SmartMed: An IoT-Enabled Pill Dispensing and Monitoring System for Medication Adherence of AFib Patients

Atrial fibrillation (AFib), a form of cardiac arrhythmia, demands consistent medication adherence to prevent severe complications such as stroke and thromboembolic events. This study introduces an Internet of Things (IoT)-based smart pill dispensing system designed for medication management and caregiver support in patients with AFib, particularly in resource-constrained settings. Using an experienced prototyping-based iterative design approach, SmartMed integrates automated medication scheduling, real-time dose verification, and a mobile application that enables both routine adherence monitoring and remote emergency dispensing by caregivers. The system features an ESP32 microcontroller, ultrasonic sensors for pill retrieval detection, and cloud-based synchronization through Firebase, ensuring seamless communication between the device and mobile platforms. Testing demonstrated 100% adherence rates, significantly outperforming traditional manual medication management (average 78.3%). System Usability Scale (SUS) evaluations yielded an overall score of 86.5/100, reflecting excellent usability and strong user confidence in safety and reliability. Feedback from patients, caregivers, and healthcare professionals highlighted the system's user-friendly interface, effective real-time alerts, and safety mechanisms that prevent accidental double-dosing. SmartMed presents a clinically relevant solution that bridges critical gaps in medication adherence, especially in underserved and rural communities. Future work will focus on integrating wearable health monitoring. This innovation showcases the potential of IoT-enabled healthcare tools to enhance patient outcomes and revolutionize chronic disease management in the digital health era.