Smartphone Medication Adherence Apps

Looking to recommend some mobile apps for your patients? The Journal of the American Pharmacists Association has an article titled, "Smartphone medication adherence apps: Potential benefits to patients and providers."

Here are some brief snippets from the abstract:

Practice innovation:  Using smartphone adherence apps represents a novel approach to improving adherence. This readily available technology offers many features that can be designed to help patients and health care providers improve medication-taking behavior.

Results:  160 adherence apps were identified and ranked. These apps were most prevalent for the Android OS. Adherence apps with advanced functionality were more prevalent on the Apple iPhone OS. Among all apps, MyMedSchedule, MyMeds, and RxmindMe rated the highest because of their basic medication reminder features coupled with their enhanced levels of functionality.

J Am Pharm Assoc. 2013;53(2):172-181.

MedSnap

What if your patients could identify their prescription medications with a snap of a mobile phone camera?

MedSnap ID is a subscription-based service that uses the built-in camera on your mobile device, MedSnap's proprietary visual-identification technology and a precision imaging surface to visually recognize prescription medications. MedSnap instantly lists each pill or capsule, describing it by name and strength.

Here's a short video describing how this works:

How mobile technology can improve patient adherence to medications

I invite you to join me in this series of CME activities: "Medication Adherence: The Evolving Role of Technology"

• Video Roundtable 2: Mobile Health and Digital Communication to Improve Medication Adherence

Medication adherence remains a persistent and pertinent issue in health care. Nonadherence poses challenges to adequate control of the target condition and often leads to further unnecessary complications. Many of the latest practice management and communication technologies afford clinicians the opportunity improve patient medication adherence.

This online series will focus on:

• How EHR tools and functions can improve medication adherence
• How to use mobile and digital communication to promote medication adherence
• How social media can help you communicate and work with your patient population

Learn how mHealth can improve medication adherence

I invite you to join me in this series of CME activities: "Medication Adherence: The Evolving Role of Technology"

• Video Roundtable 1: Electronic Health Records to Improve Medication Adherence
• Video Roundtable 2: Mobile Health and Digital Communication to Improve Medication Adherence
• Video Roundtable 3: Social Media to Improve Medication Adherence

Medication adherence remains a persistent and pertinent issue in health care. Nonadherence poses challenges to adequate control of the target condition and often leads to further unnecessary complications. Many of the latest practice management and communication technologies afford clinicians the opportunity improve patient medication adherence.

This online series will focus on:

• How EHR tools and functions can improve medication adherence
• How to use mobile and digital communication to promote medication adherence
• How social media can help you communicate and work with your patient population

Mobile Health and Digital Communication to Improve Medication Adherence

I invite you to join me in this series of CME activities: "Medication Adherence: The Evolving Role of Technology"

• Video Roundtable 1: Electronic Health Records to Improve Medication Adherence
• Video Roundtable 2: Mobile Health and Digital Communication to Improve Medication Adherence
• Video Roundtable 3: Social Media to Improve Medication Adherence

Medication adherence remains a persistent and pertinent issue in health care. Nonadherence poses challenges to adequate control of the target condition and often leads to further unnecessary complications. Many of the latest practice management and communication technologies afford clinicians the opportunity improve patient medication adherence.

This online series will focus on:

• How EHR tools and functions can improve medication adherence
• How to use mobile and digital communication to promote medication adherence
• How social media can help you communicate and work with your patient population

We're also having a discussion on Sermo about the topic of "Medication Adherence and The Evolving Role of Technology." If you're a physician, please join us in that online discussion.

SMS (text messages) and medication adherence in HIV

A few weeks ago, The Lancet published an article titled, "Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial." In summary, the investigators wanted to know whether SMS intervention would improve adherence to antiretroviral therapy (ART) in HIV patients living in Kenya. What was the outcome?

Patients who received SMS support had significantly improved ART adherence and rates of viral suppression compared with the control individuals. Adherence to ART was reported in 168 of 273 patients receiving the SMS intervention compared with 132 of 265 in the control group. Suppressed viral loads were reported in 156 of 273 patients in the SMS group and 128 of 265 in the control group.

It seem like mobile health initiatives will be more fruitful in developing nations. Here in the United States, we're flooded with too much information. A text message can easily get lost in the shuffle of a busy day. However, if you're living in Kenya, that single text message could be a life-saving reminder.

Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial
Dr Richard T Lester MD,Paul Ritvo PhD,Edward J Mills PhD,Antony Kariri BSc,Sarah Karanja BSc,Michael H Chung MD,William Jack DPhil,James Habyarimana PhD,Mohsen Sadatsafavi MD,Mehdi Najafzadeh MSc,Carlo A Marra PharmD,Benson Estambale MBChB,Elizabeth Ngugi PhD,T Blake Ball PhD,Lehana Thabane PhD,Lawrence J Gelmon MD,Joshua Kimani MBChB,Marta Ackers MD,Prof Francis A Plummer MD
The Lancet - 10 November 2010
DOI: 10.1016/S0140-6736(10)61997-6

Text Messages as a Reminder Aid and Educational Tool in Adults and Adolescents with Atopic Dermatitis: A Pilot Study

There's a study that was recently published titled, "Text Messages as a Reminder Aid and Educational Tool in Adults and Adolescents with Atopic Dermatitis: A Pilot Study." The authors found that texting (SMS) is an effective reminder aid and educational tool. Given that this was a pilot study, the findings needs to be confirmed with additional studies.

