None listed
Conditions
Brief summary
Poor adherence to medication is a global concern, especially in chronic diseases, such as cardiovascular disease. In Australia, it is estimated that between 14 to 43% of patients with cardiovascular disease do not adhere to medications. The use of smartphone apps has been proposed as a potential solution for this problem. In recent years, the increasing popularity of apps is evident as there has been exponential growth in numbers of apps available in online stores. Despite the plethora of health apps, there is a lack of information on the quality of apps, how they differ, which are more effective and why, making it difficult for health professionals to recommend a useful app to patients. In our systematic search of app stores, we have identified around 300 medication adherence apps. About half of these apps identified had basic features involving simple reminders for patients to take medication at appropriate times. The other half included additional customisable and interactive features that could increase engagement with the app and motivate sustained usage. Through a quality assessment, we selected two high-quality apps to be tested in this study. In this trial, we aim to determine whether smartphone apps to remind patients to take their medication can improve medication adherence, blood pressure and cholesterol levels. We also aim to compare and contrast the features of the smartphone apps through a detailed qualitative evaluation that will provide evidence on which features consumers perceive to be most useful, enhance engagement and optimise effects.. Our results will inform future research about the role of apps in improving medication adherence.
Interventions
There will be two different intervention groups as described below.
1) Basic app: Participants in the basic app group will be provided with and supported to access the basic app in addition to standard care. This app has basic features to provide daily simple timed reminders to take the medications with no further interactivity. The basic app will act similarly to an alarm or a text-message by showing a reminder on the smartphone screen at a set time every day. Participants will be encouraged t
There will be two different intervention groups as described below. 1) Basic app: Participants in the basic app group will be provided with and supported to access the basic app in addition to standard care. This app has basic features to provide daily simple timed reminders to take the medications with no further interactivity. The basic app will act similarly to an alarm or a text-message by showing a reminder on the smartphone screen at a set time every day. Participants will be encouraged to set daily reminders to take each cardiovascular medication at the prescribed time. The duration of the intervention period will be 3 months. 2) Interactive app: Participants in the interactive app group will be provided with and supported to access the interactive app in addition to standard care. This interactive app has the ability to provide daily reminders to take medications and, in addition, it has more customisable and interactive features, including features to mark doses as taken or missed, to snooze the reminder, to interact and share data with family members and health professionals, multiple user support, adherence statistics, customisable alert sounds and visual cues like tablets and syringes icons. Participants will be encouraged to set daily reminders to take each cardiovascular medication at the prescribed time. In addition, participants will also be encouraged to track their doses daily by clicking in one of the following options every time a reminder pops-up in the smartphone screen: taken on the schedule, taken on a different time, snooze or skip the dose. The duration of the intervention period will be 3 months. Information about engagement with the app will be obtained by extracting the adherence data from the app at the end of the study. These apps were selected through a stepwise approach to identify the best available apps to be tested in this trial. A comprehensive and systematic search of all available apps in the Australian iTunes and Google Play app stores was conducted and the apps were selected using a pre-defined set of criteria. The highest quality apps were selected. Both apps are available for free in iTunes and Google Play stores and have ongoing technical support, having been recently updated in April 2016.
Sponsors
The George Institute for Global Health
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants will be eligible if they have a confirmed diagnosis of coronary heart disease, including a prior diagnosis of myocardial infarction, stable or unstable angina, coronary revascularisation procedure or current admission with an acute coronary syndrome event or >50% stenosis in at least one major vessel on the coronary angiogram. In addition, participants will have to meet the following criteria: 1) be an adult (> 18 years), 2) own an active smartphone that operates with iOS or Android operating systems, 3) have sufficient English skills, and 4) provide written informed consent.
Exclusion criteria
Patients will be excluded if they already use a medication reminder app or other electronic reminder systems to help them adhere to their medication regimen, e.g. calendar alerts in their phones. In addition, smartphones that are not capable of downloading the apps, for example older Apple iPhones, such as iPhones 4, that operate with older iOS versions, will be excluded, as the basic app is only compatible with iOS version 7.0 or later and the advanced app with iOS version 8.0 or later.
Outcome results
None listed