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Tuesday, February 24, 2015

Impact of mHealth on Adherence and Patient Outcomes Needs Improving. How "Open, Crowdsourced" Data from Pharma Can Help

A study just published in the Journal of Medical Internet Research (JMIR) concludes that "there is potential for mHealth tools to better facilitate adherence to chronic disease management, but the evidence supporting its current effectiveness is mixed. Further research should focus on understanding and improving how mHealth tools can overcome specific barriers to adherence."

The study was a systematic review of 107 studies published in peer-reviewed journals. It aimed to evaluate the effectiveness of mHealth in supporting adherence of patients to chronic disease management -- which the authors call “mAdherence” -- and the usability, feasibility, and acceptability of mAdherence tools and platforms for chronic disease management.

The authors classified mAdherence tools and platforms into four main categories: SMS; phone plus software or application; phone plus specific instrument (medical device connected to phone via a cord); or phone plus wireless or Bluetooth-compatible device (see figure below):

Types of mobile tools used in mAdherence. Click on image to enlarge.

What were the results and how can the pharmaceutical industry help?

Only 27 studies employed randomized controlled trial (RCT) methods to assess impact on adherence behaviors, and significant improvements were observed in 15 of those studies (56%).

The authors conclude:
"mAdherence is a potential high-impact tool to improve health outcomes among those living with chronic diseases through enhanced chronic disease management adherence. Further evaluation of mAdherence tools will be critical, especially research that informs how these tools overcome barriers to chronic disease management. More innovation, optimization, and high-quality research in mAdherence has the potential to transform the promise of mHealth technology into the reality of improved health care delivery and outcomes."
The pharmaceutical industry is interested in improving adherence and has developed a several mobile  apps/tools designed to improve adherence. It would be very helpful if the industry performed randomized controlled trials to assess the impact of its mAdherence tools on outcomes and to make the results publicly available.

Like Lilly's Open Innovation project team, I believe that "open data, linked, crowdsourced, consumed and curated by experts outside (as well as inside) the walls of pharma will bring innovative insights and wisdom. And that open communities will set and meet objectives to reduce costs and improve outcomes."

Imagine the possibilities if that sentiment were applied to mHealth tool development.

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