Why I created a habit-training smart pill bottle

People often ask me why I decided to build a smart pill cap.

The answer is simple: I wanted it for myself, and I discovered that a lot of other people wanted it too.

Before we made Pillsy, I had a cabinet full of vitamins that I constantly forgot to take. Then I got a prescription for allergy medication. Without any type of cue, I couldn’t get myself to form a habit for taking any type of pill. It didn’t help that I was working for a startup that prevented me from having a consistent daily routine.

My conscious mind knew that I would benefit from taking these products, but I couldn’t create the habit by myself. I tried reminders on my phone, but they would often go off when I was nowhere near my pills. They quickly became annoying, and so I dismissed them.

There were some other things that got in the way too. The vitamins upset my stomach when I took them without food. So if I messed up my breakfast routine I’d automatically mess up the vitamins too.

As I began to look at others around me, I realized that I wasn’t the only one with this problem, including many people who are taking pills more serious than the ones I was taking. I learned that “medication non-adherence” — that is, not taking medications as prescribed — currently causes over 125,000 deaths each year in the U.S., and that people only take their medications correctly about 50% of the time. For older adults, I learned that medication errors are the leading cause of placement in nursing homes.

It shocked me that despite the hundreds of billions spent each year to develop and market new blockbuster drugs, that people were having little success in taking their pills correctly. It was also surprising to learn that young people are statistically worse at taking their pills than the elderly.

But when you break it down, it’s really not that surprising. Today, most people are simply handed new pills and told to take them once or twice a day, but with none of the tools needed to build a new habit. There are no visual cues, no rewards, and no regular support. A short discussion with a doctor or a pharmacist is simply not enough.

As I begun to discuss this with people, it became clear that although they weren’t necessarily talking about it out in the open, many people felt the same way. If somebody didn’t need it for themselves they almost certainly knew a few people who did

So I decided to create Pillsy.

I wanted Pillsy to be friendly, fun and easy-to-use and affordable enough that anybody could use it to help them build new habits to help them better manage their health. I began reading extensively about other attempts to use technology to solve this problem, and new theories of behavioral economics intended to help people to overcome psychological barriers to being healthy. I recruited a team of passionate, expert advisors who helped me to design not only a great product, but something that is clinically relevant.

Pillsy applies principals of habit-building to the act of taking vitamins or medications.

Many behavioral scientists have written about the need to form a “Habit Loop” when developing a new habit. They believe that developing a new habit requires:

1. A cue, or trigger

2. The desired action

3. A reward

Experts will debate the best type of trigger or the best type of reward, but they will almost certainly agree that this pattern is required to “program” new behaviors to become habits.

Unfortunately, most pills that have longer-term benefits don’t come with a trigger or a reward. Doctors prescribe the medications that fix the physical problem, but there is an underlying assumption that the medication will be taken as prescribed 100% of the time. Realistically, this rarely happens and a contributing factor is that most people receive zero training on how to build the habits needed to take a medicine as prescribed. In fact, research has shown that most people forget the prescription instructions that are given to them verbally only 10 minutes after leaving the doctor’s office.

We’re just getting started, but it’s working well so far.

Then, after a few months of working on Pillsy my wife became pregnant, and went from taking zero pills to taking prenatal vitamins, DHA and iron supplements. My wife is a very capable person who is good at almost everything she does. But she found that it was difficult to remember to take these new vitamins on a regular basis. It was a totally new habit for her that she needed to learn.

She became one of our first beta testers, and went from taking her vitamins about 40% of the time to taking them over 98% of the time. Knowing that my unborn child was getting more complete nutrition because of my prototype was great motivation to keep going even when funding was tight.

With Pillsy, my allergies are now generally under control. What’s even better is that we’ve already been able to help dozens of beta testers, who are already using Pillsy to help them with anything from prenatal vitamins to anti-depressants to ADHD medications to more serious drugs for cancer or HIV.

Pillsy is intentionally simple-to-use, but we believe it can help many people take control over an important part of their health. We’re starting with a smart pill cap, but our ambitions are actually much greater.

We hope that you like it.