Use of medication reminder apps increases people's adherence to cardiovascular medication

We use them for everything from banking to workouts, and now research from the University of Sydney shows mobile apps could potentially save lives by helping people with coronary heart disease keep on top of their medication.

Published today in Heart, and presented at the European Society of Cardiology Congress in Germany, the study shows the use of high-quality medication reminder apps increases people's adherence to cardiovascular medication.

While medication apps have long been available online, this is some of the first research to explore the evidence around their effectiveness in people with heart disease and whether they work in terms of health and behavior.

Senior author Associate Professor Julie Redfern said coronary heart disease is the leading cause of death globally and around 40 percent of patients do not adhere to their medications, therefore increasing their risk of subsequent heart attacks.

"Patients with coronary heart disease can become overwhelmed with the amount of pills they are taking as they are often prescribed up to four different types of medication, which need to be taken sometimes up to three times a day," said Associate Professor Redfern from the University of Sydney's Westmead Applied Research Centre.

The randomized clinical trial followed 160 predominately male patients over a three month period and compared the medication usage of patients in usual care to those supported to download and use medication apps.

Researchers also compared the use of basic apps (with one-time reminder alarms) to those with more advanced features. They found no additional benefits were gained from the advanced apps with elements such as the ability to snooze reminders and track taken and missed doses, adherence statistics and social support structures including alerting a friend or family member to missed doses.

Lead author Dr Karla Santo from the University of Sydney said the results from the trial are very encouraging.

"It's exciting that a basic app - some of which can be accessed for free - could help improve people's medication use and prevent further cardiovascular complications."

In 2016, Dr Santo and colleagues from the University of Sydney and George Institute for Global Health conducted a review of medication reminder apps available via iTunes and Google app stores.

The review rated Medisafe as the top ranking interactive app, and My Heart my Life (currently being updated) and Pill reminder among the top basic apps available at the time. However, the vast majority of the apps on the market were judged to be low quality.

Dr Santo said the next step is to carry out further research to see if apps can be used to sustain medication adherence over a longer period and the impact this has on health outcomes. Also, to trial the apps for other health conditions such as cancer, lung disease and stroke.

"Participants in our trial were followed up after 3 months but longer term and larger studies are more likely to be able to show benefits or challenges of app usage, as well as the impact on additional measures such as blood pressure and cholesterol."

The clinical trial is a collaboration between the University of Sydney's Westmead Applied Research Centre, the George Institute for Global Health and Westmead Hospital, with colleagues from the Westmead Institute for Medical Research and University of New South Wales.