Revista Científica Interdisciplinaria Investigación y Saberes

2024, Vol. 14, No. 1 e-ISSN: 1390-8146

Published by: Universidad Técnica Luis Vargas Torres

How to cite this article (APA):

Salinas, C., Serrano, K., Pacheco J. (2024) Mobile applications for

medication management in the elderly: a systematic review, Revista Científica Interdisciplinaria

Investigación y Saberes, 14(1) 13-32

Mobile applications for medication management in the elderly: a

systematic review.

Aplicaciones móviles para el control de la medicación del adulto mayor: una revisión

sistemática

Camila Elizabeth Salinas Ramírez

Estudiante de Medicina de la Universidad Católica de Cuenca, Licenciada en Ciencias de la

Comunicación Social en Comunicación Organizacional y Relaciones Públicas. Universidad Católica de

Cuenca. camsalinasramirez@gmail.com, https://orcid.org/0009-0002-5201-0027

Karina de Lourdes Serrano Paredes

Ingeniera de Sistemas, Magister en Procesos Educativos Mediados por Tecnologías, Magister en

Administración de empresas con mención en Gestión de Proyectos. Estudiante del doctorado en

Tecnología Educativa. Docente de la Unidad Académica de Salud y Bienestar carrera de Medicina.

Universidad Católica de Cuenca. kserrano@ucacue.edu.ec, https://orcid.org/0000-0002-3598-7963

Jenny Alexandra Pacheco Sarmiento

Médica, Especialista en Cirugía General, Especialista en Gerencia y Planificación Estratégica en Salud.

Docente de la Unidad Académica de Salud y Bienestar carrera de Medicina. Universidad Católica de

Cuenca. lolapsja@gmail.com, https://orcid.org/0000-0003-1545-1667

The increasing use of mobile applications has profoundly influenced

various facets of human progress, including the medical area.

Electronic applications have demonstrated their ability to improve

healthcare, monitor disease progression and serve as a constant

stimulus for medication compliance in people with polypathology.

Bringing multiple advantages in monitoring medication consumption

in older adults who often suffer from cognitive disorders. To

determine the importance of the use of mobile applications as a

medication aid in the older adult. The search was conducted in

Scopus, Pubmed and Ovid, using terms such as "Technology",

"mobile applications", "medication system", "medication in older

adult", with a maximum age of 5 years. Mobile applications are

Abstract

Received 2023-09-09

Revised 2023-11-17

Published 2024-01-05

Corresponding Author

Camila Elizabeth Salinas Ramirez

camsalinasramirez@gmail.com

Pages: 14-32

https://creativecommons.org/lice

nses/by-nc-sa/4.0/

Distributed under

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

valuable in improving medication adherence, particularly among the

older adult population, depending on the method of engagement,

whether through personal interaction, email or telephone means, and

on the regularity of dispensing and the intended therapeutic target.

Mobile applications improve medication adherence for various

chronic diseases in older adults, in direct relation to the quality and

quantity of medication and the sociodemographic characteristics of

the patient, which favors medication recall.

Keywords:

mobile apps, medication, elderly, biomedical technology

Resumen

La creciente utilización de aplicaciones móviles ha influido

profundamente en diversas facetas del progreso humano, incluida el

área médica. Las aplicaciones electrónicas han demostrado su

capacidad para mejorar la atención sanitaria, supervisar el avance de

las enfermedades y servir de estímulo constante para el cumplimiento

de la medicación en personas con polipatología. Aportando múltiples

ventajas en la supervisión del consumo de medicamentos en adultos

mayores que a menudo padecen trastornos cognitivos. Determinar la

importancia del uso de aplicaciones móviles como ayuda de la

medicación en el adulto mayor. La búsqueda se realizó en Scopus,

Pubmed y Ovid, usando términos como “Tecnología”, “aplicaciones

móviles”, “sistema de medicación”, “medicación en adulto mayor”,

con una antigüedad máxima de 5 años. Las aplicaciones móviles son

valiosos para mejorar la adherencia a la medicación, particularmente

entre la población adulta mayor, dependiendo del método de

contratación, ya sea mediante la interacción personal, el correo

electrónico o los medios telefónicos, y de la regularidad de la

dispensación y del objetivo terapéutico previsto. Las aplicaciones

móviles mejoran la adherencia a la medicación para diversas

enfermedades crónicas en adultos mayores, en relación directa con la

calidad y cantidad de la medicación y las características

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

sociodemográficas del paciente, lo que favorece el recuerdo de la

medicación.

