A new study published in the Journal of American Medical Association finds that use of a smartphone app can result in a small, but significant improvement in self-reported medication adherence, although it does not affect blood pressure control in patients with hypertension.
Half of the patients with uncontrolled hypertension do not adhere to their medications. About 160 medication-adherence apps exist, but they have not been evaluated on a large scale. Morawski et al. sought to determine if the Medisafe smartphone app could improve self-reported medication adherence and blood pressure control.
[perfectpullquote align=”full” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]“The MedISAFE-BP trial is, to our knowledge, the first randomized clinical trial reporting the effect of a stand-alone mHealth platform to increase medication adherence and improve blood pressure control.” -Morawski et al. [/perfectpullquote]
Medication adherence Improvement Support App For Engagement—Blood Pressure (MedISAFE -BP) was a two-arm, randomized clinical trial in which 411 subjects were enrolled for 6 months through an online format and were mailed home blood pressure (BP) monitors. The participants included were 18-75 years of age, having BP greater than 140/90 mm Hg and less than 180/120 mm Hg, and treated with at least 1, but not more than 3 antihypertensive drugs. They were randomized at a ratio of 1:1. The 8-item Morisky medication adherence scale (MMAS-8) was recorded in the smartphone app ‘Medisafe’ which recorded BP as per instructions and sent alerts when doses were missed for the intervention arm of 209 participants. The control arm (202) did not use the application. The participants were followed at 4, 8, and 12 weeks.
The investigators found out that 90% of the intervention arm participants actually completed the study. The mean (SD) adherence by MMAS-8 was 6.0(1.8) at baseline and increased by 0.4(1.5) in the arm that used the group while it remained unchanged in the control arm participants after 12 weeks of follow up. Although there is a statistically significant improvement in adherence from the intervention, this small magnitude of change should not translate into significant improvement in blood pressure. Also, there was no difference in change of blood pressures between both arms after 12 weeks of follow up.
Dr. Morawski et al acknowledged that the results were not generalizable as the recruitment was done using online mechanisms. Home BP measurements were lower than in healthcare settings and the intervention could not be applied to those with blood pressure >180/120 mm Hg. Since the trial was done for 12 weeks, it was not advisable to rely on longer outcomes of a smartphone app.
However, the investigators stressed on the importance of the trial, stating that “The MedISAFE-BP trial is, to our knowledge, the first randomized clinical trial reporting the effect of a stand-alone mHealth platform to increase medication adherence and improve blood pressure control.”
Source: Association of a Smartphone Application With Medication Adherence and Blood Pressure Control
The MedISAFE-BP Randomized Clinical Trial,