How Can Innovative Uses of Technology be Harnessed to Improve Medication Adherence?

Hayden B Bosworth

Disclosures

Expert Rev Pharmacoeconomics Outcomes Res. 2012;12(2):133-135. 

In This Article

mHealth Devices & Medication Adherence

mHealth is the use of mobile technology as a healthcare delivery method. mHealth is unique, in that it uses a ubiquitous technology, mobile phones, and is utilized even among underserved populations. In the USA, more than 87% of the population uses a mobile phone.[6] There are over 285 million wireless subscribers in the USA alone.[101]

mHealth has distinct advantages: it reaches across geographic boundaries; can be delivered directly to people; is inexpensive; and is easy to use. This affords an easily disseminated model of care that is cost effective. The use of mHealth interventions has the capacity to interact with the individual with much greater frequency, and in the context of the behavior, at a convenient time for the patient. The use of mHealth provides the potential to also deliver health behavior interventions tailored to a person's baseline characteristics, such as disease, demographic, as well as frequently changing behaviors and environmental contexts.[7]

In a recent review, ten studies were identified that evaluated the use of mobile technology to improve treatment adherence.[8] Of these, only two addressed medication adherence but focused on HIV treatment adherence. Specifically for hypertension, a review of randomized clinical trials showed that reminder systems, apart from mailed postcard reminders, improved patient adherence in most studies.[9] Given the substantial use of technology for measuring medication adherence[10] and the availability of smart pillboxes for improving adherence,[11] it is surprising that more work has not been published examining the impact of mHealth on medication adherence. Perhaps, while there are increasing developments of this technology, much of this work is not being published or disseminated in peer-reviewed clinical journals.

In a systematic review of text messaging as an intervention for disease prevention and management, focused more globally than just medication adherence, the majority of studies found evidence for short-term effects on behavior changes or clinical outcomes related to disease prevention and management, such as smoking cessation, self-monitoring of blood glucose levels, weight loss and decrease in hemoglobin A1C.[12]

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