Abstract
Adherence to prescribed medication is suboptimal in 50% of the chronic population, resulting in negative medical and economic outcomes. With the widespread use of mobile phones worldwide, medication adherence apps for mobile phones become promising medication adherence aids thanks to simplicity, user-friendliness, and accessibility for the public. Yet, until today, there is insufficient evidence in favor of using mobile health (mHealth) apps to increase medication adherence. This study aims to develop a methodology for scientific and end-user (patient) mHealth evaluation (a) to identify medication adherence apps search terms, (b) to evaluate identified apps based on scientific criteria, and (c) to report best smartphone apps evaluated by patients. Search terms were identified via literature review and expertise. Firstly, an online questionnaire was developed to identify frequently used search terms by recruited patients. Related medication adherence apps were identified and selected using predefined inclusion criteria. Secondly, identified apps were evaluated thanks to a scientific evaluation method and a created online questionnaire for patient feedback. Recruited patients were invited to test and evaluate the selected apps. Out of 1,833 free-of-charge and 307 paid apps identified, only four free-of-charge and three paid apps remained included in the study after eligibility criteria. None of the selected app reached a high score. Looking at the overall scores, Medisafe (59%), MyTherapy (56%), and Meds on time (44%) received the highest scores in the scientific app evaluation. In the patient evaluation, Dosecast (3.83 out of five points), Medisafe (3.62), and SwissMeds (3.50) received the highest scores. None of the apps in this research has undergone a process for certification, for example, CE marking, through a notified body. Security and data protection aspects of existing apps highly contribute to these low evaluation scores through little information on patient's data processing and storage. This might be corrected through the introduction of General Data Protection Regulation (GDPR) in the European Economic Area (EEA) and more scrutiny through regulatory bodies in the EU/EEA and the USA. None of the applications should be recommended by healthcare providers. In addition, clinical studies with chronic patients are necessary to measure long-term app impacts.
Highlights
Medication adherence is highly associated with healthcare clinical outcomes such as treatment effectiveness, medical visits, hospitalization, and morbidity and mortality rates
The World Health Organization (WHO) reports 50% of the population being non-adherent, resulting in negative medical and economic outcomes
This study aims to propose a novel methodology enabling (a) to identify search terms and smartphone applications for medication adherence of chronic diseases, (b) to evaluate identified apps and establish a ranking based on scientific criteria, and (c) to report the best smartphone applications evaluated by patients
Summary
Medication adherence is highly associated with healthcare clinical outcomes such as treatment effectiveness, medical visits, hospitalization, and morbidity and mortality rates. This is especially true when it comes to chronic disease treatments [1,2,3,4]. The World Health Organization (WHO) reports 50% of the population being non-adherent, resulting in negative medical and economic outcomes. This percentage is reportedly increasing in parallel with the rise in the prevalence of chronic diseases worldwide [6,7,8,9]. To improve patients’ long-term adequate drug management, healthcare providers need to partner with patients to define clear treatment objectives and to reinforce patients’ autonomous and active role in adhering to their treatment plans
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