Here's the abstract:

Optimal management of atopic dermatitis (AD) requires patients to adhere to self-care behaviors. Technologies, such as cell phones, have been widely adopted in the USA and have potential to reinforce positive health behaviors. We conducted a pilot study with 25 adolescents and adults age 14 years and older [mean 30.5 yrs, SD 13.4] with AD. Daily text messages (TMs) that provided medication reminders and AD education were sent for six weeks to participants. Our goals were to (1) measure changes in pre- and posttest scores in treatment adherence, self-care behaviors, disease severity, and quality of life and (2) assess the usability and satisfaction of the TM system. Significant improvements in treatment adherence, self-care behaviors, skin severity, and quality of life (P ≤ .001, .002, <.001, and .014, resp.) were noted postintervention. User feedback on the TM system was positive with 88% and 92% of participants reporting that the reminder TMs and educational TMs were helpful, respectively. In conclusion, study participants were receptive to using TMs as a reminder aid and educational tool. The positive trends observed are promising and lay the ground work for further studies needed to elucidate the full potential of this simple and cost-effective intervention.

Venessa Pena-Robichaux, Joseph C. Kvedar, and Alice J. Watson, “Text Messages as a Reminder Aid and Educational Tool in Adults and Adolescents with Atopic Dermatitis: A Pilot Study,” Dermatology Research and Practice, vol. 2010, Article ID 894258, 6 pages, 2010. doi:10.1155/2010/894258

You can read the article here.

How to Address Patient Medication Adherence With Text Messages (SMS)

You can listen to my short ReachMD Mobile Medical Minute commentary about patient medication adherence and SMS (text messages).

Can something as simple as a text message help solve a complicated problem like medication adherence?

Click here to listen to the ReachMD recording (ReachMD registration required).

Using SMS to remind heart transplant patients to take their meds

According to this story on MobiHealthNews, the Pediatric Heart Transplant Program at NewYork-Presbyterian/Morgan Stanley Children’s Hospital is using CareSpeak Communications to boost medication adherence in teenage patients who undergo a heart transplant. Medication adherence in critical in this population because you can't afford to risk organ rejection by missing doses of your meds.

These SMS reminders aren't simple one-way reminders. Patients will need to reply back, indicating that they've taken their pills. If they don't reply, then text messages will get sent to family members who will make sure that their teen takes the pills.

CareSpeak Communications develops wireless communications technologies for the institutional and consumer healthcare markets. Our main goal is to ensure that our products / services are efficacious, easy to use and affordable for the end user whether it is a patient, caregiver and/or health care professional.

Here's a video that shows you CareSpeak in action:

Daily SMS did not improve adherence to oral contraceptive pills

You'd think that daily SMS (text messages) would improve adherence to pills, right? After all, many patients miss doses because they forget. So what happens if you randomize 82 women to either receive a daily SMS reminder or no SMS reminder?

Here's what the authors found:

METHODS: This randomized controlled trial estimated whether there was an effect of daily text-message reminders on oral contraceptive pill adherence of new oral contraceptive pill users. Pill-taking was tracked for 3 months by an electronic monitoring device with wireless data collection. During the study period, participants assigned the intervention received a daily reminder text message. Eighty-two women were assigned randomly to detect a 1.6±2.0 pill difference (90% power, 5% α, 15% dropout).

RESULTS: Participants were 79% white, non-Hispanic, 99% high school graduates, and 99% nulliparous with a mean age of 22 years. Most reported condom use with past coital activity, and more than half reported prior emergency contraception use. The mean number of missed pills per cycle did not differ significantly between the groups: 4.9±3.0 for the text-message group and 4.6±3.5 for the control group (P=.60). The number of missed pills per cycle increased over the course of the study, but this pattern did not increase differentially between the groups. Adherence recorded by the electronic monitoring device indicated much poorer adherence than that recorded by patient diaries. Despite poor pill-taking, there were no pregnancies.

CONCLUSION: Daily text-message reminders did not improve oral contraceptive pill adherence. Although the lack of benefit may be attributed to the frequent use of alternative reminder systems in the control group, the rate of missed pills when measured objectively was still very high in both groups.

Using Daily Text-Message Reminders to Improve Adherence With Oral Contraceptives: A Randomized Controlled Trial

Obstetrics & Gynecology: September 2010 - Volume 116 - Issue 3 - pp 633-640
Hou, Melody Y. MD, MPH; Hurwitz, Shelley PhD; Kavanagh, Erin MPP; Fortin, Jennifer MPH; Goldberg, Alisa B. MD, MPH

Click here to read the abstract.

Are you surprised by the results? I don't think SMS will be effective unless people are already using SMS on a regular basis. You could also build a feedback system so that the patient continues to receive an SMS reminder until the patient replies back indicating that he/she has taken the medication.