Background
Methods
Development of app assessment criteria
S/N | App assessment criteria | Excerpt of extracted guidance/justification | References supporting the guidance |
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1 | Planning and organisation | ||
1.1 | The app has a feature that allows the user to display scheduled medications as different visual compartments (e.g. visual pillbox in the app) | Reduce dosing complexity: Use blister or compartmentalised boxes to reduce dosing complexities | |
1.2 | The app has a feature that allows the user to switch between daily and weekly medication schedule displays | ||
1.3 | The app has a feature that allows the user to schedule medication-taking on alternate days (e.g. Pill A on Monday, Wednesday, Friday; Pill B on Tuesday, Thursday, Saturday) | ||
1.4 | The app has a feature to enter the purpose of the medication | Planning and organisation: Develop an individualised, documented self-management plan including the plan’s start and review date, conditions being managed, description of the medication (frequency, dose, strength, instructions, known reactions, and allergies, length of treatment) | |
1.5 | The app has a feature that allows the user to enter special instructions for medication (e.g. taken before food) | ||
1.6 | The app has a feature that allows the user to organise “take as needed” medications in a separate section from medicines with a fixed regimen | ||
1.7 | The app has a feature that allows the user to enter/log at least 4 different medications at any given time | ||
1.8 | The app has a variety of dosage input options (e.g. subcutaneous insulin for diabetes, oral medications) | ||
1.9 | The app has a feature that allows the user to document allergies (i.e. via prompts/greyed out instructions or a separate tab) | ||
1.10 | The app has a feature that allows the user to sync medication-taking schedule with the phone calendar | For user’s convenience without having to open a separate calendar to view medication schedule. | |
2 | Adherence and monitoring | ||
2.1 | The app has a feature that allows the user to record the fraction of an actual pill or volume of a liquid medication prescribed (i.e. ½ pill or 5 ml of a syrup) to be recorded. | Oral tablets may be prescribed as a fraction of one and liquids are prescribed as a specified volume. Apps that do not allow this will be less helpful and could introduce errors. | |
2.2 | The app has a feature that allows users to document medication-intake | Monitoring: Record medicines taken, self-monitor the condition and report all adverse reactions. | |
2.3 | The app has a feature that allows users to record notes on any medication event (i.e. a “note/comment” section at the logging page or a as a separate tab) | ||
2.4 | The app has a feature that allows users to document medication side-effects (i.e. via prompts/greyed-out instructions or a separate tab) | ||
2.5 | The app has a feature that assesses medication adherence by comparing planned and actual medication taking (E.g. the app generates weekly percentage of adherence or has a visual display). | Adherence assessment: Routinely assess adherence during prescribing, dispensing, and reviewing medicines. | |
3 | Information provision | ||
3.1 | The app has a feature that provides users with information about the prescribed medication | Information provision: Repeatedly offer clear, understandable, and relevant information about the medication prescribed. Provide resources to where information about medication can be obtained. | |
3.2 | The app has a feature that provides users with resources (in-app or external link) to access information about the prescribed medication | ||
4 | Complementary medicines | ||
4.1 | The app has a feature that asks users about the use of complementary medicines | Complementary medicine: Take into account all complementary medicines the person is taking or using, and its purpose. | |
4.2 | The app has a feature that flags possible contraindications with the use of complementary medicines | ||
5 | Reminders | ||
5.1 | The app has a feature that allows users to set up reminders for taking medications | Reminders: Reminders have shown to improve adherence to medicines despite inconclusive evidence. | |
5.2 | The app has a feature that allows users to set up reminders to refill prescriptions | Refill medication: Prescription refill is an indirect method for measuring medication adherence, and could alert prescribers and pharmacists to problems of adherence. | |
6 | Motivation | ||
6.1 | The app has a feature that provides statements to motivate users about the importance of medication adherence | Behavioural change: Positive reinforcements are important in sustaining behavioural change (Guidelines). Providing consequences and benefits of effective medication adherence helps the patient to understand the need and to establish motivation to adhere to medication [26]. Positive reinforcements are important in sustaining behavioural change [27]. | |
6.2 | The app has a feature that provides encouragement when medication is taken on schedule (i.e. encouraging messages, “badges or awards”) | ||
7 | Caregiver’s involvement | ||
7.1 | The app has a feature that allows users to sync medication-taking schedule with caregiver’s phone | Carer’s involvement: Keep an up-to-date list of all medicines the patient is taking and take note of any allergic or adverse reactions to medicines. | |
7.2 | The app has a feature that supports multiple user profiles (e.g. For family members or carers) | ||
8 | Communication with healthcare provider | ||
8.1 | The app has a feature that allows users to contact a healthcare provider regarding queries on medication | Communication with health provider: Establish the most effective way of communicating with each patient. | |
9 | Communication with health system | ||
9.1 | The app has a feature that supports data export | Communication within/across health settings: Health and social care practitioners should share relevant information about the person and their medicines when a person transfers from one care setting to another. Use the most effective and secured way with one or multiple approaches, such as secure electronic communication. |