Palabras clace:

Aplicaciones móviles, medicación, ancianos,

tecnología biomédica

Introduction

In recent decades, the advancement of technology has led the

Internet, social networks and applications to become the focal point

of global communication. This phenomenon is evident in all aspects

of human life, including the field of healthcare. In light of this, the

increasing use of electronic devices is becoming more and more

evident. However, this trend is not limited to the millennial population

alone. According to The Pew Research Center's Internet & American

Life Project, a sizable percentage of older adults worldwide,

specifically over 15%, own at least one tablet or smartphone (Leslie et

al., 2016). Thus, the democratization of information through the

internet and different technological devices in all age ranges is an

increasingly visible fact.

Now, a particularity of this technological development is precisely the

application it has had in the healthcare field, a situation that according

to the World Health Organization (WHO) is known as eHealth, a term

used for the practice of healthcare supported by Information and

Communication Technologies (ICT). (Sánchez Rodríguez et al., 2018).

In such a way, that this tool has shown great acceptance by different

types of users; a situation that is evidenced by the creation of more

than 400,000 health applications, the same, are available for

download in mobile application stores worldwide (van der Storm et

al., 2023).. Mobile health (mHealth) represents a modern version of e-

health, which focuses on the use of smartphones and technologies in

public health.modifying health behaviors, fosters patient skills and

accelerates the treatment of diseases, especially chronic ones

(Rodríguez Mariblanca and Cano de la Cuerda, 2021)..

That is why, the development of mobile applications can facilitate

access to health, by acting cognitively and behaviorally on the

patient's habits, providing a unique ability to empower and monitor

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

their current situation (Sánchez Rodríguez et al., 2018), promoting the

opportunity to improve patient-physician communication and above

all a role in the control of different diseases (Patel et al., 2013).

In the case of older adults, new technology platforms aimed at

improving healthcare are used after education and technological

support to make the experience simple and easy to use, but represent

a potential for medical support, which, while not replacing the

experience with a healthcare provider, represents a widely useful

clinical tool, especially for following up on medical treatments

(Pergolotti et al., 2019).. Mobile applications in older adults may have

effectiveness due to the very high percentage in the elderly

population who have multiple comorbidities that are associated with

the need for pathology control, where their treatment is daily and

long-term, so it is important to maintain good medication adherence

and strict control for disease management (Leslie et al., 2016).

In this regard, the Center for Disease Control and Prevention (CDC)

estimates that the prevalence of elderly people suffering from chronic

diseases related to diabetes, hyperlipidemia and arterial hypertension

is very high, reaching percentages of up to 70% and it is believed that

it will continue to increase over the years (Nurakysh et al., 2022)..

Additionally, the WHO estimates that overall adherence to

medication intake in patients with chronic diseases is only 50%, which

means that only 5 out of 10 patients adhere correctly to treatment

(Ping et al., 2022).

In relation to the above, the chronicity in pathologies and the lack of

adherence is an aspect of care due to the fact that a treatment must

have an adherence of at least 80% to be considered effective and thus

avoid the consequences of poor adherence such as high costs of

medical care and worse clinical outcomes (Lee et al., 2022). For this

reason, patient participation is essential since the success of the

treatment will depend on their collaboration, especially in the follow-

up and taking of medication (Al-Arkee et al., 2021)..

Previous studies have investigated the usability attributes of mobile

applications, but so far, few have focused on older users, whose needs

differ from those of the younger generation who grew up with cell

phones and touchscreen technology (Nurakysh et al., 2022)..

Technological progress has recently resulted in the implementation

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

of mobile applications in healthcare to improve clinical outcomes for

patients. Studies have confirmed that one of the best options for

patients who miss medication due to forgetfulness is a medication

reminder by a short message (Ping et al., 2022).

