Department of Pharmacy, Minhang Hospital, Fudan University, Shanghai, China.
Department of Pharmacy Administration & Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.
JMIR Mhealth Uhealth. 2021 Jun 15;9(6):e26262. doi: 10.2196/26262.
As a computerized drug-drug interaction (DDI) alert system has not been widely implemented in China, health care providers are relying on mobile health (mHealth) apps as references for checking drug information, including DDIs.
The main objective of this study was to evaluate the quality and content of mHealth apps supporting DDI checking in Chinese app stores.
A systematic review was carried out in November 2020 to identify mHealth apps providing DDI checking in both Chinese iOS and Android platforms. We extracted the apps' general information (including the developer, operating system, costs, release date, size, number of downloads, and average rating), scientific or clinical basis, and accountability, based on a multidimensional framework for evaluation of apps. The quality of mHealth apps was evaluated by using the Mobile App Rating Scale (MARS). Descriptive statistics, including numbers and percentages, were calculated to describe the characteristics of the apps. For each app selected for evaluation, the section-specific MARS scores were calculated by taking the arithmetic mean, while the overall MARS score was described as the arithmetic mean of the section scores. In addition, the Cohen kappa (κ) statistic was used to evaluate the interrater agreement.
A total of 7 apps met the selection criteria, and only 3 included citations. The average rating score for Android apps was 3.5, with a minimum of 1.0 and a maximum of 4.9, while the average rating score for iOS apps was 4.7, with a minimum of 4.2 and a maximum of 4.9. The mean MARS score was 3.69 out of 5 (95% CI 3.34-4.04), with the lowest score of 1.96 for Medication Guidelines and the highest score of 4.27 for MCDEX mobile. The greatest variation was observed in the information section, which ranged from 1.41 to 4.60. The functionality section showed the highest mean score of 4.05 (95% CI 3.71-4.40), whereas the engagement section resulted in the lowest average score of 3.16 (95% CI 2.81-3.51). For the information quality section, which was the focus of this analysis, the average score was 3.42, with the MCDEX mobile app having the highest score of 4.6 and the Medication Guidelines app having the lowest score of 1.9. For the overall MARS score, the Cohen interrater κ was 0.354 (95% CI 0.236-0.473), the Fleiss κ was 0.353 (95% CI, 0.234-0.472), and the Krippendorff α was 0.356 (95% CI 0.237-0.475).
This study systematically reviewed the mHealth apps in China with a DDI check feature. The majority of investigated apps demonstrated high quality with accurate and comprehensive information on DDIs. However, a few of the apps that had a massive number of downloads in the Chinese market provided incorrect information. Given these apps might be used by health care providers for checking potential DDIs, this creates a substantial threat to patient safety.
由于计算机化药物相互作用（DDI）警报系统尚未在中国广泛实施，医疗保健提供者依赖移动健康（mHealth）应用程序作为检查药物信息（包括 DDI）的参考。
本研究的主要目的是评估中国应用商店中支持 DDI 检查的 mHealth 应用程序的质量和内容。
2020 年 11 月进行了系统评价，以确定在中 iOS 和 Android 平台上提供 DDI 检查的 mHealth 应用程序。我们根据多维评估应用程序的框架，提取了应用程序的一般信息（包括开发者、操作系统、成本、发布日期、大小、下载量和平均评分）、科学或临床依据以及问责制。使用移动应用程序评分量表（MARS）评估 mHealth 应用程序的质量。使用数字和百分比描述性统计来描述应用程序的特征。对于每个选择进行评估的应用程序，通过取算术平均值来计算特定于节目的 MARS 得分，而整体 MARS 得分则描述为节目的算术平均值。此外，使用 Cohen kappa（κ）统计来评估评分者间的一致性。
共有 7 个应用程序符合选择标准，其中只有 3 个包含引文。Android 应用程序的平均评分为 3.5，最低为 1.0，最高为 4.9，而 iOS 应用程序的平均评分为 4.7，最低为 4.2，最高为 4.9。MARS 得分为 5 分中的 3.69（95%CI 3.34-4.04），最低得分为 1.96 的《用药指南》和最高得分为 4.27 的 MCDEX mobile。信息部分的变化最大，范围为 1.41 至 4.60。功能部分的平均得分最高，为 4.05（95%CI 3.71-4.40），而参与部分的平均得分最低，为 3.16（95%CI 2.81-3.51）。在信息质量部分，这是本分析的重点，平均得分为 3.42，其中 MCDEX mobile 应用程序的得分为 4.6，而《用药指南》应用程序的得分为 1.9。对于整体 MARS 评分，Cohen 评分者间 κ 为 0.354（95%CI 0.236-0.473），Fleiss κ 为 0.353（95%CI，0.234-0.472），Krippendorff α 为 0.356（95%CI 0.237-0.475）。
本研究系统地回顾了中国具有 DDI 检查功能的 mHealth 应用程序。大多数调查应用程序的质量都很高，具有准确且全面的 DDI 信息。然而，一些在中国市场拥有大量下载量的应用程序提供了不正确的信息。鉴于这些应用程序可能被医疗保健提供者用于检查潜在的 DDI，这对患者安全构成了重大威胁。
