Analysis of Apps With a Medication List Functionality for Older Adults With Heart Failure Using the Mobile App Rating Scale and the IMS Institute for Healthcare Informatics Functionality Score: Evaluation Study

Abstract

Background Managing the care of older adults with heart failure (HF) largely centers on medication management. Because of frequent medication or dosing changes, an app that supports these older adults in keeping an up-to-date list of medications could be advantageous. During the COVID-19 pandemic, HF outpatient consultations are taking place virtually or by telephone. An app with the capability to share a patient’s medication list with health care professionals before consultation could support clinical efficiency, for example, by reducing consultation time. However, the influence of apps on maintaining an up-to-date medication history for older adults with HF in Ireland remains largely unexplored. Objective The aims of this review are twofold: to review apps with a medication list functionality and to assess the quality of the apps included in the review using the Mobile App Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality scale. Methods A systematic search of apps was conducted in June 2019 using the Google Play Store and iTunes App Store. The MARS was used independently by 4 researchers to assess the quality of the apps using an Android phone and an iPad. Apps were also evaluated using the IMS Institute for Healthcare Informatics functionality score. Results Google Play and iTunes App store searches identified 483 potential apps (292 from Google Play and 191 from iTunes App stores). A total of 6 apps (3 across both stores) met the inclusion criteria. Of the 6 apps, 4 achieved an acceptable MARS score (3/5). The Medisafe app had the highest overall MARS score (4/5), and the Medication List & Medical Records app had the lowest overall score (2.5/5). On average, the apps had 8 functions based on the IMS functionality criteria (range 5-11). A total of 2 apps achieved the maximum score for number of features (11 features) according to the IMS Institute for Healthcare Informatics functionality score, and 2 scored the lowest (5 features). Peer-reviewed publications were identified for 3 of the apps. Conclusions The quality of current apps with medication list functionality varies according to their technical aspects. Most of the apps reviewed have an acceptable MARS objective quality (ie, the overall quality of an app). However, subjective quality (ie, satisfaction with the apps) was poor. Only 3 apps are based on scientific evidence and have been tested previously. A total of 2 apps featured all the IMS Institute for Healthcare Informatics functionalities, and half did not provide clear instructions on how to enter medication data, did not display vital parameter data in an easy-to-understand format, and did not guide users on how or when to take their medication.

Evaluating and rating HIV/AIDS mobile apps using the feature-based application rating method and mobile app rating scale

“…This tool is based on seven functionality criteria and four functional subcategories detailed in the report of the IQVIA Institute for Healthcare Informatics [ 21 , 45 ]. In some previous studies [ 26 , 43 , 45 ], this tool was used along with the MARS tool to rate mobile health app features. The IQVIA functionality score focuses on the availability of the 11 previously determined functionalities, and finally, each mobile app gives a score between 0 and 11.…”

Prevalence and correlates of medication reminder app ‘use and use intention’ among older adults

“…A review on apps with a medication list functionality reported that some apps had a poor interface and did not provide sufficient instructions on how to record medication-taking histories and set medication reminders. 27 Polypharmacy may exacerbate such issues, which could possibly explain why it was found to be associated with a lower likelihood of app use and use intention in our study. Second, most medication reminder apps use English as the default or only language.…”

“…We suggest three possible reasons for the low prevalence of medication reminder app use and use intention. First, studies have found that such apps have complex interfaces, and user-unfriendly and dense usage instructions, 27 , 28 which may make app sign-up and navigation difficult for older adults with lower educational attainment. A review on apps with a medication list functionality reported that some apps had a poor interface and did not provide sufficient instructions on how to record medication-taking histories and set medication reminders.…”

“…Second, most medication reminder apps use English as the default or only language. 27 , 29. , 30 , 31 Singapore has four official languages (English, Chinese, Malay and Tamil); yet 44% of Singaporeans aged 65–74 years, 66% of those aged 75–84 years, and 80% of those aged 85 years and older are not literate in English.…”

Mobile Health Apps Providing Information on Drugs for Adult Emergency Care: Systematic Search on App Stores and Content Analysis

“…The authors distinguished among apps for patients, apps for health professionals, and apps that can be used by both groups. Recent studies on patient-focused drug apps have analyzed those that help patients understand and take their medications or those with a medication list function [ 28 , 29 ]. In addition, apps for treatment adherence have been the subject of intensive research [ 30 - 35 ].…”