Effect and usability of mobile health applications for medication adherence in patients with heart failure: A systematic review

• Published in: International journal of medical informatics (Shannon, Ireland) Ireland), 2023-10, Vol.178, p.105206, Article 105206
• Main Authors: Alves Leite de Barros, Kátia Adriana, da Silva Praxedes, Marcus Fernando, Pinho Ribeiro, Antônio Luiz, Parreiras Martins, Maria Auxiliadora
• Format: Article
• Language: English
• Subjects: Heart failure; Medication adherence; Mobile applications; Systematic review
• ISSN: 1386-5056; 1872-8243; 1872-8243
• DOI: 10.1016/j.ijmedinf.2023.105206

•This is the first systematic review investigating the effect of mobile apps on medication adherence in adults diagnosed with HF.•The studies included in this review provided results in favor of the use of apps in medication adherence of HF patients.•Further studies are needed to investigate the effect of appś features on medication adherence. This review aimed to evaluate the effect of mobile health applications (apps) use on medication adherence in heart failure (HF) patients, and to verify their quality of use. We searched MEDLINE, Embase, Web of Science, Scopus, CINAHL, LILACS, Cochrane, Clinical Trial Registries, Google Scholar, ProQuest, Open Access Theses and dissertations (OATD), Annual Symposium Proceedings of the American Medical Informatics Association (AMIA). Of the 836 records identified, eight studies (five randomized clinical trials (RCTs) and three observational studies) were included, totaling 484 participants, with a mean age ranging from 51.1 to 72 years and 65% were male. The apps improved medication adherence when compared with their comparators in only two RCTs (n = 111, Cohen d = 3.23, 95% confidence interval (CI) 2.66; 3.80 and n = 80, d = 1.20, 95% CI 0.71; 1.66), and two observational studies, one of them with large effect size (n = 142, Cohen d = 1.51, 95% CI 1.12; 1.90). Apps proved to be more effective interventions than their comparators allowed continuous monitoring of patients. All included studies used self-report measures to assess medication adherence behaviors and their results should be interpreted with caution, as such tools may cause social desirability bias or recall bias. The included studies indicate a possible outcome in favor of the use of apps to improve medication adherence in HF patients, but with very low quality level of evidence. Further studies are needed to investigate the effects of the use of apps, optimal frequency and duration of its use in HF patients.