Table 2 The effectiveness of technology on medication adherence

Hale et al. [15], USA

One question from Medical Outcomes Study (MOS)

MedSentry data- counted as 'missed if not taken within 1 h

At 90 days follow-up, Intervention group medication adherence was 69% (n = 9) versus 73% (n = 13) measured using a MOS question

Medication adherence in the intervention group did not improve from baseline of 98.7% versus 94.2% at 90 days follow-up using data from the MedSentry device

Gallagher et al. [16], USA

Percentage of days where number of correct doses were taken

(Mann–Whitney U test used to compare adherence percentages between groups)

Adherence to diuretics (> 88% doses taken) was 29.4% (n = 5 participants) in the intervention group at 30 days follow-up, compared to 36.8% (n = 7) in the control group

Goldstein et al. [17], USA

Pillbox opening recording

Smartphone- electronic self-report (patients recorded their medication-taking on a log available on the medication adherence app – options for each event were taking a medication or skipping it)

At 28 days follow-up, intention-to-treat analyses showed patients in both intervention groups adhered to their medications 79% of the time, a mean of 84% for pillbox and 73% for smartphone intervention. This is compared to a mean of 78% adherence in the passive medication device groups (from 76% in pillbox and 79% in smartphone)

Per protocol analysis found that the intervention groups had a mean adherence rate of 85% versus a mean of 80% in the control groups

Boyne et al. [18], Netherlands

Heart Failure Compliance Scale

(Higher scores indicate better adherence)

Perceived importance of medication increased after 6 (93.5% intervention versus 88% control, p = 0.012) and 12 months (93.5% intervention versus 89.8% control, p = 0.037)

Estimated medication adherence based on X was greater in the intervention at 12 months (100% intervention versus 98.7% control) but was not found to be statistically significant)

Wu et al. [19], USA

MEMS (> 88% recorded opening as scheduled = adherent;

 < 88% = non = adherent)

PLUS patients had significantly better medication adherence versus control group at 2 months follow-up (82% intervention versus 59% control, p = 0.05) and at 9 months follow-up (74% intervention versus 36% control, p = 0.012)

Felker et al. [20], USA

Adherence questionnaire developed by Voils et al

Medication adherence did not change from baseline to 3 months (Least Squares (LS)-mean change: –0.08 in mHealth vs –0.15 in usual care; LS-mean difference = 0.07; 95% CI: –0.12, 0.26)

Yanicelli et al. [21], Argentina

Morisky Modified Scale (MMS) questionnaire

(Higher scores indicated better adherence)

Mean MMS overall scores in 3 months follow-up were 4.73 (intervention) and 4.73 (control)

Young et al. [22], USA

Self-reported number of days where medication had been missed in the previous 7 days

Intervention group also reported significantly fewer days missing any doses of prescribed medication

Mean number of days for any missed medication in the previous 7 days was 0.39 in the intervention group versus 0.81 (control) at 3 months and 0.26 (intervention) versus 0.80 (control) at 6 months. Estimated marginal mean was 0.30 (intervention) versus 0.80 (control). 95% CI: -0.51 (-0.97, -0.05)

Ross et al. [23], USA

Questions derived from Morisky Scale

At 6 months, medication adherence scores were 3.5 (Intervention) versus 3.4 (control), with a CI of + 0.1 (-0.2, 0.4). At 12 months, scores were 3.6 (intervention) versus 3.4 (control) with a CI of + 0.2 (-0.1, 0.6)