In this context, it is important to know that medication adherence is a

complex behavior that is influenced by multiple factors that are

associated with the patient, the physician, the pharmacist, and the

specific treatment (Haramiova et al., 2017).. The development of

interventions to address medication nonadherence is important to

improve health outcomes (Al-Arkee et al., 2021).. For this reason, it is

important to investigate medication nonadherence, which can be

intentional when the decision is premeditated by the patient and

unintentional when there are physiological factors such as memory

loss, loss of senses such as vision and hearing in order to develop

tools that are adapted to the needs of patients by increasing

treatment adherence and improving a health problem in the geriatric

population (Lee et al., 2022; Ping et al., 2022)..

From the above, the need for systematic research on mobile

applications for medication management in older adults is revealed,

by identifying it as crucial, because it allows a comprehensive

evaluation of its effectiveness in improving medication adherence in

a population susceptible to complex medical treatments, enabling

the comparison of mobile applications with traditional methods, in

such a way, that the systematic literature review (SLR) contributes to

scientific knowledge by identifying areas that require further research

and development in health technology for older adults.

Consequently, despite the increasing adoption of mobile applications

in healthcare, few studies have investigated how they work and are

useful for older adults, whose needs and challenges differ from those

of younger generations. Hence, the aim of the manuscript aims to

determine the importance of the use of mobile applications as

medication aids in the older adult.

Methodology

For the following research, the systematic review type was used,

which was carried out using the PRISMA statement model. The

systematic literature search was performed in high impact scientific

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

sources, such as: Pubmed, Ovid and Scopus, The MeSH/DeCS terms

used for the search were: "technology", "medication system",

"medication in older adult".

Only original articles, published in English and Spanish between 2018

and 2022 and open access, will be included in the research.

All documents that are not relevant to the subject matter will be

excluded, and the research must have been conducted in the older

adult age group. This review was guided by the following research

question: Is there a benefit with the use of mobile applications for the

control of medication in the elderly?

Figure 1 shows the systematic search process. The initial search

resulted in 890 manuscripts (PubMed=532, SCOPUS=284, OVID=74),

after eliminating duplicate articles and applying the inclusion and

exclusion criteria, 120 manuscripts were obtained. Finally, 15

documents were selected to be analyzed in the study.

Figure 1.

Flow chart of the search under the prism methodology.

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

Results

Over the past few decades, the accelerated development and

advancement of technology has brought about very marked changes

in virtually every aspect of human endeavor with major implications

for health (Abernethy et al., 2022).. Thanks to the rise of information

and communication technologies (ICT) applied to health, it is possible

to open new windows of opportunity for population health coverage

and their respective monitoring of the different pathologies and their

evolution and management (Sánchez Rodríguez et al., 2018).

In relation, in the field of medicine, pharmacotherapy remains one of

the main strategies in the intervention of medicine; however, there

are still large gaps that fail to be solved, for example, one of the

biggest problems in taking medication is to do it routinely (Tabi et al.,

2019). Thus, adherence to prescribed pharmacotherapeutic regimens

is crucial to maintain the clinical efficacy of prescriptions, especially in

chronic diseases (Ping et al., 2022). (Ping et al., 2022).

Reason why, the increase in the number of chronic diseases results in

the growth of financial expenditures in the health care system

worldwide (Leslie et al., 2016). Non-communicable diseases are the

cause of 41,000,000 deaths in a year, which is equivalent to 70% of all

deaths in the world (Ping et al., 2022).

Thus, chronic diseases in older adult patients are one of the main

Public Health challenges in the world (Gong et al., 2020). Among

many of the pathologies that entail higher daily medication use in

older adults is arterial hypertension, which has been described as one

of the reasons for the development of cardiovascular diseases that

have ended in high mortality, implying that these diseases should be

more meticulously assessed and that they need more measures to be

effectively controlled (Gong et al., 2020; Nurakysh et al., 2022)..

