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Smartphone apps could help heart patients remember to stick to prescribed regimens

By Thomson Reuters Foundation - Sep 02,2018 - Last updated at Sep 02,2018

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Smartphone apps that remind heart patients to take their pills could help them stick to prescribed regimens, an Australian study suggests. 

Heart patients often take up to four medications a day, three times a day, and that can be overwhelming, said Karla Santo. 

“Our results are really encouraging, especially because the apps that we used were already freely available in the app stores and were already being used by millions of people,” Santo told Reuters Health by e-mail. 

As reported in the journal Heart, Santo and colleagues at the University of Sydney in New South Wales randomly divided 150 volunteers with coronary heart disease into three groups. One group used a basic medication reminder app, a second used an advanced app with customisable features, and a third group was not given an app. 

Before the study, none of the participants had used apps to remind them to take their pills. 

The apps were chosen for the experiment based on an earlier study by the same researchers in which they ranked medication reminder apps available in Australia for iOS and Android devices. 

The top-scoring free basic app was My Heart, My Life (from the Heart Foundation of Australia), and the top-scoring free advanced app was Medisafe, which is available in the US and the UK. 

Three months later, patients in each group took a questionnaire designed to assess medication adherence. Scores showed that app-users stuck more closely to their pill regimens than patients who weren’t using a reminder app. 

The average difference between app-users and non-users was small, however — only 0.47 points on an 8-point scale. That may have been because participants generally had medium or high medication adherence to start with, the researchers suggest. 

“Low-adherence” — meaning people largely did not comply with their schedule — was more common without apps (29 per cent, versus 19 per cent among app users). 

App users did not seem to get extra benefit from advanced features, such as the ability to snooze reminders, track doses, provide adherence statistics and alert a friend or family member to missed doses. 

Heart disease and stroke are the leading causes of death globally, according to the World Health Organization, and researchers note about 40 per cent of cardiovascular patients worldwide do not abide by their medication schedule. 

“The best way to keep track of medications is to use the tool you have within reach, and more often than ever, that involves an app,” said Karandeep Singh, an assistant professor at the University of Michigan in Ann Arbor, who was not involved in the study. 

Singh, who researches mobile health apps, called the study design “encouraging”. He said a lack of rigorous research has slowed the uptake of apps into guidelines and clinical practice. 

Indeed, Santo’s team writes, while there are thousands of health apps available, there is minimal evidence of their effectiveness in improving health or medication adherence. Regarding the current study, they admit their data only reflects a three-month period and longer-term follow up is needed. 

Still, Santo thinks more patients could benefit from reminder apps. 

“I think these apps would be useful for any patient that is required to take long-term medications such as patients with chronic diseases like diabetes, respiratory disease and HIV/AIDS,” she said. 

“We could recommend to physicians to start a conversation with their patients about how well they are taking their medications and probably suggest the use of a medication reminder app,” she added. 

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