Chronic Disease Management Adherence Mixed Using mHealth Tools

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While mobile health tools have the potential to better facilitate patient adherence to chronic disease management, the current evidence supporting mHealth’s effectiveness is mixed.

That is the conclusion of a new study published in the Journal of Medical Internet Research, which notes that mobile technologies are increasingly being used in healthcare and public health practice for patient communication, monitoring, and education, and to facilitate adherence to chronic disease management.

Researchers conducted a systematic review of literature published in peer-reviewed journals that evaluated mHealth tools for effect on patient adherence to chronic disease management (mAdherence), disease-specific clinical outcomes, as well as usability, feasibility, and acceptability features.

The review concludes that although the potential of mAdherence tools is high, their implementation and execution has achieved mixed results. “In all, 50 of the studies employed [randomized controlled trial] methodology, and of those, just more than half demonstrated significant effects on adherence (56 percent) and less than half (40 percent) on clinical outcomes,” states the article.

Further, though mAdherence tools were generally accepted, patients and providers documented a number of negative elements and perceptions. Difficulty in understanding and using the technology were reported, including technical issues such as too many menus to navigate and small buttons on the mobile phone. Some patients who had not used smartphones before found them frustrating to use. And, among providers, concerns included the amount of time and effort required to review data and respond in time.

“Factors such as the cost of implementing the system, increased clinical workload and workflow, maintaining up-to-date records, and concerns about being supervised and depending too much on technology were some of the main concerns regarding implementation of mAdherence interventions,” states the article.

According to the article’s authors, further research should focus on understanding and improving how mHealth tools can overcome specific barriers to adherence.

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