App selection and assessment
Search strategy
Screening
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Apps with medication self-management features
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Apps with any blood glucose logging features
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Apps in the English language
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Free apps and apps requiring payment
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Patient health portals linking to patients’ electronic health records
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Apps that were not updated after January 1, 2017
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Intended for healthcare professionals
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Insulin calculators/bolus correctors only
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Apps with exclusive blood glucose monitoring device tie-in requirement
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Apps duplicated on the same platform
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Apps with regional restrictions
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Technical problems (e.g. crashes, screen hangs, unable to login, unable to download)
App assessments
Statistical analysis
Screening
App assessments
Results
Characteristics of included apps
Classification | App features | All apps (n = 143) (%) | Android (n = 81) (%) | iOS (n = 62) (%) | p value | |
---|---|---|---|---|---|---|
Planning and organisation | 1.1 | The app has a feature that allows the user to display scheduled medications as different visual compartments (e.g. visual pillbox in the app) | 7 (4.9) | 4 (4.9) | 3 (4.8) | 1.000^ |
1.2 | The app has a feature that allows the user to switch between daily and weekly medication schedule displays | 4 (2.8) | 3 (3.7) | 1 (1.6) | 0.633^ | |
1.3 | The app has a feature that allows the user to schedule medication-taking on alternate days (e.g. Pill A on Monday, Wednesday, Friday; Pill B on Tuesday, Thursday, Saturday) | 37 (25.9) | 24 (29.6) | 13 (21.0) | 0.241 | |
1.4 | The app has a feature to enter the purpose of the medication | 42 (29.4) | 22 (27.2) | 20 (32.3) | 0.507 | |
1.5 | The app has a feature that allows the user to enter special instructions for medication (e.g. taken before food) | 57 (39.9) | 33 (40.7) | 24 (38.7) | 0.806 | |
1.6 | The app has a feature that allows the user to organise “take as needed” medications in a separate section from medicines with a fixed regimen | 12 (8.4) | 6 (7.4) | 6 (9.7) | 0.628 | |
1.7 | The app has a feature that allows the user to enter/log at least 4 different medications at any given time | 98 (68.5) | 56 (69.1) | 42 (67.7) | 0.859 | |
1.8 | The app has a variety of dosage input options (e.g. subcutaneous insulin for diabetes, oral medications) | 123 (86.0) | 66 (81.5) | 57 (91.9) | 0.074 | |
1.9 | The app has a feature that allows the user to document allergies (i.e. via prompts/greyed out instructions or a separate tab) | 5 (3.5) | 4 (4.9) | 1 (1.6) | 0.389^ | |
1.10 | The app has a feature that allows the user to sync medication-taking schedule with the phone calendar | 7 (4.9) | 2 (2.5) | 5 (8.1) | 0.239^ | |
Monitoring and adherence | 2.1 | The app has a feature that allows the user to record the fraction of an actual pill or volume of a liquid medication prescribed (i.e. ½ pill or 5 ml of syrup) to be recorded. | 83 (58.0) | 45 (55.6) | 38 (61.3) | 0.491 |
2.2 | The app has a feature that allows users to document medication-intake | 112 (78.3) | 57 (70.4) | 55 (88.7) | 0.008* | |
2.3 | The app has a feature that allows users to record notes on any medication event (i.e. a “note/comment” section at the logging page or as a separate tab) | 70 (49.0) | 35 (43.2) | 35 (56.5) | 0.116 | |
2.4 | The app has a feature that allows users to document medication side-effects (i.e. via prompts/greyed-out instructions or a separate tab) | 5 (3.5) | 4 (4.9) | 1 (1.6) | 0.389^ | |
2.5 | The app has a feature that assesses medication adherence by comparing planned and actual medication taking (e.g. the app generates weekly percentage of adherence or has a visual display). | 24 (16.8) | 17 (21.0) | 7 (11.3) | 0.175 | |
Information provision | 3.1 | The app has a feature that provides users with information about the prescribed medication | 12 (8.4) | 6 (7.4) | 6 (9.7) | 0.628 |
3.2 | The app has a feature that provides users with resources (in-app or external link) to access information about the prescribed medication | 8 (5.6) | 4 (4.9) | 4 (6.5) | 0.727^ | |
Complementary medicines | 4.1 | The app has a feature that asks users about the use of complementary medicines | 2 (1.4) | 0 (0.0) | 2 (3.2) | 0.186^ |
4.2 | The app has a feature that flags possible contraindications with the use of complementary medicines | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1.000^ | |
Reminders | 5.1 | The app has a feature that allows users to set up reminders for taking medications | 83 (58.0) | 47 (58.0) | 36 (58.1) | 0.996 |
5.2 | The app has a feature that allows users to set up reminders to refill prescriptions | 9 (11.1) | 6 (9.7) | 15 (10.5) | 0.782 | |
Motivation | 6.1 | The app has a feature that provides statements to motivate users about the importance of medication adherence | 8 (5.6) | 3 (3.7) | 5 (8.1) | 0.293^ |
6.2 | The app has a feature that provides encouragement when medication is taken on schedule (i.e. encouraging messages, “badges or awards”) | 6 (4.2) | 3 (3.7) | 3 (4.8) | 1.000^ | |
Caregiver’s involvement | 7.1 | The app has a feature that allows users to sync medication-taking schedule with caregiver’s phone | 9 (6.3) | 5 (6.2) | 4 (6.5) | 1.000^ |
7.2 | The app has a feature that supports multiple user profiles (e.g. For family members or carers) | 22 (15.4) | 11 (13.6) | 11 (17.7) | 0.494 | |
Communication with healthcare provider | 8.1 | The app has a feature that allows users to contact a healthcare provider regarding queries on medication | 16 (11.2) | 7 (8.6) | 9 (14.5) | 0.269 |
Communication with health system | 9.1 | The app has a feature that supports data export | 89 (62.7) | 44 (55.0) | 45 (72.6) | 0.036* |