JMIR Publications

ABSTRACT

Background:

Medication non-adherence is a significant barrier to therapy success. Smartphone applications (apps) represent reasonable tools for simple adherence enhancing interventions. While the benefits of reminder functions on adherence have been extensively investigated by recent research, little is known about educational and behavioral strategies of adherence apps. We define “output of an adherence app” as the processing and visualization of data recorded by the app user and related to adherence. In 2016, Santo et al. defined five desirable features in the output of adherence apps: Tracking History, Charts, Statistics, Rewards and an Exportable File. Identifying and fulfilling users’ needs are essential when developing an adherence app for patients’ self-management and professional adherence services such as therapy support provided by healthcare professionals (HCP). Our research question is: To what extent do freely available medication adherence apps deliver outputs that match user’s needs.

Objective:

We aimed to investigate the Smartphone app market regarding desirable features in the outputs, explore the users’ needs and evaluate the concordance.

Methods:

We searched for Smartphone adherence apps in the two largest commercial app repositories. Search results were screened for eligibility by applying inclusion and exclusion criteria. Eligible apps were tested regarding desirable features in their output according to Santo et al. We conducted two focus groups and one online survey to explore users’ needs. Participants rated their desire for features on a 7-point Likert scale. Focus groups were analyzed using the framework method by Gale et al. Descriptive statistics were calculated by median or mean and standard deviation. We compared survey subgroups with a two-tailed t-test. A p-value < 0.05 was considered as statistically significant.

Results:

We screened 80 apps for eligibility and included 9 in our analyses. All desirable features were present with Tracking History being the most frequent feature (in 8/9 apps). All other desirable features were observed in three or less of the apps. During the focus groups, all five desirable features were rated as important in adherence apps. Three additional features were mentioned: Professional feedback regarding therapy or intake course; Additional recommendations based on intake course; and Option to discuss the data with a HCP. In the online survey, the Tracking History was the most desired and Rewards the least desired feature in the output. Participants with or without regular medication use showed no significant differences.

Conclusions:

Freely available Smartphone adherence apps only partly deliver adherence data outputs that match users’ needs. Users showed a special interest in the interpretation of their data with a HCP. Therefore, adherence apps cannot substitute for the HCP, but can be used to enhance current patient care.