An mHealth intervention to improve medication adherence among patients with coronary heart disease in China: Development of an intervention.
Zhao Ni, Changqing Liu, Bei Wu and 3 others
PMID 31406843WHAT IT FOUND
Medication adherence improved in both groups over 30 days, but daily reminders plus education did not improve adherence significantly more than education alone.
Heart rate decreased in controls and increased in the reminder group; this difference was significant.
Key findings
01At 30 days, the experimental group had a larger mean decrease in medication non-adherence score than the control group, but the difference was not statistically significant.
02Heart rate decreased in the control group and increased in the experimental group at 30 days, and the between-group difference was statistically significant.
03The study was feasible and acceptable: 72% of participants completed the 30-day study, and all interviewed participants reported the reminders helped them remember medications.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis used only 36 participants, so the study was too small to detect a meaningful difference in medication adherence. The intervention lasted only 30 days, which is short for assessing medication adherence and blood pressure outcomes. Participants came from one hospital and 91.7% lived in urban areas, so results may not apply to rural patients with less phone access. Baseline groups differed in education, body weight, and heart rate, which may affect the outcome comparisons. Reminders were sent manually by a study coordinator, so the feasibility may not translate to routine clinical care without automated systems. Medication adherence and health outcomes were self-reported by participants via WeChat and REDCap, and participants might forget or misreport doses.
The easy way to misread this
Do not conclude that phone reminders plus education improve medication adherence or heart rate. The adherence difference was not significant, and the significant heart rate finding favoured the control group, which may reflect baseline differences and the small 36-participant analysis.