Despite the above, the rate of compliance with preventive medication

in chronic cardiovascular diseases is found to be 55% and 9% of

cardiovascular disease complication events, a situation attributed to

poor medication compliance (Al-Arkee et al., 2021).. In relation, the

effective control of chronic diseases is closely linked to the patient's

adherence to treatment; thus, good adherence to medications

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

contributes to improve health outcomes, reduce hospitalization and

medication costs, and reduce the cost of treatment (Ping et al., 2022).

(Ping et al., 2022).

Normally, adherence to treatment should have a compliance of more

than 80% for it to work effectively, despite this, in chronic diseases

this value can be as low as 50% (Ping et al., 2022). (Ping et al., 2022).

In addition, there are different factors that cause pharmacological

adherence to be affected, for example, polypharmacy (Tan et al.,

2022). In addition, inadequate adherence to treatment among adults

is also attributed to a higher prevalence of comorbidities and

cognitive impairment in the patient who is unable to remember

medication dosage taking (Ping et al., 2022).

Now, as mentioned, polypharmacy is considered one of the most

important reasons that create the need to seek an adequate control

of drug administration, where a correct use of drugs is essential and

where it is required to follow up and improve adherence to treatment

(Tan et al., 2022).

In response to this issue, in recent years, emerging technological

innovations have transformed the health care landscape by providing

new opportunities for chronic disease management of the elderly (Tan

et al., 2022). However, it should be considered that, in the current

context, medication adherence in older adults is still considered

relatively poor (Ping et al., 2022). From this perspective, cell phones

are useful tools for their control, however, their effectiveness is still

under investigation (Gong et al., 2020). (Gong et al., 2020).

Such is the case of medication reminder applications, which, despite

their effectiveness, still have a somewhat limited use but provide users

with multiple benefits (Ping et al., 2022). Thus, at present, the mobile

health digital market or mHealth offers a variety of mobile

applications in the health field, for example, applications to support

the administration of medications, monitor blood pressure, schedule

medical appointments, among others; being considered a public

health tool supported by mobile devices (Paiva et al., 2020).

In the case of polypharmacy, a mobile application provides users with

multiple functions such as, for example, having all the medications

that the patient uses stored with images of these so that the frequency

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

and correct doses of the medications can be shown, resulting in a

simpler and more accessible control mechanism for the person taking

the medication. (Tan et al., 2022).

Thus, different statistical studies indicate that in terms of health in

older adults the most popular software are those that are oriented to

direct patients in the timely application of medications, help to record

vital parameters such as blood pressure and glucose levels, or

educate about possible lifestyle modifications (Skrzypecki et al.,

2019)..

Similarly, certain apps allow users to understand pharmacological

effects, and monitor outcomes; hence, the use of an app is a reliable

method for medication management before the patient's condition

may become critical (Tabi et al., 2019).

In the case of the elderly, the most optimal target in the can be

altered by medication noncompliance (Zhang et al., 2020).. Thus,

through the use of mobile health technologies, especially mobile

applications, medication adherence and, in general, improved clinical

outcomes can be enhanced (Al-Arkee et al., 2021). (Al-Arkee et al.,

2021).. However, despite the practicality of the use of mobile

applications for the general population, when it comes to elderly

users, some factors must be considered, such as accessibility (Paiva et

al., 2020).

Thus, according to statistics, the most downloaded health

applications for geriatric care are Medscape, MIMS, and Epocrates;

apps that have multiple options in terms of disease management,

medical dictionaries, and pharmacological reminders (Berauk et al.,

2018)..

Another benefit is the possibility of scheduling remote reminders,

which have been shown to be effective in improving medication

adherence (Tan et al., 2022). The use of the smartphone application

according to studies resulted in being a small improvement in self-

reported medication adherence, covering patients who have

presented non-adherence (Morawski et al., 2018)..

The above mentioned so far leads to the reflection that technological

innovations provide a viable solution to perform multicomponent

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

interventions alleviating the burden on hospital resources (Tan et al.,

2022). Where the use of e-health and mobile health technology as

primary prevention in older adults is evidenced in studies where the

scope of the use of these tools for disease prevention has been

demonstrated (Kampmeijer et al., 2016).. In this way, it is how digital

interventions such as smartphone apps become over time an agile

way to support medicine and patients, even more so with medication

adherence and chronic disease management (Márquez Contreras et

al., 2019)..

