Feasibility and Preliminary Outcomes of a Web and Smartphone-Based Medication Self-Management Platform for Chronically Ill Patients

J Med Syst. 2016 Apr;40(4):99. doi: 10.1007/s10916-016-0456-y. Epub 2016 Feb 12.

Abstract

Objective: The aim of this study was to assess the feasibility and preliminary outcomes of a medication self-management platform for chronically ill patients, Medplan.

Methods: We performed a 6-month single-arm prospective pre-post intervention study of patients receiving treatment for hypertension and/or dyslipidemia and/or heart failure and/or human immunodeficiency virus infection. During the pre-intervention phase, participants were followed according to their usual care; during the intervention phase, they used Medplan. We evaluated adherence, health outcomes, healthcare resources and measured the satisfaction of patients and health care professionals.

Results: The study population comprised 42 patients. No differences were found in adherence to medication measured by proportion of days covered with medication (PDC). However, when adherence was measured using the SMAQ, the percentage of adherent patients improved during the intervention phase (p < 0.05), and the number of days with missed doses decreased (p < 0.05). Adherence measured using the Medplan app showed poor concordance with PDC. No differences were found in health outcomes or in the use of health care resources during the study period. The mean satisfaction score for Medplan was 7.2 ± 2.7 out of 10 among patients and 7.3 ± 1.7 among health care professionals. In fact, 71.4 % of participants said they would recommend the app to a friend, and 88.1 % wanted to continue using it.

Conclusion: The Medplan platform proved to be feasible and was well accepted by its users. However, its impact on adherence differed depending on the assessment method. The lack of effect on PDC is mainly because patients were already good adherers at baseline. The study enabled us to validate the platform in real patients using many different mobile devices and to identify potential barriers to scaling up the platform.

Keywords: Applications; Chronic patients; Medication adherence; Mobile phones.

MeSH terms

  • Adult
  • Aged
  • Anti-Retroviral Agents / therapeutic use
  • Cardiovascular Agents / therapeutic use
  • Cardiovascular Diseases / drug therapy*
  • Chronic Disease
  • Dyslipidemias / drug therapy
  • Female
  • HIV Infections / drug therapy*
  • Heart Failure / drug therapy
  • Humans
  • Hypertension / drug therapy
  • Internet
  • Male
  • Medication Adherence*
  • Middle Aged
  • Mobile Applications*
  • Patient Satisfaction
  • Prospective Studies
  • Self Care / methods*
  • Smartphone

Substances

  • Anti-Retroviral Agents
  • Cardiovascular Agents