Effect of Interactive eHealth Interventions on Improving Medication Adherence in Adults With Long-Term Medication: Systematic Review

Medication nonadherence leads to suboptimal treatment outcomes, making it a major priority in health care. eHealth provides an opportunity to offer medication adherence interventions with minimal effort from health care providers whose time and resources are limited. The aim of this systematic revie...

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Bibliographic Details
Published in:Journal of medical Internet research 2021-01, Vol.23 (1), p.e18901
Main Authors: Pouls, Bart P H, Vriezekolk, Johanna E, Bekker, Charlotte L, Linn, Annemiek J, van Onzenoort, Hein A W, Vervloet, Marcia, van Dulmen, Sandra, van den Bemt, Bart J F
Format: Article
Language:English
Subjects:
Adherence
Adults
Bias
Caregivers
Citations
Clinical decision making
Clinical outcomes
Clinical research
Clinical trials
Collaboration
Decision making
Drugs
Feedback
Health education
Health promotion
Humans
Interactive voice response
Intervention
Managerial skills
Medical personnel
Medication Adherence - psychology
Mobile Applications
Patient compliance
Quality assessment
Quality of care
Review
Risk Assessment
Systematic review
Telemedicine - methods
Text messaging
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Summary:Medication nonadherence leads to suboptimal treatment outcomes, making it a major priority in health care. eHealth provides an opportunity to offer medication adherence interventions with minimal effort from health care providers whose time and resources are limited. The aim of this systematic review is twofold: (1) to evaluate effectiveness of recently developed and tested interactive eHealth (including mHealth) interventions on medication adherence in adult patients using long-term medication and (2) to describe strategies among effective interventions. MEDLINE, EMBASE, Cochrane Library, PsycINFO, and Web of Science were systematically searched from January 2014 to July 2019 as well as reference lists and citations of included articles. Eligible studies fulfilled the following inclusion criteria: (1) randomized controlled trial with a usual care control group; (2) a total sample size of at least 50 adult patients using long-term medication; (3) applying an interactive eHealth intervention aimed at the patient or patient's caregiver; and (4) medication adherence as primary outcome. Methodologic quality was assessed using the Cochrane risk of bias tool. Selection and quality assessment of studies were performed by 2 researchers (BP and BvdB or JV) independently. A best evidence synthesis was performed according to the Cochrane Back Review Group. Of the 9047 records screened, 22 randomized clinical trials were included reporting on 29 interventions. Most (21/29, 72%) interventions specified using a (mobile) phone for calling, SMS text messaging, or mobile apps. A majority of all interactive interventions (17/29) had a statistically significant effect on medication adherence (P 2.0). Our best evidence synthesis provided strong evidence for a positive effect of interventions using SMS text messages or interactive voice response, mobile app, and calls as mode of providing adherence tele-feedback. Intervention strategies "to teach medication management skills," "to improve health care quality by coordinating medication adherence care between professionals," and "to facilitate communication or decision making between patients and health care providers" also showed strong evidence for a positive effect. Overall, this review supports the hypothesis that interactive eHealth interventions can be effec
ISSN:1438-8871
1439-4456
1438-8871
DOI:10.2196/18901