However, it is necessary to mention that, despite their multiple

functions, benefits and accessibility, the use of mobile applications for

medication management in the elderly is still low, since figures

indicate usage percentages of 2.6%, a situation that could be related

to multiple factors such as age, ethnicity, participation in computer

courses, comorbidities, medication adherence, and polypharmacy

per se (Zhang et al., 2020).

In relation to the aforementioned, one should consider characteristics

of the geriatric public that cause rejection of mobile health

applications, for example, cognitive barriers such as the need for

more time to learn, lack of motivation, physical capacity - poor visual

acuity, and perception; categories that justify the lack of adoption of

mHealth in older adults despite the benefits that these applications

can provide (Paiva et al., 2020).

Finally, one aspect that should be carefully considered is the fact that

healthcare apps that are used to monitor, guide, diagnose, or treat

patients should be considered medical devices and, therefore,

comply with medical device regulations that allow for the assessment

of their efficacy and veracity, not to mention that if apps that collect

and/or process medical data must comply with data privacy

regulations (Al-Arkee et al., 2021).. From this view, healthcare

personnel should review apps themselves before issuing

recommendations to patients (Skrzypecki et al., 2019).. Additionally,

it should be considered that, the large number of mobile health

(mHealth) apps available in commercial app stores makes it difficult

for lay users and healthcare professionals to choose the right one for

their individual needs, even more so the geriatric population (Berauk

et al., 2018)..

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

Technology adoption as a strategy to improve medication adherence

in older adults.

According to Lesli et al, in the relevant results of their research

interprets that strategies to improve medication adherence will vary

according to the mode of medication entry, this means that it varies

according to the person, mail, phone, etc., as well as the frequency of

administration and the target audience of the treatment, these trials

conducted on mobile applications describe the positive effectiveness

of these interventions as reminder methods in selected populations

such as the elderly population (Leslie et al., 2016).

Tan et al, in their trial with 16 older adults with the use of technology

as a frailty prevention tool had a significant improvement, overall, this

means that there is a good acceptance of technology in the medical

resources of older adults (Kampmeijer et al., 2016)..

Ying Jong in the results on her research on the use of apps as

medication reminders was a by 2.6% where the factors most

associated to differentiate their use were age, ethnicity, educational

level, health literacy, comorbidities, medication adherence, and

polypharmacy (Zhang et al., 2020).

Saule et al, in their research concluded that adherence to treatment

in patients with arterial hypertension increased with the use of mobile

applications on the patients' cell phones, thus demonstrating a

positive effect on their use. (Nurakysh et al., 2022)..

Shahd et al. in their research included 16 different articles from the

last 6 years old, where in a total of 12 reported medication adherence

as the primary outcome, being that medication adherence rates

showed statistically significant improvements (Al-Arkee et al., 2021)..

Manuscript synthesis

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

Table 1 describes the articles that were selected for the study, in order

to present their metadata and main results.

Table 1.

Articles analyzed

Base

Magazine

Title

Year and author

Target

Main results

PubMed

Journal of

Managed

Care &

Specialty

Pharmacy

A multichannel

intervention for

medication

adherence

influences patient

and prescriber

behavior

Scott, et al. 2016

To evaluate the

impact of a quasi-

experimental

multichannel

adherence

intervention on

beneficiary

medication

adherence and

health plan quality

performance

measures for 2 MA-

PD plans.

During the first year of the

intervention, the response rate of

the prescribers was 53.7%.

Positive influence of the

intervention on adherence to HTA

and CHOL was shown. The odds

of achieving adherence (PDC ≥

80%) were higher in the

intervention group compared with

the control for HTA.

PubMed

Neurology

(English

Edition

Journal)

Neurorehabilitation

and apps: a

systematic review of

mobile apps.

Sanchez et al.

2018

To carry out a

systematic review of

the published

information on

applications aimed

at the field of

neurorehabilitation,

in order to classify

them and describe

their main

characteristics.

There are numerous applications

with potential for use in the field

of neurorehabilitation, so it is

important that developers and

designers understand the needs

of people with neurological

disorders so that their products

are valid and effective in light of

those needs.

