mHealth tools lead to improved adherence to chronic disease management

Mobile health tools can lead to improved adherence to chronic disease management, according to a study published in the Journal of Medical Internet Research.

Researchers analyzed 107 studies that assessed the role of mobile health on chronic disease management (mAdherence) of diabetes, cardiovascular disease, and chronic lung diseases over the period between 1980 and 2014.

The authors found that while the evidence provided in the studies shows that the “potential of mAdherence tools is high, their implementation and execution is mixed.” Fifty of the studies employed randomized control trial methodology, they pointed out, and of those 56 percent demonstrated “significant” effects on adherence, while 40 percent significantly impacted clinical outcomes.

While these tools are generally accepted, the researchers pointed out they are accompanied by concerns on the part of patients and providers. Patients, for example, are concerned about the “dependence on professional supervision, unnecessarily medicalization, and undue anxiety” if the technology fails. There were also reports of difficulty using the technology, such as too many menus to navigate or difficulty operating small buttons on mobile phones. Providers, on the other hand, have concerns about the time and effort it takes to review data and respond in a timely fashion.

The study also found that while the “usability, feasibility, and acceptability” of mHealth tools for chronic disease management adherence were generally high among patients and providers, the development of innovative mAdherence tools could inadvertently increase health disparities due to unequal access to technology.

“There is a clear recognition that mHealth tools have the potential to impact patients who are less inclined to engage traditional health services,” the authors wrote. “mAdherence offers a way to address barriers to care and to reduce health disparities. There is also some recognition that unequal access to, use of, and knowledge of information and communication technology can influence the uptake and use of mHealth tools. These inequalities and the needs of the target user group should be taken into consideration early in the design and development of the mAdherence tool.”

Further evaluation of the role mAherence tools play “will be critical,” the authors concluded, but added that “[m]ore innovation, optimization, and high-quality research in mAdherence has the potential to transform the promise of mHealth technology into the reality of improved healthcare delivery and outcomes."