JMIR Publications

ABSTRACT

Background:

Integrating ehealth into medication prescription, dispensing and administration processes is a promising direction towards achieving better medication safety, treatment and health outcomes.

Objective:

To assess evidence on whether ehealth can improve drug compliance and health outcomes through self-administration of medication in non-hospital settings.

Methods:

We searched randomized controlled trials (RCTs) from PubMed, MEDLINE, CINAHL, Embase, Emcare, ProQuest, Scopus, Web of Science, ScienceDirect, and IEEE Xplore, in addition to other published sources between 2000 to 2018. We evaluated the studies against primary outcome measures of medication adherence and multiple secondary healthcare outcome measures relating to adverse events, quality of life, patient satisfaction and health expenditure. Subgroup comparison was performed and the quality of the included studies was assessed using the Cochrane Collaboration’s Risk of Bias tool.

Results:

Twenty-four studies met the selection criteria and they were all designed for patient home-based care application. Fifteen studies reported an outcome measure of medication adherence and of these 13 indicated improvement of medication adherence at a significant level p < 0.1. The top three associated functions including: mechanisms to communicate with care givers, monitoring health features, and reminders and alerts. Multi-functional intervention was a more commonly adopted model for designing ehealth for self-medication management. The overall quality of the included studies were rated as moderate.

Conclusions:

A mechanism to communicate with care givers was the common function offered by all the ehealth interventions. Integrating multiple functions into the ehealth design tended to be more effective in achieving an enhanced medication adherence level. A targeted study population, such as older patients, should be considered to maximize the public health impact on the self-management of diseases. Clinical Trial: PROSPERO registry number: CRD42018096627.