus” video as a treatment adherence teach-back tool. Instructions were provided during clinic visits on how to use the device as well as the device features. Clinic staff also showed the patients how to set the alarm to their preferred time and addressed any concerns or questions they had. Mode of communication along with dates or frequency of check-in to monitor patients’ progress were established. Seven patients reached viral suppression using the devices while two patients with the devices are currently out of care after they reached viral suppression. Patients expressed that they found the “day/time” indicator which showed when the bottle was last opened, to be more useful than using the alarm only. Viral suppression among youth increased from 53.3% (8/15) to 69.2% (9/13) for this intervention between July 2018 and December 2019.

1 Spratt ES, Papa CE, Mueller M, Patel S, Killeen T, Maher E et al. Using Technology to Improve Adherence to HIV Medications in Transitional Age Youth: Research Reviewed, Methods Tried, Lessons Learned. Journal of General Medicine. 2017. 1(1).

2 Haberer JE, Robbins GK, Ybarra M, Monk A, Ragland K, Weiser SD et al. Real-time electronic adherence monitoring is feasible, comparable to unannounced pill counts, and acceptable. AIDS and Behavior. 2012. 16(2): 375–382.

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