Mobile App Interventions to Improve Medication Adherence Among Type 2 Diabetes Mellitus Patients: A Systematic Review of Clinical Trials

Abstract

Background: Medication adherence in type 2 diabetes mellitus (T2DM) patients is often suboptimal resulting in complications. There has been a growing interest in using mobile apps for improving medication adherence. Objective: The objective of this work was to systematically review the clinical trials that have used mobile app–based interventions in T2DM patients for improving medication adherence. Methodology: A systematic search was performed to identify published clinical trials between January 2008 and December 2020 in databases—PubMed, Cochrane Library, and Google Scholar. All studies were assessed for risk of bias using quality rating tool from the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seven clinical studies having 649 participants were studied. The median sample size was 58 (range = 41-247) and the median age of participants was 53.2 (range = 48-69.4) years. All studies showed improvements in adherence; however, only three studies reported statically significant improvements in adherence measures. Selected studies were deemed as unclear in their risk of bias and the most common source of risk of bias among the studies was the absence of objective outcome assessment. Conclusions: Mobile apps appear to be effective interventions to help improve medication adherence in T2DM patients compared with conventional care strategies. The features of the App to improvise medical adherence cannot be defined based on the meta-analysis because of heterogeneity of study designs and less number of sample size. Systematically planned studies would set up applicability of mobile apps in the clinical management of T2DM.

A framework for understanding sources of bias in medication adherence research

“…A summary of the included reports and the biases extracted from each is presented in Table S2. Of the 42 reports, 17 were systematic reviews examining the effects of clinical interventions on adherence 10,16–31 . These reports included a risk of bias assessment using either the Cochrane Risk of Bias tool 32 or the Newcastle–Ottawa tool 22 .…”

“…Of the 42 reports, 17 were systematic reviews examining the effects of clinical interventions on adherence. 10,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] These reports included a risk of bias assessment using either the Cochrane Risk of Bias tool 32 or the Newcastle-Ottawa tool. 22 One report assessed the methodological T A B L E 2 Biases mapped to common adherence measures and the phases of adherence (initiation, implementation and discontinuation).…”

Wearable Sensors in Other Medical Domains with Application Potential for Orthopedic Trauma Surgery—A Narrative Review

“…Another challenge is medication adherence among patients discharged from the hospital, estimated to be only 55–70% [ 80 ]. On a basic level, apps on smartphones can be programmed to remind patients to take their medications, improving adherence [ 81 , 82 , 83 ]. This is also true for medication adherence in cardiovascular disease, which represents the leading cause of death worldwide [ 82 , 84 ].…”

Machine Learning and Smart Devices for Diabetes Management: Systematic Review

“…Mobile app interventions to improve medication adherence among type 2 diabetes mellitus patients: a systematic review of clinical trials [22] 2021 -Presents only the management of diabetes using mobile applications.…”