PubMed

Surgical

endoscopy.

Mobile applications

in gastrointestinal

surgery: a

systematic review.

L van der Storm

et al. 2023

To provide an

overview of

available

gastrointestinal

surgical applications

and evaluate their

prospects for the

delivery of surgical

care.

Thirty-eight articles describing

twenty-nine applications were

included. The applications were

classified into seven categories:

follow-up, weight loss,

postoperative recovery,

education, communication,

prognosis, and clinical decision

making.

PubMed

Acta

Informatica

Medica

Journal

Evaluation of the

effectiveness of

mobile application

on adherence in

patients with arterial

hypertension.

Nurakysh et al.

2022

The aim of the study

was to evaluate the

effect of the use of a

mobile application

on adherence to

treatment in

patients with

diagnosed

hypertension.

In the T1 period in both the GC

and GI groups, moderate

adherence to treatment was

recorded with equal indices. After

12 months on the adherence scale

in patients who used the mobile

application "My Therapy" (IG),

despite a slight decrease in

scores, the results were relatively

superior.

Elseiver

Exploratory

Research in

Clinical and

Social

Pharmacy

Prevalence and

correlates of 'use

and intention to

use' medication

reminder app

among older adults.

Ping et al. 2022

To examine the

prevalence and

sociodemographic

and health

correlates of

medication

reminder app use

and intention to use

among older adults

in Singapore.

The prevalence of use and

intention to use the medication

reminder application was low, at

2.6%. Age, ethnicity, educational

level, previous participation in IT

or computer-related courses,

comorbidity, health literacy,

medication adherence, and

polypharmacy were correlated

with app use and intention to use

in multivariable analyses.

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

PubMed

Journal of

Medical

Internet

Research

Mobile applications

to improve

medication

adherence in

cardiovascular

disease: systematic

review and meta-

analysis.

Al Arkee et al.

2021

To evaluate the

effects of mobile

healthcare

applications on

medication

adherence and

health-related

outcomes in

patients with CVD.

Medication adherence was shown

as the primary outcome.

Medication adherence rates

showed statistically significant

improvements. In addition, they

reported improvement in systolic

blood pressure, diastolic blood

pressure, total cholesterol, and

low-density lipoprotein

cholesterol levels in the

intervention group. In the 7 trials

that evaluated the usability of the

application, all were acceptable.

Ovid

Perspectives.

Journal of

National

Academy of

Medicine.

The promise of

digital health: then,

now and the future

Abernethy et al.

2022

Highlight the

compelling

possibilities and

unresolved

challenges for

advancing reliable

digital technology

for the benefit of all

people at every

stage of their lives.

Identify structural, technical, and

political preconditions for long-

term progress; identify critical

priorities for cooperation and

collaboration among

policymakers, practitioners, and

industry leaders to drive the

development and application of

best-in-class digital health tools.

PubMed

JMIR

mHealth and

uHealth

Mobile applications

for medication

management:

review and analysis.

Tabi et al. 2019

Provide an overview

of available mobile

apps, focusing on

those that help

patients understand

and take their

medications.

A total of 328 apps were

categorized (175 Android and 153

iOS). Most apps were developed

by the software industry (73 %,

11/15), a minority of them were

co-developed by healthcare

professionals (15 %, 3/20) or

academia (2.1 %; 7/328). The

most prevalent specialty was

diabetes (23 applications). The

most frequent functions were

reminder, symptom tracking and

the ability to share data with a

family member or physician.

PubMed

Medicine

(Baltimore)

Mobile health apps

for the treatment of

primary

hypertension: a

multicenter,

randomized,

controlled trial.

Gong et al. 2020

The purpose was to

evaluate the impact

of m-Health

applications on

blood pressure

control and

medication

adherence.

At the end of the study,

participants in the 2 groups had

lower systolic blood pressure and

diastolic blood pressure than at

baseline, and the intervention

group demonstrated a

significantly greater reduction in

systolic blood pressure and

diastolic blood pressure than the

control group (P<0.05). In

addition, the percentage of

participants with controlled blood

pressure was higher in the

intervention group (P<0.05).

