User profiles of a smartphone application to support drug adherence--experiences from the iNephro project

Abstract

Purpose: One of the key problems in the drug therapy of patients with chronic conditions is drug adherence. In 2010 the initiative iNephro was launched (www.inephro.de). A software to support regular and correct drug intake was developed for a smartphone platform (iOS). The study investigated whether and how smartphone users deployed such an application.

Methods: Together with cooperating partners the mobile application "Medikamentenplan" ("Medication Plan") was developed. Users are able to keep and alter a list of their regular medication. A memory function supports regular intake. The application can be downloaded free of charge from the App Store™ by Apple™. After individual consent of users from December 2010 to April 2012 2042338 actions were recorded and analysed from the downloaded applications. Demographic data were collected from 2279 users with a questionnaire.

Results: Overall the application was used by 11688 smartphone users. 29% (3406/11688) used it at least once a week for at least four weeks. 27% (3209/11688) used the application for at least 84 days. 68% (1554/2279) of users surveyed were male, the stated age of all users was between 6-87 years (mean 44). 74% of individuals (1697) declared to be suffering from cardiovascular disease, 13% (292) had a previous history of transplantation, 9% (205) were suffering from cancer, 7% (168) reported an impaired renal function and 7% (161) suffered from diabetes mellitus. 69% (1568) of users were on <6 different medications, 9% (201) on 6 - 10 and 1% (26) on more than 10.

Conclusion: A new smartphone application, which supports drug adherence, was used regularly by chronically ill users with a wide range of diseases over a longer period of time. The majority of users so far were middle-aged and male.

Figure 1. Generating a medication plan on the smartphone (exemplary screenshots).

Figure 2. Relative proportion by age of users of "Medication Plan" who provided demographic data (n = 2279) and all smartphone users (*Federal Statistical Office, 2011 [11]).

Figure 3. 1095 regular users (defined as applying "Medication Plan" at least once a week for at least 28 days) specified their age.

At 28 days after download 23% (124/530) of users <50 years and 28% (156/565) of users >50 years were still using the application at least once a week (p>0.05). The proportion of older individuals using “Medication Plan” at 165 days was significantly higher (<50 years: 9% (46/530) and >50 years 15% (82/565); p<0.004*). After 365 days only 1% of regular users <50 years (6/530) as well as >50 years (4/565) were using the application.