Effect and usability of mobile health applications for medication adherence in patients with heart failure: A systematic review
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Cited by 3 publications
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Mobile Application‐Based Interventions for People with Heart Failure: A Systematic Review and Meta‐Analysis
Aim. To examine the effectiveness of mobile health application‐based interventions on mortality, hospitalization rate, self‐care, and quality of life in people with heart failure. Background. Mobile health application‐based interventions are reported to potentially help people with heart failure improve health‐related clinical outcomes. However, evidence on the effects of mobile health application‐based interventions on mortality, hospitalization, self‐care, and quality of life remains inconclusive and limited. Methods. A systematic literature search was conducted in six databases (MEDLINE, CINAHL Plus with Full Text, PsycINFO, Web of Science, EMBASE, and CENTRAL) to identify relevant studies from inception to 21 October 2023. Two authors independently extracted the data and assessed the risk of bias using the Cochrane risk‐of‐bias tool. The meta‐analysis was conducted in Review Manager (version 5.4) and the statistical software R 4.3.3. Sensitivity analysis and subgroup analysis were also performed. The certainty of the evidence was evaluated by the GRADE approach. Results. Twenty‐four studies involving 2886 participants were identified in this review. The pooled analysis showed that mobile health application‐based interventions had statistically significant beneficial effects on reducing heart failure‐related hospitalization (RR = 0.72, 95% CI 0.57 to 0.91, p = 0.01) and improving quality of life (SMD = 0.46, 95% CI 0.09 to 0.83, p = 0.02), but had no statistically significant effects on all‐cause mortality (RR = 0.90, 95% CI 0.66 to 1.25, p = 0.47), cardiovascular mortality (RR = 0.87, 95% CI 0.59 to 1.26, p = 0.24), all‐cause hospitalization (RR = 0.74, 95% CI 0.39 to 1.42, p = 0.29), or self‐care (MD = −2.42, 95% CI −15.07 to 10.24, p = 0.64). Subgroup analyses indicated that intervention duration and monitoring frequency may influence the effects of mobile health application‐based interventions on quality of life. Conclusions. Mobile health application‐based interventions were effective at reducing heart failure‐related hospitalization and improving quality of life in people with heart failure. More well‐designed randomized controlled trials are needed to strengthen the evidence. Implications for Nursing Management. Mobile health application‐based interventions may have benefits for improving heart failure‐related hospitalization and quality of life. More rigorous studies are warranted to confirm the effects of mobile health application‐based interventions for people with heart failure.
Mobile Application‐Based Interventions for People with Heart Failure: A Systematic Review and Meta‐Analysis
Aim. To examine the effectiveness of mobile health application‐based interventions on mortality, hospitalization rate, self‐care, and quality of life in people with heart failure. Background. Mobile health application‐based interventions are reported to potentially help people with heart failure improve health‐related clinical outcomes. However, evidence on the effects of mobile health application‐based interventions on mortality, hospitalization, self‐care, and quality of life remains inconclusive and limited. Methods. A systematic literature search was conducted in six databases (MEDLINE, CINAHL Plus with Full Text, PsycINFO, Web of Science, EMBASE, and CENTRAL) to identify relevant studies from inception to 21 October 2023. Two authors independently extracted the data and assessed the risk of bias using the Cochrane risk‐of‐bias tool. The meta‐analysis was conducted in Review Manager (version 5.4) and the statistical software R 4.3.3. Sensitivity analysis and subgroup analysis were also performed. The certainty of the evidence was evaluated by the GRADE approach. Results. Twenty‐four studies involving 2886 participants were identified in this review. The pooled analysis showed that mobile health application‐based interventions had statistically significant beneficial effects on reducing heart failure‐related hospitalization (RR = 0.72, 95% CI 0.57 to 0.91, p = 0.01) and improving quality of life (SMD = 0.46, 95% CI 0.09 to 0.83, p = 0.02), but had no statistically significant effects on all‐cause mortality (RR = 0.90, 95% CI 0.66 to 1.25, p = 0.47), cardiovascular mortality (RR = 0.87, 95% CI 0.59 to 1.26, p = 0.24), all‐cause hospitalization (RR = 0.74, 95% CI 0.39 to 1.42, p = 0.29), or self‐care (MD = −2.42, 95% CI −15.07 to 10.24, p = 0.64). Subgroup analyses indicated that intervention duration and monitoring frequency may influence the effects of mobile health application‐based interventions on quality of life. Conclusions. Mobile health application‐based interventions were effective at reducing heart failure‐related hospitalization and improving quality of life in people with heart failure. More well‐designed randomized controlled trials are needed to strengthen the evidence. Implications for Nursing Management. Mobile health application‐based interventions may have benefits for improving heart failure‐related hospitalization and quality of life. More rigorous studies are warranted to confirm the effects of mobile health application‐based interventions for people with heart failure.