Medication adherence in the

intervention group was much

higher than in the control group

(P<0.05).

Scopus

Frontiers in

Medicine

Effectiveness and

usability of a frailty

assessment and

intervention system

in pre-frail older

adults living in

communities: a pilot

study.

Tan et al. 2022

To explore the

efficacy of SAIF in

improving frailty

status, physical

performance and

strength, and its

usefulness in pre-

fragile older adults.

There was a significant

improvement in FFP score (-0.5, p

< 0.05, effect size, r = 0.43), but

not in CFS (-1.0, p = 0.10, r =

0.29). Five (31.3%) improved in

their frailty status for both FFP

and CFS. Three themes were

identified: "Difficulty in module

navigation" (barriers to SAIF

interaction); "User engagement

by gamification" (facilitators

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

encouraging participation); and

"Perceived physical health

benefits" (subjective

improvements in physical well-

being), which were corroborated

by SUS (68/100) and interest-

enjoyment (3.9/5.0) scores.

PubMed

Prior

physical

illness

Journal

Mobile applications

for healthcare of the

elderly: a systematic

mapping.

Paiva et al. 2020

Identify the state of

the art in the

literature related to

the development of

mobile applications

for elderly health

care, considering

the point of view of

health and software

engineering.

A total of 2533 articles were

found and, after applying our

eligibility criteria, we obtained

149. We observed aspects related

to the type of digital health

initiative, using the classification

proposed by the World Health

Organization (WHO), the profile of

older persons prioritized by the

application, the spatio-temporal

distribution of the studies, the

type of empirical validation and

the research contribution of each

work.

PubMed

Clinical and

Experimental

Optometry

Patient-oriented

mobile applications

in ophthalmology

Skrzypecki et al.

2019

To analyze the

market for patient-

oriented mobile

applications in

ophthalmology.

Fifty-six applications were found

that met the established criteria.

The total number of downloads

was estimated at 1.5 million, while

the weighted average score for all

applications was 4.21/5. The

number of applications by

subspecialty did not correlate with

the prevalence of a particular eye

disorder.

Scopus

Therapeutic

Innovation &

Regulatory

Science

Mobile health apps

for elderly care:

review and

comparison.

Laput et al. 2018

Evaluate the

contents and

features of mHealth

applications for

elderly care.

Twenty-five mHealth apps were

evaluated. Medscape and

Skyscape Medical Library are the

most comprehensive mHealth

apps for general drug information,

physician referrals, clinical scoring,

and medical calculator. The

Alzheimer's Disease Pocketcard

and Confusion: Delirium &

Dementia: A Bedside Guide apps

are recommended for clinical

assessment, diagnosis,

medication information, and

treatment of geriatric patients

with Alzheimer's disease, delirium,

and dementia.

PubMed

JAMA

Internal

Medicine

Journal

Association of a

smartphone app

with medication

adherence and

blood pressure

control: randomized

clinical trial

MedISAFE-BP.

Morawski et al.

2018

To determine

whether the

Medisafe

smartphone app

improves

medication

adherence and

blood pressure

control.

Participants had a mean age of

52.0 years and a mean body mass

index, calculated as weight in

kilograms divided by height in

meters squared, of 35.5; 247

(60%) were female and 103 (25%)

were black. After 12 weeks, mean

(SD) MMAS score improved by

0.4 (1.5) among intervention

participants and remained

unchanged among controls

(between-group difference: 0.4;

95 % CI, 0.1 to 0.7; P = 0.01).

Mean systolic blood pressure (SD)

at baseline was 151.4 (9.0) mm Hg

and 151.3 (9.4) mm Hg, among

intervention and control

participants, respectively. After 12

weeks, mean systolic blood

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

pressure (SD) decreased 10.6

(16.0) mm Hg among intervention

participants and 10.1 (15.4) mm

Hg among controls (between-

group difference: -0.5; 95 % CI, -

3.7 to 2.7; P = 0.78.

PubMed

BMC Health

Services

Research

The use of e-health

and m-health tools

in health promotion

and primary

prevention among

older adults: a

systematic review of

the literature.

