JMIR Publications

ABSTRACT

Background:

Educating patients is a crucial element in healthcare. It is a known predictor for increased engagement in shared decision making, improved medication and treatment adherence, higher levels of satisfaction and even better treatment outcomes. Unfortunately, patients’ memory for medical information is often very limited. An important reason is that most patients are simply not capable of processing large amounts of new, medical information in a short time. Apps for smartphones and tablets have the potential to actively educate patients by providing them with timely information through the use of push notifications.

Objective:

The objective of this systematic review is to provide an overview of the effects of using smartphones and tablet apps to educate patients with timely education. We assess the effects on knowledge, medication and treatment adherence, satisfaction, health care economics and clinical outcomes.

Methods:

A comprehensive search of MEDLINE, EMBASE, CINAHL and Web of Science was conducted. Randomized Controlled Trials (RCTs) published between January 2014 and November 2019 were eligible for inclusion. Two reviewers independently searched, screened, and assessed the study quality, risk of bias and extracted the data. Due to the heterogeneity of populations, interventions and outcomes a meta-analysis was not deemed appropriate. Instead, a narrative synthesis is presented.

Results:

A total of 21 RCTs with 4106 participants were included. Compared to usual care, overall effectiveness of the interventions was demonstrated in 69% of the outcomes. Effectiveness increased to 82% when the intervention had a duration shorter than one month and to 78% when the intervention provided at least one push-notification per week. The interventions showed the highest effect on satisfaction with information, adherence with instructions and medication usage, clinical outcomes and knowledge.

Conclusions:

This review demonstrates that educating patients with timely medical information through their smartphone or tablet has a positive effect on multiple outcomes, ranging from knowledge and satisfaction to adherence and clinical outcomes. The effects are most pronounced in interventions with a relatively short duration (less than a month) and with a high frequency of messaging patients (at least once per week). Knowing patient education is a predictor for improved outcomes and the fact patients are merely capable of processing large amounts of new, medical information, our results suggest offering timely information through smartphones and tablets in current medical practices.