Potential of medical applications to improve medication adherence. A narrative review of its benefits and limitations

• Jesús Tremaria School of Medicine, Universidad del Zulia (LUZ), Maracaibo - Venezuela.
• Diego Soto School of Medicine, Universidad del Zulia (LUZ), Maracaibo - Venezuela.
• Edison Pascal Center for Molecular Biomedicine, Venezuelan Institute for Scientific Research (IVIC), Maracaibo - Venezuela.
• José Luis Arcaya Pharmacology Section. Dr. Américo Negrette” Clinical Research Institute. School of Medicine. University of Zulia (LUZ), Maracaibo - Venezuela.

DOI: https://doi.org/10.5281/10.5281/zenodo.15748813

Keywords: Mobile health, medication adherence, mobile applications, mHealth

Abstract

Adherence to medications is an important factor in the treatment of various diseases, mainly those of
a chronic nature. This is because non-compliance with treatment is associated with worse health outcomes and economic losses for the patient and the health system. There is evidence that implementing mobile applications can moderately improve adherence to medical treatment. However, it is necessary to highlight that the effectiveness of these strategies depends on several important characteristics of the application. For example: Reminders, and medication monitoring. refill reminders, medication information, and adherence functions. The presence of these features can determine the effectiveness of the mobile application in its impact on adherence. However, there are still several limitations in the context of these applications. The economic or technological barriers to user access, as well as the lack of literacy regarding the use of technology, acceptability by beneficiaries, the lack of protection of privacy and information, which compromises patient reliability, and the difficulty of implementing its scaling at a national level. It is necessary to advance in the context of the regulatory framework and promote the development of applications that ensure the privacy, equality, and security of users.

References

Arshed, M., Mahmud, A. B., Minhat, H. S., Ying, L. P., & Umer, M. F. (2023). Effectiveness of mHealth Interventions in Medication Adherence among Patients with Cardiovascular Diseases: A Systematic Review. Diseases (Basel, Switzerland), 11(1), 41.

De León-Casillas, C. E., Bermonti-Pérez, M., & Moreno-Torres, M. A. (2020). Guía metodológica para una Revisión de Literatura Sistemática. Revista Salud y Conducta Humana, 7(1).

Enricho Nkhoma, D., Jenya Soko, C., Joseph Banda, K., Greenfield, D., Li, Y. J., & Iqbal, U. (2021). Impact of DSMES app interventions on medication adherence in type 2 diabetes mellitus: systematic review and meta-analysis. BMJ health & care informatics, 28(1), e100291.

Garmendia, C. M., Miranda, R. M. P., Verello, E., Goyeneche, A., Furmento, J. F., & Costabel, J. P. (2021). Una aplicación digital aumenta la adherencia al tratamiento médico farmacológico en pacientes con síndrome coronario agudo. MEDICINA BUENOS AIRES, Volumen 81, Enero – Febrero No 1

González de León B, León Salas B, Del Pino-Sedeño T, Rodríguez-Álvarez C, Bejarano-Quisoboni D, Trujillo-Martín MM. (2021). Aplicaciones móviles para mejorar la adherencia a la medicación: revisión y análisis de calidad. Aten Primaria 2021 (9):102095. Spanish. doi: 10.1016/j.aprim.2021.102095. PMID: 34139398; PMCID: PMC8213909.

Greer, J. A., Jacobs, J. M., Pensak, N., Nisotel, L. E., Fishbein, J. N., MacDonald, J. J., Ream, M. E., Walsh, E. A., Buzaglo, J., Muzikansky, A., Lennes, I. T., Safren, S. A., Pirl, W. F., & Temel, J. S. (2020). Randomized Trial of a Smartphone Mobile
App to Improve Symptoms and Adherence to Oral Therapy for Cancer. Journal of the National Comprehensive Cancer Network: JNCCN, 18(2), 133–141. https://doi.org/10.6004/jnccn.2019.7354

Higgins J. & Green S (Eds.). (2008). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. The Cochrane Collaboration.

Jhossmar, C., Jose A., Oscar A., Sara M., Carlos S., Blas A., (2022). mHealth en los sistemas de salud: barreras para la implementación. Health Leadership and Quality of Life, 1, 7

Kleinman NJ, Shah A, Shah S, Phatak S, Viswanathan V. (2017) Improved medication adherence and frequency of blood glucose self-testingusing an m-health platform versus usual care in a multisite randomized clini cal trial among people with type 2 diabetes in India. Telemed J E Health. 2017;23(9):733-40.

Liu Y, Chen J, Lamb KV, Wu P, Chang P, Cui Y, et al. (2019) Aplicación de autoempoderamiento para teléfonos inteligentes para la prevención secundaria de pacientes con enfermedades cardiovasculares. Stud Health Technol Inform 2019;264:1712-1713.

Maaß, L., Freye, M., Pan, C. C., Dassow, H. H., Niess, J., & Jahnel, T. (2022). The Definitions of Health Apps and Medical Apps From the Perspective of Public Health and Law: Qualitative Analysis of an Interdisciplinary Literature Overview. JMIR mHealth and uHealth, 10(10), e37980.

Márquez-Contreras E, Márquez-Rivero S, Rodríguez-García E, et al. (2019) Specific hypertension smartphone app to improve medication adherence in hypertension: a cluster-randomized trial. Curr Med Res Opin. 2019;35(1):167-73.

Martínez, S., & Sánchez, J. (2024). Eficacia de las aplicaciones móviles en la adherencia y control de pacientes hipertensos. Garnata, 91, e2708gt

Peng, Y., Wang, H., Fang, Q., Xie, L., Shu, L., Sun, W., & Liu, Q. (2020). Effectiveness of Mobile Applications on Medication Adherence in Adults with Chronic Diseases: A Systematic Review and Meta-Analysis. Journal of managed care & specialty pharmacy, 26(4), 550–561.

Pérez-Jover, V., Sala-González, M., Guilabert, M., & Mira, J. J. (2019). Mobile Apps for Increasing Treatment Adherence: Systematic Review. Journal of medical Internet research, 21(6), e12505.

Steinkamp, J. M., Goldblatt, N., Borodovsky, J. T., LaVertu, A., Kronish, I. M., Marsch, L. A., & Schuman-Olivier, Z. (2019). Technological Interventions for Medication Adherence in Adult Mental Health and Substance Use Disorders: A Systematic Review. JMIR mental health, 6(3), e12493.

Shreya S., Katherine G., John M., Rebecca G., (2022). Evaluation of mHealth Apps for Diverse, Low-Income Patient Populations: Framework Development and Application Study. Journal of Medical Internet Research, 6, 2.

Tran S, Smith L, El-Den S, Carter S. (2022) The Use of Gamification and Incentives in Mobile Health Apps to Improve Medication Adherence: Scoping Review. JMIR Mhealth Uhealth. 2022 Feb 21;10(2):e30671. doi: 10.2196/30671. PMID:
35188475; PMCID: PMC8902658.

Zhao N., Bei W., Qing Y., Lijing Y., Changqing L., Ryan J., (2022). An mHealth Intervention to Improve Medication Adherence and Health Outcomes Among Patients With Coronary Heart Disease: Randomized Controlled Trial. Journal of Medical Internet Research, 24, 3