Impact of a mobile app on medication adherence and adherence-related beliefs in patients with type 2 diabetes

Abstract

Objectives: To assess the impact of a customizable medication management mobile app (Medsimple) on medication adherence and adherence-related beliefs in patients with type 2 diabetes. The app contains a medication database, list tracking, reminders, cost-saving information, and other features. A second objective was to determine differentiating factors associated with 6 months of use.

Design: A prospective, observational, single-cohort study using previously tested scales at 3 time points over 6 months.

Settings and participants: Participants included a convenience sample of community-dwelling adults with type 2 diabetes in the United States who used at least 2 prescriptions, had Internet access, and used e-mail and a mobile device for operating the study app.

Outcome measures: Participants who served as their own controls were assessed on psychosocial theory-based concepts of self-efficacy, locus of control, and outcome expectations in addition to self-reported adherence. Instrument reliability, repeated assessments, and differential dropout analyses were conducted.

Results: Repeated assessments of 51, 49, and 41 participants occurred at baseline and 90 and 180 days (6 months), respectively. Instrument measurement of concepts showed strong reliability, except in the locus of control subscales. Participants exhibited no significant change on the scales of self-reported adherence behaviors or adherence-related beliefs during the study. Results showed that the mobile app may have influenced specific adherence behaviors or beliefs, but significant differences on overall scales were not found. Differential dropout analyses comparing study finishers to dropouts revealed that 6-month use was associated with being younger, lower self-efficacy beliefs, lower internal locus of control beliefs, and lower adherence behaviors.

Conclusion: Scales were reliable to measure concepts but the locus of control scale warrants further testing. The mobile app may not affect adherence and adherence-related beliefs in a 6-month period. Further testing is needed to determine benefit for patients with specific adherence behaviors or who hold certain beliefs.