Special FeatureSmartphone medication adherence apps: Potential benefits to patients and providers
Section snippets
Epidemiology of nonadherence
According to the International Society for Pharmacoeconomics and Outcome Research (ISPOR), adherence is “the extent to which a patient acts in accordance with the prescribed interval, and dose of a dosing regimen.”1 Medication nonadherence can affect patient health adversely, negatively impact a patient's relationship with his/her care provider, skew results of clinical therapy trials, and increase health resource consumption.2,3 Medication nonadherence remains a common health care problem.
Methods to improve medication adherence
Many methods to improve medication adherence have been studied. Most methods attempt to change patient behavior by using reminders, counseling, reinforcement, education, dosage simplification, or a combination of these methods.21,22 Generally, adherence interventions are categorized as behavioral, educational, or organizational based on modifying the patient's environment or incentives, providing more information, or lifting barriers associated with medication complexity and communication with
Currently available mobile app adherence technologies
Currently, a resource does not exist that compares the features of available apps. To develop such a resource, we searched the available medication adherence–oriented apps, provider websites, and app sources for Apple iTunes, Android Marketplace, and BlackBerry App World during August and September of 2012, which reflects a snapshot of the app market space for that time period. Search terms included adherence, compliance, dose, drug, med(s), medication(s), remind, reminder, Rx, take, therapy,
Implications for pharmacy practice and future directions
There has been a proliferation of consumer- rather than clinician-oriented adherence apps. We evaluated more than 160 apps and suspect that many more will be available in the foreseeable future, until the market consolidates to the apps that garner a substantial market share and support a viable business model. As previously stated, currently no evidence exists regarding the efficacy or effectiveness of apps at actually improving adherence or clinically relevant outcomes. This lack of data
Conclusion
Despite decades of research, medication nonadherence still represents a fundamental health care challenge. Adherence apps are inexpensive, scalable, accessible to anyone with smartphones, and do not require separate devices or packaging, which allows them to be easily implemented. Despite not being tested in trial settings, they could be considered a possible strategy for pharmacists to recommend to nonadherent patients and to incorporate into their practice. Although none of the evaluated apps
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Disclosure: The authors declare no conflicts of interest or financial interests in any product or service mentioned in this article, including grants, employment, gifts, stock holdings, or honoraria.
Funding: Dr. Martin's work was partly supported by the Translational Research Institute, University of Arkansas for Medical Sciences (grant 1UL1RR029884).