Discussion Post

Medication non-adherence is a major public health issue that contributes to poor health outcomes and increased healthcare spending. It is estimated that around 50% of patients with chronic conditions do not take their medications as prescribed (Kleinsinger, 2018). This leads to worse disease control and more complications. Among patients with conditions like diabetes, hypertension, and high cholesterol, medication adherence is a key part of successful disease management. However, average adherence rates remain around 50-60% based on pharmacy refill data (Campbell et al., 2021). Patients report barriers like forgetfulness, cost, side effects, and lack of understanding as reasons for non-adherence. This highlights a need for improved solutions to promote better medication-taking behaviors. As a nurse practitioner in primary care, many of my patients struggle to adhere to their prescribed regimens for managing chronic illness. Finding ways to increase adherence is essential to improving health in this population.

The purpose of this randomized controlled trial (RCT) is to evaluate the impact of using a tailored mobile medication reminder app on improving medication adherence rates in primary care patients with chronic conditions like diabetes, hypertension, and/or high cholesterol over a 6-month period. Patients will be randomized to use the app with tailored reminders matched to their regimen or usual care without the app. It is hypothesized that patients using the app will have significantly higher medication adherence rates compared to usual care. This study aims to build on prior research showing the promise of mobile apps for adherence and test an innovative feature of tailored reminders to provide individual-level support. If effective, the app could be a simple and scalable solution to promote better adherence in chronic disease management.

In primary care patients over 18 years old diagnosed with diabetes, how does the use of a customized mobile medication reminder app with tailored reminders matched to the patient's regimen (I) compared to usual care without the app (C) influence the increase in medication adherence rates (O) over a 6-month period (T)?

Campbell, P. J., Axon, D. R., Taylor, A. M., Smith, K., Pickering, M., Black, H., Warholak, T., & Chinthammit, C. (2021). Hypertension, cholesterol and diabetes medication adherence, health care utilization and expenditure in a Medicare Supplemental sample. Medicine, 100(35), e27143. https://doi.org/10.1097/MD.0000000000027143

Kleinsinger, F. (2018). The Unmet Challenge of Medication Nonadherence. The Permanente Journal, 22, 18–033. https://doi.org/10.7812/TPP/18-033