Kim Sun Kyung, Park Su Yeon, Hwang Hye Ri, Moon Su Hee, Park Jin Woo
Department of Nursing and Department of Biomedicine, Health & Life Convergence Sciences, BK21 Four, Mokpo National University, Muan, Jeonnam, 58554, Republic of Korea.
Department of Nursing, Mokpo National University, Muan, Jeonnam, 58554, Republic of Korea.
J Med Syst. 2025 Jan 17;49(1):13. doi: 10.1007/s10916-024-02135-2.
Low medication adherence poses a great risk of poor treatment outcomes among patients with chronic diseases. Recently, mobile applications (apps) have been recognized as effective interventions, enabling patients to adhere to their prescriptions. This study aimed to establish the effectiveness of mobile app interventions for medication adherence, affecting features, and dropout rates by focusing on previous randomized controlled trials (RCTs). This study conducted a systematic review and meta-analysis of mobile app interventions targeting medication adherence in patients with chronic diseases. Electronic searches of eight databases were conducted on April 21, 2023, for studies published between 2013 and 2023. Comprehensive meta-analysis software was used to estimate the standardized mean difference (SMD) of pooled outcomes, odds ratios (ORs), and confidence intervals (CIs). Subgroup analysis was applied to investigate and compare the effectiveness of the interventional strategies and their features. The risk of bias of the included RCTs was evaluated by applying the risk of bias tool. Publication bias was examined using the fail-safe N method. Twenty-six studies with 5,174 participants were included (experimental group 2603, control group 2571). The meta-analysis findings showed a positive impact of mobile apps on improving medication adherence (OR = 2.371, SMD = 0.279). The subgroup analysis results revealed greater effectiveness of interventions using interactive strategies (OR = 2.652, SMD = 0.283), advanced reminders (OR = 1.849, SMD = 0.455), data-sharing (OR = 2.404, SMD = 0.346), and pill dispensers (OR = 2.453). The current study found that mobile interventions had significant effects on improving medication adherence. Subgroup analysis showed that the roles of stakeholders in health providers' interactions with patients and developers' understanding of patients and disease characteristics are critical. Future studies should incorporate advanced technology reflecting acceptability and the needs of the target population.
药物依从性差会给慢性病患者带来治疗效果不佳的巨大风险。最近，移动应用程序（应用）已被视为有效的干预措施，可使患者坚持服药。本研究旨在通过关注以往的随机对照试验（RCT）来确定移动应用干预对药物依从性、影响因素和退出率的有效性。本研究对针对慢性病患者药物依从性的移动应用干预进行了系统评价和荟萃分析。2023年4月21日对八个数据库进行了电子检索，以查找2013年至2023年发表的研究。使用综合荟萃分析软件来估计汇总结果的标准化平均差（SMD）、比值比（OR）和置信区间（CI）。应用亚组分析来研究和比较干预策略及其特征的有效性。通过应用偏倚风险工具评估纳入的RCT的偏倚风险。使用失效安全N方法检查发表偏倚。纳入了26项研究，共5174名参与者（实验组2603名，对照组2571名）。荟萃分析结果显示移动应用对改善药物依从性有积极影响（OR = 2.371，SMD = 0.279）。亚组分析结果显示，使用互动策略（OR = 2.652，SMD = 0.283）、提前提醒（OR = 1.849，SMD = 0.455）、数据共享（OR = 2.404，SMD = 0.346）和药盒（OR = 2.453）的干预效果更佳。当前研究发现移动干预对改善药物依从性有显著效果。亚组分析表明，利益相关者在医疗服务提供者与患者互动中的作用以及开发者对患者和疾病特征的理解至关重要。未来的研究应纳入反映目标人群可接受性和需求的先进技术。
