A 3D-Printed Assistive Technology Intervention: A Phase I Trial

PURPOSE: Health care professionals are increasingly using three-dimensional (3D) printing. Limited research, however, supports the use of this new technology in occupational therapy practice. The purpose of this study was to test the safety and acceptability of a 3D-printed assistive technology intervention.

METHOD: This study was a quasi-experimental pretest–posttest intervention study. Through word of mouth, we recruited 14 adults who used a pillbox and consumed five or more medications per day. We compared participants’ experiences with their previously used off-the-shelf pillbox to their experiences with a new 3D-printed pillbox designed and printed according to their needs and desires. The 3D-printed pillbox was designed and printed by the research team using a manualized process that included an occupational profile and information on the participant’s medication regimen. The Quebec User Evaluation of Satisfaction With Assistive Technology (QUEST) 2.0 was used to evaluate changes in satisfaction, the Adherence to Refills and Medications Scale (ARMS) was used to determine changes in medication adherence, and a semistructured interview was used to determine safety and general acceptability.

Paired samples t tests were used to evaluate changes in satisfaction and adherence. Participant interviews were transcribed and coded line by line. Coding began with open coding and progressed to axial coding. Constant comparative analysis was used to distill participants’ experiences with their off-the-shelf and 3D-printed devices. Triangulation was achieved through comparisons of interviews, survey data, and literature reviews.

RESULTS: The research team successfully designed and printed 14 pillboxes. Participants’ satisfaction with the pillbox (QUEST scores) significantly increased from 3.00–5.00 (SD = 0.49) to 4.66–5.00 (SD = 0.22). Medication adherence (average ARMS scores) improved from 19.00 (SD = 2.93) to 16.43 (SD = 2.03). Qualitatively, participants indicated no concerns related to safety and reported high satisfaction with the aesthetics and dimensions of the 3D-printed device.

CONCLUSION: Occupational therapy practitioners prescribe assistive technology devices to help clients return to the occupations they need and want to do. Often, practitioners are limited by off-the-shelf devices that are expensive and fail to meet clients’ unique needs. 3D printing has been used in other areas of health care, such as orthotics and prosthetics, and this study demonstrates that occupational therapy practitioners can use a 3D printer to design and manufacture an assistive technology device that is safe and generally preferable to its off-the-shelf equivalent. 3D printing can increase access to assistive technology devices for low-resource clinics, including those in low-income and rural facilities. Future research with a larger and more representative sample, blinding, and a control group is warranted.

References

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Ganesan, B., & Luximon, A. (2016). 3D printing technology applications in occupational therapy. Physical Medicine and Rehabilitation International, 3(3), 1–4.

Lunsford, C., Grindle, G., Salatin, B., & Dicianno, B. E. (2016). Innovations with 3-dimensional printing in physical medicine and rehabilitation: A review of the literature. PM&R, 8, 1201–1212. https://doi.org/10.1016/j.pmrj.2016.07.003

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