Medication Management Among Individuals With Neurodevelopmental Disabilities
Condition: Spina Bifida; Cerebral Palsy
MeSH terms: Cerebral Palsy; Spinal Dysraphism
Study type: Interventional

Summary: 
      This is a pilot study to develop a reinforcement learning (RL)-adaptive visual and
      interactive support application (hereafter RL-adaptive support) to help young adults with
      spina bifida or cerebral palsy become more independent with medication management.
      Individuals with disabilities who are empowered to manage several aspects of their lives can
      ultimately be better integrated into and contribute more to society.
    

Detailed description: 
      In this study, an application will be iteratively developed and tested using RL-adaptive
      support for young adults with disabilities, with the goal to promote the transition to
      independent self-medication administration among young adults with cerebral palsy and spina
      bifida.

      Stochastic mathematical models of how individuals with varying levels of executive function
      and psychomotor skills will respond to the interventions (i.e. the different types and
      formats of messages) of the RL-adaptive support will be developed.

      Up to 6 dyads of individuals with disabilities and their caregivers were intended to be
      recruited to collaborate in defining the features and content of the RL-adaptive support. The
      investigators recruited 3 dyads.

      The steps in developing the RL-adaptive support include having the dyads use for
      approximately 6 weeks each:

        1. young adult uses an electronic medication pillbox that sends its pillbox openings within
           one hour of opening to the research team,

        2. young adult uses the electronic medication pillbox + both use a commercially available
           medication reminder app + caregiver uses a pillbox opening notification app, and

        3. young adult uses the electronic medication pillbox + the RL-adaptive support including
           push notifications in the form of text messages + caregiver uses the pillbox opening
           notification app

      The goal was to reduce the number of caregiver prompts necessary for the medication pillbox
      to be opened. Using these data, the number and type of prompts necessary for the caregiver to
      open the electronic pillbox can be determined. In case the young adult does not open the
      electronic pillbox within two hours, the caregiver will be notified so that pills are not
      missed. In each step, the useful features of the system will be determined via qualitative
      and quantitative feedback with specific suggestions about how to improve this supportive
      system.
    

Intervention name(s): RL-adaptive application
Intervention type(s): Device
Intervention description(s): Up to 6 dyads of individuals with disabilities and their caregivers will be recruited to collaborate in defining the features and content of the RL-adaptive support. The steps in developing the RL-adaptive support include having the dyads use for approximately 6 weeks each:
young adult uses an electronic medication pillbox that sends its pillbox openings within one hour of opening to the research team,
young adult uses the electronic medication pillbox + both use a commercially available medication reminder app + caregiver uses a pillbox opening notification app, and
young adult uses the electronic medication pillbox + the RL-adaptive support including push notifications in the form of text messages + caregiver uses the pillbox opening notification app.
The goal is to reduce the number of caregiver prompts necessary for the medication pillbox to be opened.
Intervention model: Single Group Assignment
Intervention model description: Unblinded pilot study with 1 intervention arm
Masking: None (Open Label)
Primary purpose: Device Feasibility
Keywords: Mobile technology; Reinforcement-learning; Medication management