Can your smartphone help you to remember to take your medication? If yes, which application to use? In 2019, of the 300,000 health applications available in the various stores, 25% were intended for information and reminders of medicines.
Even if doctors are convinced that the vast majority of their patients are well aware of the drugs prescribed, the reality is quite different. The WHO estimates that long-term therapeutic adherence is only 50% and that this is the main reason why patients do not reap all the benefits they might expect from their drugs. Is mobile health part of the solution? Are there quality applications that could be recommended for chronic patients?
Using keywords, there were identified 2683 App Stores. Then they were subjected to inclusion and exclusion criteria to select only the best. The selection criteria were for example that the application had to be available in English, that its last update requested was less than a year and that it had to be free.
One wonders if it was right to introduce free as a criterion. Indeed, if an application is useful, it seems justified to invest a few U.S. dollars for its acquisition. It is unlikely that a patient will invest in the purchase of an application without having been able to test it first. Regarding exclusion criteria, applications were excluded if they did not offer a reminder function but also if they were specific to a certain medication (contraception) or to a disease (diabetes). The proposed applications for selling drugs online have also been eliminated.
Ann App to Remember to Take or Refill Your Medication
A free app is a great tool for those who have to take one or more medications: it allows you to manage your medication intake and also offers a practical reminder function so that you do not forget a dose. Moreover, you can allow family members or friends to receive an alert when a dose has not been taken. In separate cases, My Canadian pharmacy medication-dedicated portal points out that the difference between having and not having automatized refills can be as meaningful as to determine whether or not the patient continues with the crucial therapy course, such as antibiotics or blood pressure agents.
Since all actions are kept in memory, you know when a medication to be taken as needed has been ingested, how many refills are left on a prescription or in how many days you will have to go to the pharmacy to renew a medication. Such applications are compatible with phones and tablets on iOS and Android and are tools that have advantages for people taking drugs as well as for their loved ones. First, create your profile by adding all the medications you need to take.
You must specify what type of medication it is (syrup, inhaler, injection, pill, etc.) and specify the form and color of the tablet for the pills. Then indicate how many times of the day you should take the medication, the dosage prescribed by a doctor, then program the reminder functions.
Depending on the schedule you choose, you will receive an alert on your mobile device to remind you to take the medication. When it is done, you just have to confirm that you took it. You can also add an app to the medication card. That way, if you forget to take a dose despite the alert, a notification is sent to that friend or family member to let them know.
This is very practical for, for example, relatives of elderly people or diabetic children who must manage their medication independently without missing a dose. Finally, it is also possible to program a reminder to go and renew your prescription at the pharmacy, print a report displaying the doses taken and synchronize the data with that of other family members who use the app.
The Winners Are
In order to scientifically provide the applications included, 27 criteria were selected and divided into the following six categories: security, quality of health content, quality of information about the application, functionality, aesthetics and absence of advertising. According to Healthcare Technology the prize list is as follows: RxTx is the application with the highest score (59%) followed by UpToDate (56%), DynaMed Plus (45%) and Epocrates (32%)”.
It is interesting to note that all the applications have lost a number of important points in the category ‘quality of information about the application’. In fact, no application mentions the sources or bibliographic references from which the information and educational content are taken, which limits the trust placed in the application. There is also no app to indicate sources of funding or expressions of interest.
When you have to take one or more medications every day in the long run, it is not always easy to think about it, or even sometimes to remember if you took it or not. This is why new online tools are emerging to help patients improve adherence to their treatment.
It Is Essential to Follow Your Treatment Well
We often talk about good adherence to a treatment to say that a patient follows his doctor’s prescription to the letter by taking his medication properly. When one suffers from a chronic illness, the therapeutic adherence must be increased, as well as the medical follow-up or the hygiene-dietetic rules. According to Canadian Pharmacists Association, one in two patients suffering from a chronic pathology (diabetes, hypertension, epilepsy, asthma, psychiatric illnesses, etc.) forget to take their medication. The consequences of poor compliance can be very serious, up to hospitalization or death. One of the essential factors for good compliance is the patient’s understanding of his pathology and his treatment. Healthcare professionals are therefore on the front line and can also involve the family and friends of the patient for more impact. But once at home, a patient sometimes needs daily help to discipline himself.
To Think about Taking Your Medication: Take Reminder Applications
In recent years, pharmaceutical companies and mobile solution design companies have developed applications for smartphones specializing in medication recall. Here are the most useful:
For parents of large families Canadian Pharmacy Association advises: RxTx (download app)
RxTx app allows you to create several profiles: yours, that of your husband and your children; then add drugs, specifying the dosage, duration and times for each, and receive an alert at the time of taking, to know which drug should be taken by which person in the family. You can also compile a directory of your medical contacts (attending physician, pediatrician, emergencies, etc.) and anticipate your trips or those of your loved ones: you enter the number of days of stay and the application automatically generates the list of medications and the number take out boxes.
For joint monitoring of treatment with a caregiver or a family member: UpToDate (download app)
With UpToDate, you register your medications in a few simple steps and organize taking reminders. You can add someone to help you manage your treatments and the app generates intake reports that you can send to a doctor or nurse. In addition, you will have constant monitoring of your health, by recording your measurements such as blood pressure, weight, blood sugar, etc.
The most complete app, also accessible to the elderly who do not have smartphones: DynaMed Plus (download app)
On DynaMed Plus, you can register your medication (s) by scanning the packages. Once the prescription has been filled in, the application provides the user with functionalities allowing to:
- Receive reminder notifications when it’s time to take your treatment, on your phone or by email;
- Visualize the observance of your intake plan;
- Notify of any undesirable effects, specifying the nature, date, duration and severity;
- Manage your appointments with health professionals;
- Share all of the elements with your loved ones and especially with the health professionals in charge of your follow-up (nurse, pharmacist, attending physician).
In order to remotely monitor medication for elderly people who are losing their autonomy and who do not have a smartphone, a caregiver’s functionality has been created in this application: the caregiver is alerted by reminders and notifications from the taking medication and can intervene if you forget. Caregivers can also manage all the functionalities for the caregiver, for example sending monitoring reports to health professionals themselves.
For homeopathy enthusiasts: Epocrates (download app)
Once the application has been downloaded, you enter the name and dosage of the drugs prescribed by your doctor, or recommended by your pharmacist thanks to a semi-automatic data entry mode. Here, the names of homeopathic medicines are easily recorded, the spelling of which is sometimes difficult to remember. Then, a personalized schedule is created and an automatic alarm system allows you to choose how often you want to be warned of taking your medication.
For diabetics: Visual Anatomy (download app)
In the Visual Anatomy app, you can find practical information on your diabetes on a daily basis, a follow-up diary to better manage it, reminders for taking medications and medical appointments, monitoring your results of analysis or blood sugar and advice on diet and physical activity. You can also scan, save and send your prescriptions to your pharmacist.
Applications not to Be Advised!
In view of these disappointing results, including for the four applications selected, the quality applications are still difficult to find and pharmacists should not advise them carefully and only if a patient is seeking applications allowing to support the price of treatment. 165,000 health applications, 10,000 for information and medication reminders and not one of sufficient quality for your pharmacist to recommend you.
The future?
The gamification functionality which consists in sending reward messages if the membership is good, is not present in any of the applications. However, studies show that gamification in health applications is an advantage because it allows a patient to engage more significantly with the application through badges, trophies or changes to a level.