Kampmeijer, R. et

al. 2016.

To provide a

systematic review of

the evidence on the

extent of the use of

e-health and m-

health tools in

health promotion

and primary

prevention among

older adults.

The initial search yielded 656

publications. After applying the

inclusion and exclusion criteria, 45

publications were selected for

review. In the reviewed

publications, several types of e-

health/m-health tools were

described, namely applications,

websites, devices, video

consultations and webinars. The

majority of the publications (60%)

reported studies in the U.S. In

37% of the publications the study

population was older adults in

general, while the remaining

publications studied a specific

group of older adults (e.g.,

women or overweight individuals).

The publications indicated several

facilitators and barriers. The most

commonly mentioned facilitator

was the support for the use of e-

health/health tools that older

adults received.

Taylor &

Francis

Current

Medical

Research

and Opinion

Hypertension-

specific smartphone

app for improving

medication

adherence in

hypertension: a

cluster randomized

trial

Contreras E. 2019

To evaluate the

effectiveness of the

intervention on

pharmacological

therapeutic

adherence in mild to

moderate arterial

hypertension (AHT),

through an

application installed

on a cell phone, as

well as the degree

of control achieved

by the patient with

this tool.

A total of 148

patients completed

the study. The mean

age was 57.5 ± 9.9.

Overall adherence

was 77.02%. Daily

adherence was

93.15% and 86.3% in

the IG, and 70.66%

and 62.66% in the CG

after 6 and 12

months, respectively.

The percentage of

uncontrolled patients

was 28.3% (CI =

21.05-35.55%).

Hypertension control

at 12 months was

17.8% and 38.6% for

IG and CG,

respectively.

Source: Authors

Patel et al. in their research targeting 50 older adults evaluated the

acceptance and use of mobile apps as a medication reminder for

established hypertension where their population was 96% African

American, with acquired diabetes in 50% and high BMI 40%, in

addition to including in their study people with low health literacy,

and low quality of life (Patel et al., 2013).

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

Zuzana et al, in research notes that short text messages are one of the

best tools for short disease management, having a more adequate

approach to treatment and treatment adherence (Nurakysh et al.,

2022)..

Ping et al, this study is the first to give a representative prevalence

estimate of 2.6% of the use of medication reminder app devices in

the elderly, in which respondents accepted the use of apps, but did

not know how to use them, in addition to having predisposing factors

such as age, where those older in age were less likely to use the apps

(Ping et al., 2022).

Saule et al, conducted the first study on the evaluation of the

adherence of patients in hypertension treatment using a mobile

application, for the reason that good adherence to treatment gives a

significantly higher probability in achieving better blood pressure

control, thus helping to lower costs and lower use of health care

resources (Márquez Contreras et al., 2019).

It also talks about the situation of the COVID-19 pandemic with the

social distancing regime that was maintained that made the health

care system transform worldwide, so the use of digital artifacts among

people who need constant controls is an advantage as it is associated

with low costs for the patient, time savings and in that time to a

reduction of the risk of infection (Haramiova et al., 2017).

Conclusions

This study found that improvements in adherence to medications

taken for the various chronic pathologies that afflict older adults are

directly related to the quality and quantity of the medication, and the

sociodemographic characteristics of the patient, which can cause a

common compliance barrier, so the use of mobile applications that

are used for medication reminders, both dosage and schedule is one

of the tools that medicine has used of technology.

However, the prevalence of the use of medication reminder apps and

the intention to use them is very low, meaning that there are other

factors that influence the use of these apps, the main ones being the

lack of knowledge of cell phone use or the use of medical apps.

Mobile applications for medication management in the elderly: a systematic review

Revista Científica Interdisciplinaria Investigación y Saberes , / 2024/ , Vol. 14, No. 1

Concluding that the use of technology as an aid to medicine is very

important, since it allows us to perform different activities that will

help the health of the patient in question, given that most patients

who forget their medication are older adults, it is a population that

should be trained more for the correct use of the application

notifications, which will make the patient take their medication at the

right time and have a good adherence to the treatment of their

chronic disease.

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