The Effects of a Medication Adherence Mobile Application Among Medically Underserved Patients with Chronic Illness

Abstract

Medication adherence is vital for individuals living with chronic illness who require long-term medication use to maintain optimum health. In the United States, lower rates of medication adherence have been found in patients with lower socio-economic status and those with multiple chronic conditions. Federally Qualified Health Centers, which provide healthcare services for medically underserved communities and populations, are reporting a growth in a more complex patient population because their patients have higher rates of chronic conditions. Therefore, interventions targeting medication adherence among medically underserved populations are needed. Mobile phone applications (apps) can help patients adhere to medications and have been cited as a promising way to reach medically underserved populations. Commercially available medication adherence apps have not been widely studied in medically underserved populations, nor have their effects been studied across multiple disease states. Additionally, few studies have isolated specific features of apps and their effects on medication adherence. To address those gaps, we conducted a Randomized Controlled Trial (RCT) to investigate the effect of the app on medication adherence, medication self-efficacy, knowledge, and social support (n=61; 30 in the intervention group and 31 in the control group). Participants were satisfied with the app and found it easy to use. Those who used the app had significantly greater medication adherence (Cohen’s d = 0.52, p = .014) and medication self-efficacy (Cohen’s d = 0.43, p = .035). No significant effects were observed related to knowledge or social support. In addition to reminders, participants accessed educational information and some used the medication list for medication reconciliation at doctors’ visits. Use of the social support feature was low. The research demonstrated that the app positively impacted medication adherence, self-efficacy and has the potential to improve chronic disease management on a larger scale in a medically underserved population. Limitations and implications for clinical practice and future research are presented.