Adhera: A Human-Centered Health Informatics Solution for Reducing Informal Caregiver Burden through Improved Medication Adherence

Abstract: The growing global population of older adults, combined with ongoing healthcare workforce shortages, has increased reliance on informal caregivers, including family members and friends who provide unpaid support to individuals with chronic illnesses. Among their daily responsibilities, medication management remains one of the most demanding and error-prone tasks. Non-adherence to prescribed regimens not only undermines patient outcomes but also intensifies caregiver stress, anxiety, and fatigue. Although digital health technologies have proliferated to address adherence, most solutions focus exclusively on patients and neglect the informational and emotional needs of caregivers. This paper introduces Adhera, a caregiver-inclusive health informatics system designed to support medication adherence while reducing caregiver burden. Using a mixed-methods research design that included fifteen semi-structured caregiver interviews, sixty-five survey responses, and five pharmacist consultations, this study identified three primary challenges: caregiver stress related to uncertainty about medication intake, fragmented communication with healthcare professionals, and distrust in existing digital tools. Informed by the CeHRes Roadmap 2.0 and the Triple Bottom Line by Design and Culture (TBLD+C) framework, as well as recent co-design studies involving caregivers, Adhera integrates a sensor-equipped smart pill organizer with a mobile companion application that records intake events, sends real-time reminders, and provides caregivers with synchronized adherence data. Preliminary evaluation suggests that Adhera enhances visibility, improves caregiver confidence, and streamlines medication routines. This study contributes to the field of health informatics by demonstrating how human-centered design and collaborative frameworks can align technical innovation with empathy-driven care.