The role of mHealth for improving medication adherence in patients with cardiovascular disease: a systematic review.Citation: European Heart Journal Quality of Care & Clinical Outcomes. 2(4):237-244, 2016 Oct 01PMID: 29474713Institution: MedStar Good Samaritan Hospital | MedStar Union Memorial HospitalDepartment: Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Cardiovascular Diseases/dt [Drug Therapy] | *Medication Adherence/sn [Statistics & Numerical Data] | *Reminder Systems/is [Instrumentation] | *Telemedicine/ut [Utilization] | Adult | Aged | Aged, 80 and over | Cardiovascular Diseases/ep [Epidemiology] | Cardiovascular Diseases/pc [Prevention & Control] | Cell Phone/ut [Utilization] | Coronary Artery Disease/dt [Drug Therapy] | Female | Heart Failure/dt [Drug Therapy] | Humans | Hypertension/dt [Drug Therapy] | Male | Middle Aged | Outcome Assessment (Health Care) | Peripheral Arterial Disease/dt [Drug Therapy] | Randomized Controlled Trials as Topic | Reminder Systems/ut [Utilization] | Stroke/dt [Drug Therapy] | Text Messaging/ut [Utilization]Year: 2016ISSN:
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Cardiovascular disease is a leading cause of morbidity and mortality worldwide, and a key barrier to improved outcomes is medication non-adherence. The aim of this study is to review the role of mobile health (mHealth) tools for improving medication adherence in patients with cardiovascular disease. We performed a systematic search for randomized controlled trials that primarily investigated mHealth tools for improving adherence to cardiovascular disease medications in patients with hypertension, coronary artery disease, heart failure, peripheral arterial disease, and stroke. We extracted and reviewed data on the types of mHealth tools used, preferences of patients and healthcare providers, the effect of the mHealth interventions on medication adherence, and the limitations of trials. We identified 10 completed trials matching our selection criteria, mostly with <100 participants, and ranging in duration from 1 to 18 months. mHealth tools included text messages, Bluetooth-enabled electronic pill boxes, online messaging platforms, and interactive voice calls. Patients and healthcare providers generally preferred mHealth to other interventions. All 10 studies reported that mHealth interventions improved medication adherence, though the magnitude of benefit was not consistently large and in one study was not greater than a telehealth comparator. Limitations of trials included small sample sizes, short duration of follow-up, self-reported outcomes, and insufficient assessment of unintended harms and financial implications. Current evidence suggests that mHealth tools can improve medication adherence in patients with cardiovascular diseases. However, high-quality clinical trials of sufficient size and duration are needed to move the field forward and justify use in routine care.