Measuring the quality of smartphone medication management applications for patients: systematic research and evaluation of the offering in France (Preprint)

Abstract

Patient adherence is estimated at around 50% for chronically ill patients in developed countries. Improving the effectiveness of adherence interventions could have a far greater impact on population health than any improvement in specific medical treatments. Mobile health is one of the most effective solutions for helping patients to improve their medication intake, notably through the use of mobile applications with reminder systems. With over 327,000 apps listed in the mobile health field, it's difficult for healthcare professionals and patients alike to choose which apps to recommend and use.

To carry out a systematic search for medication management smartphone applications available in France that send reminders to patients, and assess their quality using a validated scale

Mobile applications were identified during October and November 2022 after a systematic keyword search on the 2 main application download platforms (App Store and Google Play Store). Inclusion criteria were free availability, date of last update and availability in French. Two healthcare professionals independently evaluated the included apps using the MARS-F, an objective score validated for assessing the overall quality of apps in the mobile healthcare field. An intra-class correlation coefficient was calculated to determine inter-rater reliability

960 applications were identified, and 49 were selected (25 from the App Store and 24 from the Google Play Store). Inter-rater reliability was excellent (ICC: 0.92; 95%IC [0.87; 0.95]; p < 0.001). The average MARS-F was 3.56 on App Store and 3.51 on Google Play Store, with 10 apps scoring above 4/5. Two apps were studied by at least one randomized clinical trial with positive results. The 2 apps with the highest ratings were "mediteo rappel de médicaments" and "TOM Rappel medicaments, pilule", available on both platforms. The MARS-F of each app was weakly correlated with user ratings on the App Store, and moderately correlated on Google Play Store.

To our knowledge, this is the first study to evaluate medication management applications that send medication reminders using a validated score. The quality of the apps was heterogeneous, with only 2 having been studied in a randomized controlled trial with positive results. The evaluation of applications in real-life conditions by patients is necessary in order to study their acceptability and effectiveness. Certification of applications is also essential, to help healthcare professionals and patients identify validated applications.