Randomized comparison of the effects of tailored text messaging versus pillbox organizers on medication adherence of heart failure patients
Background Heart failure (HF) is a major public health issue worldwide, affecting approximately 64.3 million people in 2017. Non-adherence to medication is a common and serious issue in the management of HF. However, new reminder systems utilizing mobile technology, such as text messaging, have shown promise in improving medication adherence. The purpose of this study was to compare the impact of tailored text messaging (TTM) and pillbox organizers on medication adherence in individuals with HF. Methods A randomized controlled trial was conducted, involving 189 eligible patients with HF who were randomly assigned to either the TTM, pillbox organizer, or control group. Medication adherence was evaluated using pill counting and the Medication Adherence Rating Scale (MARS) over a period of three months and compared across the groups. The data were analyzed using Kruskal-Wallis, Analysis of Variance (ANOVA), and Repeated Measures ANOVA tests. Results The results indicate that both the TTM and pillbox organizers groups had significantly higher medication adherence compared to the control group, as measured by pill counting (MD = 0.05, 95%CI = 0.03–0.06; p < 0.001 for TTM group, MD = 0.04, 95%CI = 0.03–0.06; p < 0.001 for pillbox organizers group) and the MARS (MD = 1.32, 95%CI = 0.93 to 1.72; p < 0.001 for TTM group, MD = 1.33, 95%CI = 0.95 to 1.72; p < 0.001 for pillbox organizers group). However, there was no statistically significant difference in medication adherence between the two intervention groups using either measurement method. The TTM group exhibited a lower hospitalization rate than the other groups in the first follow up (p = 0.016). Conclusions Both the TTM and pillbox organizers were shown to be effective in enhancing medication adherence among patients with HF. Therefore, healthcare providers should take into account the patient’s condition and preferences when selecting one of these methods to promote medication adherence. Future research should aim to address the limitations of this study, such as controlling for confounding variables, considering long-term effects, and comparing the effectiveness of different interventions.
Predictors to Poor Quality of Life Among Patients with Heart Failure and Its Correlation with Their Medication Adherence: Finding for Healthcare Improvement and Follow-Up
Background Understanding medication adherence and its relationship with quality of life (QoL) is essential for improving health outcomes in patients with heart failure (HF). Objective This study aimed to investigate the predictors of poor quality of life and its relationship with medication adherence among patients with heart failure. Methods A cross-sectional correlational study was performed on 229 patients with HF receiving care at the Cardiac Center of King Salman Specialist Hospital from March to June 2024. Data were collected using a structured questionnaire comprising patient demographics, the Minnesota Living with Heart Failure Questionnaire (MLHFQ) to assess QoL, and the General Medication Adherence Scale (GMAS) to measure medication adherence. Results The mean medication adherence score among patients with heart HF was 17.53 ± 6.94. The level of adherence was moderate among most patients (47.2%), high (29.7%), and poor (23.1%). Regarding QoL, the mean total score for overall QoL was 42.16 ± 20.53. Specifically, the mean scores were 15.24 ± 8.65 and 10.53 ± 5.82 for the physical and emotional dimensions of QoL, respectively. More than half of the patients experienced poor QoL, while moderate QoL was observed in 31.9% and good QoL in 17% of patients. Furthermore, there were moderate negative correlations between medication adherence and physical QoL (r= −0.51), emotional QoL (r = −0.59), and overall QoL (r = −0.59), all of which were statistically significant (p <0.001). Conclusion Moderate-to-poor levels of medication adherence and QoL were found among HF patients receiving care in Hail City. Therefore, interventions to improve medication adherence among patients with HF must be prioritized to enhance health outcomes and QoL. It is also crucial to address the factors that negatively influence medication adherence to overcome the barriers that hinder optimal medication adherence.
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