The AlerHTA smartphone application significantly improved daily medication adherence at 12 months compared to usual care (86.3% vs 62.66%; p<0.05), with a number needed to treat of 4.23.
RCT (n=154)
cluster-randomized
Yes
Does a smartphone application improve medication adherence and blood pressure control in patients with mild to moderate arterial hypertension?
A dedicated smartphone application significantly improves pharmacological adherence in patients with mild to moderate hypertension.
Number Needed to Treat: 4.23
Absolute Event Rate: 86.3% vs 62.66%
Number Needed to Treat: 4.23
p-value: p=< .05
Introduction: Digital interventions, such as smartphone applications (apps), are becoming an increasingly common way to support medication adherence and self-management in chronic illness.Aim: To evaluate the effectiveness of the intervention in pharmacological therapeutic adherence in mild to moderate arterial hypertension (AHT), through an app installed on a mobile phone, as well as the degree of control reached by the patient with this tool.Methods: Prospective, randomized controlled trial, full study and multicenter study. Four primary care centers participated. One hundred and fifty-four hypertensive patients under antihypertensive treatment were included. Two groups were established: a control group (CG) with usual intervention (n = 77) and an intervention group (n = 77) (IG), targeting hypertensive people who owned and regularly used a mobile smartphone, specifically using the app called AlerHTA to promote health education and reminder of appointments. There were three visits: initial, 6 and 12 months. Drug adherence was measured by electronic monitors (MEMSs). The primary outcomes were average daily percentage adherence between 80 and 100%, and AHT control.Results: A total of 148 patients finished the study. Mean age was 57.5 ± 9.9. Global adherence was 77.02% (CI = 70.25–83.79) and daily adherence was 74.32% (CI = 67.29–81.35%). Daily adherence was 93.15% and 86.3% in IG, and 70.66% and 62.66% in CG after 6 and 12 months respectively (p < .05). The percentage of uncontrolled patients was 28.3% (CI = 21.05–35.55%). The control of high blood pressure at 12 months was 17.8% and 38.6% for IG and CG respectively (p < .05). The number of patients needed to treat to avoid non-adherence (NNT) was 4.23 patients.Conclusions: The intervention with an app installed on the mobile phones of hypertensive patients favors pharmacological therapeutic adherence and improves the percentage of hypertensive patient control.Trial registration: Spanish Agency of Medicine: EPA-SP UN-HTA-2015-01.
Contreras et al. (2018) conducted an RCT in mild to moderate arterial hypertension (n=154). AlerHTA smartphone application vs. usual intervention was evaluated on daily percentage adherence at 12 months (NNT 4.23, p=< .05). The AlerHTA smartphone application significantly improved daily medication adherence at 12 months compared to usual care (86.3% vs 62.66%; p<0.05), with a number needed to treat of 4.23.