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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Aug 28, 2025
Date Accepted: May 31, 2026

The final, peer-reviewed published version of this preprint can be found here:

Effects of the Digital App “Support, Monitoring and Reminder Technology for Mild Dementia” (SMART4MD) on People With Mild Cognitive Impairment and Their Informal Caregivers: 18-Month Multicenter Pragmatic Randomized Controlled Trial

Ghani Z, Thant PE, Saha S, Anderberg P, Aparicio MQ, Barnestein-Fonseca P, Cellek S, Cleries FM, Garolera M, Guerrero-Pertiñez G, Hayden K, Moore C, Zhang J, Berglund JS, Jarl J

Effects of the Digital App “Support, Monitoring and Reminder Technology for Mild Dementia” (SMART4MD) on People With Mild Cognitive Impairment and Their Informal Caregivers: 18-Month Multicenter Pragmatic Randomized Controlled Trial

J Med Internet Res 2026;28:e83123

DOI: 10.2196/83123

PMID: 42497412

The effects of digital application “Support, Monitoring and Reminder Technology for Mild Dementia” (SMART4MD) on people with mild cognitive impairment and their informal caregivers: An 18 Month Multicenter Pragmatic Randomized Controlled Trial

  • Zartashia Ghani; 
  • Poe Eindra Thant; 
  • Sanjib Saha; 
  • Peter Anderberg; 
  • Maria Quintana Aparicio; 
  • Pilar Barnestein-Fonseca; 
  • Selim Cellek; 
  • Fermín Mayoral Cleries; 
  • Maite Garolera; 
  • Gloria Guerrero-Pertiñez; 
  • Karen Hayden; 
  • Carmel Moore; 
  • Jufen Zhang; 
  • Johan Sanmartin Berglund; 
  • Johan Jarl

ABSTRACT

Background:

Previous research has shown that mobile health (mHealth) interventions are effective in helping remind older adults with chronic conditions about their healthcare appointments and ensuring adherence to medication schedules. However, the evidence was limited by the short duration of the interventions and their poor quality.

Objective:

We evaluated the effectiveness of the SMART4MD tablet app in improving the quality of lives of persons with mild cognitive impairment (PwMCI) and their caregivers, through medication reminders and health appointment alerts.

Methods:

An 18-month pragmatic randomized controlled trial was conducted in Spain and Sweden from December 2017 to September 2020 and included 1078 PwMCIs and their informal caregivers.

Results:

For PwMCI, there was no significant effect in quality of life or medication adherence. However, quality of life measured by QALY was significantly improved for both caregivers and dyads in the intervention group. A dropout rate of around 40% was noted in both intervention and control groups.

Conclusions:

The overall results suggest that the SMART4MD app does not add additional benefits beyond standard care over the 18-month study period except for informal caregivers. Clinical Trial: ClinicalTrials.gov: NCT03325699


 Citation

Please cite as:

Ghani Z, Thant PE, Saha S, Anderberg P, Aparicio MQ, Barnestein-Fonseca P, Cellek S, Cleries FM, Garolera M, Guerrero-Pertiñez G, Hayden K, Moore C, Zhang J, Berglund JS, Jarl J

Effects of the Digital App “Support, Monitoring and Reminder Technology for Mild Dementia” (SMART4MD) on People With Mild Cognitive Impairment and Their Informal Caregivers: 18-Month Multicenter Pragmatic Randomized Controlled Trial

J Med Internet Res 2026;28:e83123

DOI: 10.2196/83123

PMID: 42497412

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