Table of Contents

Abstract ...........................................................................................................................................1
Introduction ...................................................................................................................................2
Aims and Objectives ...................................................................................................................4
Literature Review ..........................................................................................................................5
Plan of Work ..................................................................................................................................8
Methodology ...................................................................................................................................9
References .....................................................................................................................................11
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Examining the Impact of Mobile Health Applications on Patients with Chronic

Conditions to Encourage Medication Adherence: A Mixed-Methods Approach

ABSTRACT

This study's primary focus will be on how individuals with chronic diseases are affected by mobile
health applications. In recent years, there has been a noticeable surge in the mobile and health
digital businesses due to the aging of the global population. Chronic conditions like diabetes and
hypertension, which have several side effects and cost countries money, are plaguing an increasing
proportion of senior citizens. These ailments also rank as the world's biggest cause of death.
Individuals with chronic diseases who battle with non-adherence may have a quicker worsening
of their symptoms and a higher chance of complications, both of which can lead to a higher death
rate. Several attempts have been made to employ health information technology, which is seen as
advantageous and cost-effective, to enhance pharmaceutical behavior because of the possibility of
non-adherence and its detrimental effects on health.
A mixed-method approach will be used in this investigation. Data will be collected from 250
participants in randomized controlled research who have chronic conditions such as diabetes,
hypertension, and asthma. The results highlight how crucial it is to give app functionality and
design significant thought in order to allay user fears and optimize the advantages of emerging
technology. By harnessing mHealth's capabilities, healthcare providers may assist patients in
managing their chronic conditions more efficiently, ultimately leading to improved health
outcomes and quality of life for patients.
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INTRODUCTION

The global population is getting older, and this has caused the mobile and health digital sectors to
rise significantly in recent years.Growing rates of chronic illnesses in older populations, such as
diabetes and hypertension, with its many sequelae, place a financial strain on countries and are the
primary cause of death globally.
Problems with non-adherence among chronic illness patients can hasten the worsening of their
symptoms and raise their risk of complications, both of which raise mortality. Because of the risk
of non-adherence and its negative impacts on health, several initiatives have been made to use
health information technology, which is seen to be useful and cost-effective, to improve
pharmaceutical behavior. (Pooja Mehta et al., 2021).
The goal of mobile medical applications (mmApps) that have emerged in the online market is to
assist patients with chronic illnesses in achieving drug safety. Approximately 3.25 million
mmApps had been downloaded by the end of 2023 from popular app shops, such as the Apple and
Android app stores—a whopping 50% increase from only ten years prior. Big data and 5G
technologies were utilized in the invention and development of these mmApps, which include
features like self-diagnosis, ADE reporting, information gathering and consultation, wellness
In particular, telemedicine, personalized medicine, and health information technology are a part of
mobile health, which is a subset of digital health. (Yihang Peng et al., 2020).
This might potentially be a means of producing other kinds of health data that present opportunities
to improve healthcare systems. The analysis's conclusions provide chances for creativity by
solving a variety of problems and predicting future health. As a privacy and security concern, the
proper handling of patient data and information was again underlined. A wide range of technology
is used in mobile health, such as wearable and Internet of Things (IoT) devices, smartphones, and
wearable sensors. using the possibility to identify and cure diseases using state-of-the-art
technology, this has been heralded as an unprecedented opportunity. (Sun Kyung Kim et al., 2023).
The emergence of mobile health apps, which enable the use of wireless and mobile technologies
in the provision of healthcare services, may have an impact on how patients engage with healthcare
professionals (HCPs) and how they are treated. Applications, sometimes abbreviated as "apps,"
are little software programs that operate on computers or mobile devices and provide users with
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certain functionality and connections. The main purpose of mobile health applications is to provide
users with advice and recommendations on a range of health-related topics.
They also make it easier to offer healthcare and to gather and share health data. 36% of people
worldwide owned a smartphone in 2018, up from 10% in 2011, demonstrating the enormous rise
in access to and use of smartphones and other mobile devices. A multitude of apps have been
developed as a result of the increasing demand for smartphones and the rivalry among operating
systems. In 2017, more than 325,000 health-related applications for iOS1 (Apple Inc.) and
Android1 (Google) were released, with an emphasis on consumers and healthcare providers. While
stand-alone social media platforms like Facebook, Twitter, and WhatsApp are typically not
classified as mhealth, they may help advance health and make it easier for patients and their HCP
to communicate online. ( Bonyan Qudah et al., 2019)
Sometimes, patient-centered care models neglect to take into account the multidisciplinary nature
of healthcare and the ways in which different interactions affect the direction and result of
treatment. In addition to sharing health information and guidance, mHealth may establish multiple
connections between HCPs and patients, resulting in more frequent and continuous
communication that builds relationships. Better patient outcomes and satisfaction as well as
treatment adherence were linked to the development of positive interactions between patients and
HCP. (Bonyan Qudah et al., 2019).
According to a review paper by Mohammadi et al. (2018), individuals with cardiovascular disease
might improve their medication adherence with the use of apps.19 But rather than focusing on
medication adherence, Mohammadi et al.'s primary goal was to examine how apps affect blood
pressure control. Their investigation included just three publications that showed how beneficial
apps are at improving medication adherence; a meta-analysis was not possible. As a result, a
comprehensive assessment and meta-analysis of the applications' availability and impact on
medication adherence were required.
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AIMS AND OBJECTIVES:

 To assess how well MHAs perform to motivate patients with long-term conditions to take
their prescription medications on schedule.
 To examine the variables affecting MHA application and uptake for medication adherence.
 To determine the obstacles and enablers that residents in long-term care facilities need to
overcome in order to embrace MHA and engage in it on a regular basis.
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REVIEW OF LITERATURE

Bonyan Qudah et al., 2019. Narrative analysis of how mobile health apps affect the interactions
between patients and healthcare providers To evaluate patient-provider interactions and
communication, a thorough narrative study of English-language literature on the experiences and
outcomes of using mobile health applications was conducted. The four relationship-centered care
characteristics guided the thematic organization of the results. The methodological quality of the
included papers was assessed. Mobile health applications may greatly influence patient and
provider interactions and communication, which may help to promote relationship-centered
healthcare. Practice-related implications: Mobile health can improve access to healthcare services,
boost patient confidence, and improve patient-provider interactions in both ambulatory and
inpatient settings.
Linda G Park et al., 2020. Qualitative study on older persons with coronary heart disease's
perceptions and experiences with utilizing mobile technology for medication adherence. Their aim
is to provide the beliefs, attitudes, and views of individuals with coronary heart disease on the use
of text messaging and mobile applications for medication adherence. Mobile apps and text
messaging are thought to be useful methods for improving medication adherence. Further study
should entail thorough clinical trials to investigate the efficacy of mobile health technology in
encouraging medication adherence in areas where strict adherence to medicine is mandated.
Yihang Peng et al., 2020. Gave a systematic review on Effectiveness of Mobile Applications on
Medication Adherence in Adults with Chronic Diseases. They look into how adult patients with
chronic illnesses adhere to their drug regimens while using mobile apps. Mobile applications are
effective strategies to assist increase medication adherence in persons with chronic conditions
when compared to conventional therapy. In addition to determining the best app features and
provider prices, future study must also focus on enhancing the applications' usability, security, and
efficacy using patient-centered theory.
Pooja Mehta et al., 2021. Designed a mobile health application to improve adolescent medication
adherence by Using a multidisciplinary approach and academic industry collaboration. They
supported medication adherence for the pediatric population in particular by using mobile health
(mHealth) technologies. They detail the creation of the Med Venture medication adherence
application, which integrates user interaction techniques, health behavior theory, and feedback
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from patients and healthcare providers for teenagers with chronic gastrointestinal diseases. Three
themes emerged from the text analysis: teenagers may actively avoid taking their prescriptions,
lack of routine leads to nonadherence, and healthcare professionals would rather use a tool that
encourages patient self-management than one that requires patient-provider contact. These results
led to the creation of MedVenture, a game-based application that enhances planning and habit
building, along with evidence-based adherences and user engagement tactics.
Ting ting Zhou et al., 2022. Systematic Review and Meta-analysis on Effectiveness of Mobile
Medical Apps in Ensuring Medication Safety Among Patients With Chronic Diseases. They sought
to investigate the efficacy of mmApps in guaranteeing the medication safety of patients with
chronic diseases, including whether mmApps can enhance patients' adherence to their prescribed
medications, decrease medication errors, and improve willingness to report adverse drug events
(ADEs). Their findings were based on the medication safety action plans recommended by the
World Health Organization. Large-sample studies were excluded from the analysis and a different
statistical approach was used to evaluate the degree of stability. The use of mmApps improved
medication adherence among patients with chronic diseases by recording prescriptions, providing
educational support, conveying medical solutions, and enabling remote consultations. In the end,
we were able to pinpoint three reasons why our drug error outcomes differed from those of other
studies.
Sun Kyung Kim et al., 2023. examined the impact of a mobile health intervention on drug
adherence. This study aimed to ascertain the effectiveness of mobile app therapies for medication
adherence, as well as the influencing factors and dropout rates, by focusing on randomized
controlled trials (RCTs). This study included a systematic review and meta-analysis of mobile app
therapies for medication adherence, with a focus on patients with chronic conditions. The current
study's findings indicate that mobile treatments greatly increased medication adherence. Subgroup
analysis demonstrated the significance of stakeholders' roles in the interactions between patients
and healthcare providers as well as in the developers' understanding of the features of patients and
illnesses. Cutting edge technology that is acceptable and satisfies the needs of the target audience
should be considered in future research.
Christa E. Hartch et al., 2023. A randomized controlled study examined the impact of a medication
adherence app on persons with chronic illnesses who are medically underserved. In the case of
chronic disease patients who require long-term medication, adherence is critical to the best
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possible symptom management and results. This study examined the effects of a smartphone app
on medication adherence, self-efficacy, knowledge, and social support from other individuals with
a range of chronic diseases who live in a medically disadvantaged neighborhood. Participants were
randomized to either the app user group, which used it for a month, or the control group, which
received a printed list of their medications. According to the findings, a medically disadvantaged
population in the United States may benefit from using the app to manage chronic diseases.
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PLAN OF WORK
Quantitative Phase Qualitative Phase

