Study: App improves medication adherence with no change in systolic blood pressure among hypertension patients

By Laura Lovett
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A study published in JAMA Internal Medicine today demonstrated that a smartphone app could lead to small improvements in self-reported medication adherence among participants with poorly controlled hypertension. However, participants using the app had no change in systolic blood pressure compared to their counterparts that were not using the app, according to the study. 

Medication adherence has so far been an ongoing struggle in treating individuals with hypertension, according to the researchers. 

“In fact, among patients classified as having “medication-resistant” hypertension, more than 50 percent are actually nonadherent to their prescribed medications,” they wrote in the study. “Mobile health interventions, such as smartphone applications, have been advocated as promising strategies to assist in the self-management of hypertension, and other chronic conditions. These tools have the potential to address nonadherence by providing reminders for medication taking and refilling, tracking biometric results, offering education, and facilitating social interactions that provide support and motivation.”

Researchers set out to see if an app could help medication adherence and improve blood pressure. The study was made up of 411 participants with a systolic blood pressure of 140mm Hg or higher who were using between one and three antihypertensive medications. Participants were recruited by means of online patient communities, social media, and advertisements, according to the study.  

Researchers spilt the participants into two groups. One group used an adherence app called the Medication Adherence Improvement Support App for Engagement-BloodPressure (MedISAFE-BP). Meanwhile, the control group did not receive any interventions. 

In the former group, the Medisafe app prompted patients to enter a list of medications manually, as well as when they usually take the medication. 

The app also lets users track their blood pressure and other biometric measurements. However, in the study the app didn’t sync with the home blood pressure cuff or medical professionals. Users were also given what the app calls a “Medfriend,” an individual who is granted access to the patient’s medication taking history, receives alerts when doses are missed, and can provide peer support, according to the study. 

All patients participated in follow-up assessments at four, eight, and 12 weeks after enrollment. At each assessment participants had their blood pressure measured, and by week 12 the participants were given an exit survey that measured adherence, hypertension knowledge, and patient activation. 

The researchers found that medication adherence, as reported by participants, did increase among the intervention group and had no change in the control group.

However, as a whole the intervention group did not actually have better blood pressure control than the group without the intervention.  At the end of the study, 35.8 percent of the intervention group and 37.9 percent of the control group had good blood pressure control, meaning their blood pressure was under 140/90 mm Hg. 

While the researchers noted that there are a plethora of adherence apps on the market, available research around these apps is still wanting. 

“However, there has been a lack of rigorous evaluation to date, with most studies relying on self-report and not including a clinically important outcome,” the authors of the study wrote in their conclusion. “The MedISAFE-BP trial is, to our knowledge, the first randomized clinical trial reporting the effect of a stand-alone mHealth platform to increase medication adherence and improve blood pressure control. We found significant improvement in medication adherence, but no difference in systolic blood pressure between the intervention and control groups.”

Medisafe has been in the adherence business for a while. This spring, the adherence platform announced that it will be further personalizing user experiences by adding a personalized tone feature