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Paper · act · mcdc · 2025

Utilising Memorable Music via a Smartphone Application to Support Medication Adherence: A Mixed-Methods Feasibility Study

MedTracks with NHS Highland. First empirical evaluation of music as a behavioural cue for medication adherence.

Mark Brill, Gordon Anderson, Andrew Gibson, J. Harry Whalley

Abstract

**Objective.** Medication non-adherence is a persistent challenge among older adults managing chronic conditions. This study evaluated the feasibility, acceptability, and preliminary efficacy of MedTracks, a smartphone application using personally meaningful music as push-notification reminders for medication adherence in adults aged 40 and over at elevated risk of dementia. **Methods.** A convergent parallel mixed-methods feasibility study was conducted with NHS Highland. Thirty-one participants (median age 69) were recruited through three general practices in Inverness and used MedTracks for 30 days. Quantitative outcomes were assessed using the Medication Adherence Report Scale (MARS-10; n = 25) and System Usability Scale (SUS; n = 24) at baseline and day 29. Semi-structured interviews (n = 15) were analysed using reflexive thematic analysis. **Results.** The forgetting item (Q4) showed a statistically significant improvement (Wilcoxon p = .014; paired t-test p = .004; Cohen's d = 0.633), with 40% of participants improving by one category. This finding held under sensitivity analysis for missing data (p = .005). Most remaining items showed ceiling effects at baseline, leaving minimal room for improvement. Five qualitative themes were identified, with music-based reminders generating the highest engagement (61 positive vs 18 negative coded segments). **Conclusions.** To our knowledge, this is the first empirical study to evaluate music as a behavioural cue for medication adherence. The results demonstrate feasibility and acceptability, with statistically significant improvement in self-reported forgetting despite high baseline adherence.

In plain language

MedTracks is a smartphone app from Memory Tracks Ltd that plays a 30-second clip of a personally meaningful song as a medication-reminder push notification. This study tested whether that actually works with adults aged 40 and over who are prescribed medication for conditions associated with an elevated risk of dementia (cardiovascular disease, type 2 diabetes, hypertension).

Thirty-one people in Inverness, recruited through three general practices, used the app for thirty days between December 2024 and February 2025, with NHS Highland’s Clinical Research Facility running the study. The quantitative result that moved: people self-reported forgetting their medication meaningfully less often after using the app. Most of the rest of the adherence scale showed ceiling effects — participants were already adherent at baseline, so there was nowhere to go. The qualitative data told a richer story: music-based reminders were described as doing three things at once — alerting (like an alarm), lifting mood, and in many cases creating an “earworm” that kept the prompt running in memory past the notification itself.

Novel contributions

  • The first published empirical evaluation of music as a behavioural cue for medication adherence.
  • Preliminary evidence that music-based reminders are feasible, acceptable, and measurably effective in a dementia-risk population.
  • A qualitative account of three layered mechanisms — functional alerting, emotional regulation, and involuntary musical imagery — that together distinguish music-based reminders from standard auditory alarms.

Context within the programme

MedTracks is a consumer-facing sibling product of Memory Tracks, also from Memory Tracks Ltd. Where Memory Tracks pairs songs with a range of daily care tasks, MedTracks narrows the principle to a single task — medication adherence — and targets a pre-clinical population at elevated dementia risk. The study extends the Memory Tracks evidence lineage (Cunningham et al., 2019) out of residential dementia care and into community primary-care settings.

Status and availability

  • Status: under review.
  • Corresponding author: Mark Brill, UCA · mbrill@uca.ac.uk
  • ORCIDs: Brill 0000-0001-5168-384X · Whalley 0000-0002-1763-1701 · Anderson 0000-0002-5404-0708 · Gibson 0009-0007-5606-5945
  • Keywords: medication adherence; mobile applications; reminder systems; music; dementia; polypharmacy; quality of life

Open questions for Harry

  • Target journal (the filename implies Digital Health Journal — confirm)
  • Whether the MedTracks app is public-facing (on the App Store / Google Play) or still TestFlight / Google Drive distribution at this point
  • Links to the figures (1 and 2) referenced in the paper — if you'd like them hosted on this site alongside the Papers entry
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