Study Population Selection

Study Population Selection

Survey Instrument Development Development of Interview

Gathering Data
Data Collection

Data Analysis
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METHODOLOGY
Research Design:
Mixed-methods research design will be used in this study. Data from 250 individuals with chronic
conditions, such as diabetes, hypertension, and asthma, will be collected.
Participants
Participants
A total of 250 people from various medical facilities who suffer from chronic conditions such as
diabetes, hypertension, and asthma will be selected. The qualifying conditions will include
possessing a smartphone, being over 20, and having a prescription for long-term care.
Data Collection
To disseminate the survey via paper or electronic means to the chosen patient sample.
Medication Adherence: Measured using pharmacy refill rates and the Medication Adherence
Report Scale (MARS). Pharmacy refill data was obtained from electronic health records, and the
MARS was administered using questionnaires at baseline, three months, and six months.

Gather data on the characteristics, health history, and demographics of the MHA. The baseline
demographic and health data collection will comprise age, gender, type of chronic illness, and
duration of the disease.
Data Analysis
 Analyze survey data quantitatively using appropriate statistical approaches (e.g., regression
analysis, descriptive statistics) to look for connections between MHA intake and
medication adherence.
 Use thematic analysis to identify patterns and recurring topics in focus group or qualitative
interview data.
 Integrate quantitative and qualitative information to provide a comprehensive
understanding of MHA effectiveness.
Ethical Considerations
The study was approved by the institutional review board (IRB) of the participating medical
facilities. All participants gave informed permission prior to beginning the experiment.
Participants were given assurances regarding the confidentiality of their data and the flexibility to
withdraw from the study at any time without suffering consequences. In an attempt to provide
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thorough and in-depth insights on how successfully mHealth applications improve medication
adherence in patients with chronic diseases, this study employed a mixed-methods approach.
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REFERENCES
Bonyan Qudaha , Karen Luetsch.2019. The influence of mobile health applications on patient –
healthcare provider relationships: A systematic, narrative review. Patient Education and
Counseling 102 (2019) 1080–1089. https://doi.org/10.1016/j.pec.2019.01.021.
Christa E. Hartch1, Mary S. Dietrich, B. Jeanette Lancaster, Deonni P. Stolldorf, Shelagh
A. Mulvaney.2023. Effects of a medication adherence app among medically underserved
adults with chronic illness: a randomized controlled trial. Journal of Behavioral Medicine
(2024) 47:389–404 https://doi.org/10.1007/s10865-023-00446-2.
Linda G Park, Fion Ng, Janet K Shim, Abdelaziz Elnaggar and Ofelia Villero. 2020. Perceptions
and experiences of using mobile technology for medication adherence among older adults
with coronary heart disease: A qualitative study. Digital Health Volume 6: 1–12 ! The
Author(s) 2020 DOI: 10.1177/2055207620926844.
Pooja Mehta, Susan L Moore , Sheana Bull and Bethany M Kwan.2021. Building MedVenture –
A mobile health application to improve adolescent medication adherence – Using a
multidisciplinary approach and academic–industry collaboration. Digital Health Volume 7:
1–12 ! The Author(s) 2021 Article reuse guidelines: sagepub.com/journals-permissions
DOI: 10.1177/20552076211019877 journals.sagepub.com/home/dhj.
Sun Kyung Kim, Su Yeon Park, Hye Ri Hwang, Su Hee Moon, Jin Woo Park.2023. Effectiveness
of mobile health intervention in medication adherence: A systematic review and meta-
analysis. Journal of medical system. https://doi.org/10.21203/rs.3.rs-3440357/v1
Yihang Peng, Han Wang, Qin Fang, BS, Liling Xie, BS, Lingzhi Shu, MN, Wenjing Sun and Qin
Liu, PhD.2020. Effectiveness of Mobile Applications on Medication Adherence in Adults
with Chronic Diseases: A Systematic Review and Meta-Analysis. Journal of Managed
Care & Specialty Pharmacy JMCP April 2020 Vol. 26, No. 4 www.jmcp.org
Zhou Tt, Wang R, Gu Sj, Xie Ll, Zhao Qh, Xiao Mz, Chen Yl.2022. Effectiveness of Mobile
Medical Apps in Ensuring Medication Safety Among Patients With Chronic Diseases JMIR
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