Imagine setting out your medication in a tidy weekly box. By midweek, though, life intervenes: an unexpected call, a stressful day, a foggy memory.
Did you take that tablet, or not?
For many people living with mental health conditions, this uncertainty isn’t occasional – it’s daily.
Key Points
- Forgetting or skipping medication is common in mental health treatment, yet hard to measure accurately.
- A new study tested smartphone-based ecological momentary assessment (EMA) with patients who have schizophrenia, depression, or substance use disorders.
- Participants reported on medication intake five times daily for a week — and most stuck with it.
- Medication adherence improved over time, regardless of diagnosis or treatment type.
- EMA could serve not only as a measurement tool but also as a subtle prompt that boosts adherence.
Why Sticking With Medication Is So Hard
Medication non-adherence – missing doses, taking the wrong amount, or stopping altogether – is one of psychiatry’s biggest obstacles.
Studies estimate that up to half of patients with conditions like schizophrenia or depression struggle to stay on track.
The stakes are high: missed medication can mean relapse, worsening symptoms, or even hospitalization.
Yet clinicians often rely on simple self-reports: “Have you been taking your meds?”
Memory slips, embarrassment, or the wish to please a doctor can distort the answer.
What’s missing is a reliable, real-world way to track medication use as it actually happens.
A Smartphone Check-In, Five Times a Day
Researchers in France explored a different approach: ecological momentary assessment (EMA).
Instead of relying on weekly recall, EMA asks people to log experiences in the moment.
In the study, 133 participants – including patients with schizophrenia, depression, substance use disorders, and a healthy control group – used study-provided smartphones.
Five times a day, at random intervals, they answered quick surveys:
Had they taken their prescribed medication since the last check-in?
How were they feeling?
Each mini-assessment took less than a minute.
The trial ran for just one week, but that was enough to uncover intriguing patterns.
What the Study Found
High engagement, across the board
Despite initial doubts about whether patients would tolerate so many prompts, adherence to the phone check-ins was impressive: over 90% in patient groups and 95% in healthy controls.
That’s higher than average rates seen in other EMA studies.
Medication adherence improved over time
On average, patients reported taking their medication 81% of the time.
Surprisingly, adherence increased as the week went on, no matter the diagnosis or medication schedule.
In other words, EMA didn’t lead to “survey fatigue.”
Instead, the simple act of being asked regularly may have nudged people into more consistent routines.
Differences between regimens were minor
Patients on multiple medications or multiple daily doses actually showed slightly higher adherence than those on simpler regimens.
But overall, diagnosis (schizophrenia, depression, substance use disorder) didn’t make a major difference.
Why This Matters for Mental Health Care
For clinicians, EMA offers a real-time window into a notoriously elusive behavior: whether patients take their medication as prescribed.
Instead of relying on memory or assumptions, therapists and psychiatrists could spot early warning signs of non-adherence and intervene before symptoms worsen.
For patients, EMA may do more than just track.
Each prompt can act like a gentle tap on the shoulder: Remember your treatment? It matters.
The study hints that this subtle reminder effect could make a difference, even without formal interventions.
From Tracking to Helping: The Next Step
EMA’s potential doesn’t stop at measurement.
Researchers are exploring ecological momentary interventions (EMIs) – using the same smartphone prompts not just to ask, but to support.
Imagine a check-in that doesn’t just record whether you took your pill, but also offers encouragement, coping strategies for side effects, or reminders timed to your routine.
The line between monitoring and care could blur, bringing personalized, in-the-moment support directly into people’s daily lives.
Limitations and Future Directions
Of course, EMA isn’t perfect.
This study relied on self-report, without biological confirmation like blood tests or digital “smart pills.”
Participants may also have been more motivated than average, creating a bias.
And the trial lasted only one week—longer studies are needed to see if the boost in adherence holds up.
Still, the promise is clear: combining psychology, technology, and everyday context could help solve one of mental health’s most stubborn problems.
Why It Matters: A Takeaway for Daily Life
Medication works only when it’s taken.
Yet remembering pills amid the chaos of daily life is harder than many people admit.
EMA shows that with the right kind of gentle, real-time support, people may not only track their habits better but also improve the – one small check-in at a time.
For clinicians, this points toward a future where treatment isn’t confined to appointments but extends into the rhythm of patients’ daily lives.
For individuals, it’s a reminder that help can fit into your pocket, offering structure and support without judgment.
Reference
Chirokoff, V., Tessier, A., Serre, F., Dupuy, M., Auriacombe, M., Chanraud, S., Berthoz, S., Fatseas, M., & Misdrahi, D. (2025). Relevance of ecological momentary assessment for medication adherence in clinical settings: A precision psychiatry approach. British Journal of Clinical Psychology, 64(3), 692–701. https://doi.org/10.1111/bjc.12532
