Mobile Apps and Medication Adherence: A Systematic Review

Introduction to Medication Adherence

In a groundbreaking systematic review and meta-analysis, researchers have found that mobile applications can assist patients in adhering to their prescribed medication regimens. Medication adherence refers to the extent to which patients follow the prescriptions agreed upon with their healthcare providers. Non-adherence can lead to various negative outcomes, including disease progression, diminished quality of life, and increased hospital visits.

Factors Influencing Medication Adherence

Several factors contribute to poor medication adherence. Patients may struggle to comprehend medical terminology, which can stem from language barriers or overly complicated prescriptions. Additionally, remembering to take medication at the appropriate times can pose a challenge. Some patients may also intentionally skip medications if they are skeptical about the necessity of treatment or fearful of potential side effects.

The Role of Mobile Apps

In response to these challenges, numerous mobile applications have emerged to aid patients in maintaining their medication schedules. These apps often incorporate behavior change techniques, such as reminders for taking medications and feedback on patient behaviors. However, the effectiveness of these applications has not been thoroughly examined until now.

Methodology of the Study

Recently published in BMJ Open, the systematic review analyzed studies from 1990 to 2018 that investigated mobile device applications (including smartphones, tablets, and personal digital assistants) designed to support medication adherence. The researchers employed key search terms, including “adherence,” “non-adherence,” and “smartphone app,” focusing on randomized controlled trials where participants were either given a mobile app intervention or assigned to a control group.

Two independent reviewers screened the studies, resolving discrepancies through discussions and consultations with a third reviewer. Out of 13,259 citations, nine randomized controlled trials involving 988 participants were selected for the meta-analysis, which is a statistical method for combining data from multiple studies.

Participant Demographics and Health Conditions

The nine studies included in the review were published between 2014 and 2018. Among the eight studies reporting participant ages, the mean age ranged from 20.3 to 73.8 years, with an average of 56.7 years across these studies. Participants had varied health conditions, including cardiovascular disease, depression, Parkinson’s disease, psoriasis, and multimorbidity. Medication adherence was measured using self-reported scales in six studies, while two studies utilized pill counts, and one employed a digital chip record in medication dispensers.

Findings on Mobile App Effectiveness

The analysis revealed that mobile app interventions effectively supported medication adherence across all nine studies, although five studies did not show statistically significant results. Variations in adherence measurement, unaccounted behavior change techniques, and participant factors may have influenced these differences.

The meta-analysis indicated that patients using mobile app interventions were more likely to adhere to their prescribed medications. However, the reliance on self-assessment scales in six of the studies raises concerns regarding potential biases and recall errors.

Limitations and Future Research Directions

A meta-regression analysis of behavior control techniques did not identify significant associations with medication adherence. Moreover, the researchers pointed out that the long-term effectiveness of mobile apps for medication adherence remains uncertain due to the short follow-up periods in the analyzed studies. They emphasized the need for larger-scale studies to validate the findings of this meta-analysis, as the sample sizes in the nine studies were relatively small.

Given the widespread use and accessibility of mobile apps in today’s society, further research is essential to leverage technology for enhancing healthcare outcomes.

References

Armitage LC, Kassavou A, Sutton S. Do mobile device apps designed to support medication adherence demonstrate efficacy? A systematic review of randomized controlled trials, with meta-analysis. BMJ Open 2020;10:e032045. doi: 10.1136/bmjopen-2019-032045

Jimmy, B., & Jose, J. (2011, May). Patient medication adherence: measures in daily practice. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191684/

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