Patient-Centered Tablet Application for Improving Medication Adherence after a Drug-Eluting Stent

Abstract

Background/aimsThis study’s objective was to evaluate a patient-centered educational electronic tablet application, “My Interventional Drug-Eluting Stent Educational App” (MyIDEA) to see if there was an increase in patient knowledge about dual antiplatelet therapy (DAPT) and medication possession ratio (MPR) compared to treatment as usual.MethodsIn a pilot project, 24 elderly (≥50 years old) research participants were recruited after a drug-eluting stent. Eleven were randomized to the control arm and 13 to the interventional arm. All the participants completed psychological and knowledge questionnaires. Adherence was assessed through MPR, which was calculated at 3 months for all participants who were scheduled for second and third follow-up visits.ResultsRelative to control, the interventional group had a 10% average increase in MPR. As compared to the interventional group, more patients in the control group had poor adherence (<80% MPR). The psychological data revealed a single imbalance in anxiety between the control and interventional groups. On average, interventional participants spent 21 min using MyIDEA.DiscussionConsumer health informatics has enabled us to engage patients with their health data using novel methods. Consumer health technology needs to focus more on patient knowledge and engagement to improve long-term health. MyIDEA takes a unique approach in targeting DAPT from the onset.ConclusionMyIDEA leverages patient-centered information with clinical care and the electronic health record highlighting the patients’ role as a team member in their own health care. The patients think critically about adverse events and how to solve issues before leaving the hospital.

Do mobile device apps designed to support medication adherence demonstrate efficacy? A systematic review of randomised controlled trials, with meta-analysis

“…We considered 83 of these to be eligible and retrieved the full-text articles. Of these, nine studies reported outcome data eligible for meta-analysis 12 13 15 16 22–26. The screening process and reasons for exclusion are reported in figure 1.…”

“…Health problems of the target population varied between studies. Five studies sampled a patient population with cardiovascular disease,12 13 16 23 26 and each of the remaining four studies enrolled patient populations with different health problems: depression,22 Parkinson’s disease,24 psoriasis15 and multimorbidity 25…”

“…Of the nine studies, four measured adherence using the eight-item Morisky Medication Adherence Scale,24 26 27 with one of these also measuring adherence through a medication possession ratio (see online supplementary material). 13 For this study, the Morisky Medication Adherence Scale data were extracted for the meta-analysis as these were most comparable with the data available for other studies. A further study measured adherence using the four-item Morisky Medication Adherence Scale 25.…”

“…Meta-analysis was performed, pooling results from the nine eligible studies which reported data on 988 participants, to estimate the effect of mobile apps in improving medication adherence 12 13 15 16 22–26. The results of this meta-analysis indicated that patients who participated in medication adherence interventions delivered by mobile apps were more likely to adhere to prescribed medications (OR 2.120, 95% CI 1.635 to 2.747) than those who did not use such interventions.…”

“…A comparator group which received usual care, a control condition which did not use an app12 or a control app which did not include any BCTs (eg, an app that was a non-health-related game13).…”