A Comprehensive Self-Medication Management System to Reduce Medication Errors Among People Living With Dementia: Mixed Methods Feasibility and Usability Study.

backgroundMedication adherence is a critical challenge for people living with dementia and their caregivers. Standard care relies on appropriate medication management, yet there are few effective options beyond manual pill-counting and caregiver-administered dosing. These methods are prone to errors and impose a significant burden. Technologically enhanced adherence tools include smart caps, reminder apps, and electronic dispensers, which improve tracking but still depend on manual interaction, lack clinical integration, and are often unsuitable for cognitive impairment. The HiDO HomeCare System (HCS) is an artificial intelligence-enabled self-medication device, advancing the field by removing manual pill counting, automating the chain-of-custody, verifying consumption, and logging medication adherence through neuroscience-based logic and real-time monitoring.

objectiveThis study evaluated the feasibility, usability, and performance of the HCS for at-home medication management in dyads of people living with dementia and their caregivers. We examined setup, dispensing accuracy, task efficiency, and user satisfaction.

methodsA pooled analysis usability study was conducted with 35 caregiver-patient dyads at Rush University Medical Center, combining 2 sequential in-clinic cohorts run at different time points with the same protocol. Participants were recruited from the Rush Memory Clinic and Rush Alzheimer's Disease Center data repository. Participant dyads completed device setup, medication dispensing, and simulated medication use with the system's automated logging and dual-camera verification. Dyads repeated dispensing and simulated medication use following automated reminders sent to their mobile device. Dyads were encouraged to repeat dispensing tasks multiple times. Quantitative measures included setup time, time to dispense, success rates, reliability, and System Usability Scale scores. Qualitative measures also captured caregiver perceptions of usability, acceptability, and burden.

resultsAll 35 dyads successfully completed at least one dispensing task using the HCS. The average time for the first dispense attempt was 1:41 (SD 1:13) minutes (n=35). The second attempt averaged 1:35 (SD 1:10) minutes (n=21). Attempt 3 averaged 2:03 (SD 1:34) minutes (n=6). The system maintained accuracy across all users, with some variability in timing across age groups. The HCS received an overall mean System Usability Scale score of 70.2 (SD 18.2; n=34), reflecting above-average usability of the device. Caregivers reported that access to a system like HCS could reduce stress associated with medication administration and recommended improvements to specific design elements.

conclusionsThe HCS demonstrated early feasibility, accuracy, and usability as a self-medication device tailored to people living with dementia. By automating the medication safety chain from delivery through consumption, HCS reduces caregiver workload and enhances patient safety and medication management. These findings support HCS as a viable medication adherence solution, addressing limitations of prior devices and enabling better dementia care. Larger-scale, longitudinal studies are planned to examine clinical outcomes, caregiver burden, and cost-effectiveness within real-world home and community settings.