A mobile application improves therapy-adherence rates in elderly patients undergoing rehabilitation

Abstract

Medication adherence is crucial for success in the management of patients with chronic conditions. This study analyzes whether a mobile application on a tablet aimed at supporting drug intake and vital sign parameter documentation affects adherence in elderly patients.Patients with coronary heart disease and no prior knowledge of tablet computers were recruited. They received a personal introduction to the mobile application Medication Plan, installed on an Apple iPad. The study was conducted using a crossover design with 3 sequences: initial phase, interventional phase (28 days of using the app system), and comparative phase (28 days of using a paper diary). Users experienced the interventional and comparative phases alternately.A total of 24 patients (12 males; mean age 73.8 years) were enrolled in the study. The mean for subjectively assessed adherence (A14-scale; 5-point Likert scale, from “never” to “very often” which results in a score from 0 to 56) before the study was 50.0 (SD = 3.44). After both interventions there was a significant increase, which was more pronounced after the interventional phase (54.0; SD = 2.01) than after the comparative phase (52.6; SD = 2.49) (for all pairs after both interventions, P <0.001). Neither medical conditions nor the number of drug intake (amount and frequency of drug taking) per day affected subjective adherence. Logging data showed a significantly stronger adherence for the medication app than the paper system for both blood pressure recordings (P <0.001) and medication intake (P = 0.033). The majority of participants (n = 22) stated that they would like to use the medication app in their daily lives and would not need further assistance with the app.A mobile app for medication adherence increased objectively and subjectively measured adherence in elderly users undergoing rehabilitation. The findings have promising clinical implications: digital tools can assist chronic disease patients achieve adherence to medication and to blood pressure measurement. Although this requires initial offline training, it can reduce complications and clinical overload because of nonadherence.

Do mobile device apps designed to support medication adherence demonstrate efficacy? A systematic review of randomised controlled trials, with meta-analysis

“…We considered 83 of these to be eligible and retrieved the full-text articles. Of these, nine studies reported outcome data eligible for meta-analysis 12 13 15 16 22–26. The screening process and reasons for exclusion are reported in figure 1.…”

“…The mean age of participants in the intervention group was reported by eight studies and ranged from 20.3 (SD 4.0)22 to 73.8 (SD 8)12; the mean of the mean ages across these eight studies was 56.7 years. One study did not report the mean age but presented the percentage of participants whose age fell within a series of bandwidths 15.…”

“…Health problems of the target population varied between studies. Five studies sampled a patient population with cardiovascular disease,12 13 16 23 26 and each of the remaining four studies enrolled patient populations with different health problems: depression,22 Parkinson’s disease,24 psoriasis15 and multimorbidity 25…”

“…A comparator group which received usual care, a control condition which did not use an app12 or a control app which did not include any BCTs (eg, an app that was a non-health-related game13).…”

Patient-Facing Mobile Apps to Treat High-Need, High-Cost Populations: A Scoping Review

“…In a 2016 randomized controlled crossover study of a mobile app focused on supporting drug intake and vital sign documentation, researchers found that patients who used the iPad app showed greater adherence for both medication intake and blood pressure measurement than a paper-based control group [58]. Another randomized controlled study published in 2016 found that overweight and obese adults who used a social support app lost on average 3 kg more than patients using a self-monitoring control app over the course of the study [59].…”