Assessing Parents’ Needs in Using Phone Applications to Improve Medication Adherence in an Outpatient Pediatric Oncology Clinic

Abstract

Background: Poor adherence in pediatric oncology leads to significant morbidity and mortality. Currently used medication reminder aids have shown little to no benefit in improving adherence. Phone applications (apps) have demonstrated improved adherence in recent studies involving the adult and pediatric patients. At this time, no pediatric oncology center is recommending a particular phone app. Objective: The objective of this study was to determine the proportion of parents of pediatric oncology patients interested in using a phone app for medication reminders and desired features. Methods: In this single-center observational trial, 45 questionnaires were completed by parents accompanying their child at a pediatric oncology center. See Supplemental Digital Content 1 (http://links.lww.com/JPHO/A327) for a copy of the questionnaire. Participants had a child on active cancer treatment and were able to read and write English. Primary outcomes included a number of parents currently using a phone app, the number of parents interested in using a phone app, main reasons for not using a phone app and desired phone app features. Results: Overall, 95.6% of parents had never used a phone app to aid in medication adherence. Over 85% of these parents were highly interested in using a phone app, but most were not aware of available phone apps to use (57.1%). Desired features included: refill notifications, tracking doses administered, personalizable medication schedule, free of charge, no advertisements, ability to input special instructions, use on multiple devices, unique alarms, tracking child’s results, and privacy protection. Conclusions: A majority of parents at an outpatient pediatric oncology clinic were interested in using a phone app to assist in medication adherence but were unaware of an available phone app. An ideal criteria list was created with 10 desired features to evaluate available phone apps that may be recommended for this population. Further studies are needed to evaluate if phone apps recommended by this tool improve adherence.

An Evaluation of Interactive mHealth Applications for Adults Living with Cancer

“…The authors contacted the developers of three known apps requiring an institutional log in, but access was not granted for this evaluation. Apps that required payment to access any (rather than only some) of their content were excluded, as payment is a barrier to access [ 25 , 38 , 39 ]. Potentially, apps requiring payment might be of a higher quality and/or usefulness.…”

“…The apps of interest were those that patients would be likely to identify themselves. Therefore, the focus was on apps that were free of charge (as payment is a barrier to patients using an app) [ 25 , 38 , 39 ], did not require an institutional login (anyone could access the app or login easily obtained upon request), were designed specifically for adults with cancer, were available in either English or French, were updated within two years of the search, provided information that was generally applicable across clinical settings and cancer types, referenced coping with illness, included at least one interactive feature in which the user inputted information and the app tailored its content accordingly, and were available in both the Apple and Google play stores. As both Apple for IOS devices and Google play for Android devices are used by a large share of the market [ 40 ], the aim was to ensure the apps retained would be accessible to most users.…”

Mobile medical applications’ state quo and underlying barriers: review of literature†

“…However, on average 80% of users' education level is below middle school. 33 (3) Acceptance and study of technology: owing to users' average age being over 70 years, applying smart phone and applications may be a little difficult for them, and it is also difficult for them to adopt and use it frequently like the younger generation. 34 (4) Rural districts and low-income countries: although the popular coverage of 4G technology increased from 75% to 95% recently, it is still limited in rural areas and remote regions.…”