Can Technology-Based Interventions Be Used to Improve Adherence Among Adolescents?

Low medication adherence is a problem in healthcare, in general. However, adolescents with chronic health conditions (CHCs) also have low adherence, but they are at a critical age when they can create routines and health behaviors that optimize disease management as they become adults.

A viewpoint article in JMIR mHealth and uHealth outlined the interest in development of mobile health tools to connect with patients, particularly adolescents, and the evidence to support such technology-based approaches.¹

Taking a medicine daily can be a daunting task for many adolescents. Common barriers, regardless of condition, include: aspects of physical well-being, such as side effects, reduction in symptoms, and problems swallowing a pill; forgetting to take medications due to schedule; desire to forget about the disease; and a lack of support.

“Therefore, the challenges that adolescents with CHCs need to overcome to optimize their medication adherence may be multi-faceted, but amenable to common adherence-enhancing interventions,” the authors wrote.

Technology-based approaches, such as text messaging, mobile apps, and social media, can be used to improve adherence behavior and have shown acceptability and feasibility, according to previous research from the authors.² However, evidence for efficacy is modest and the long-term benefits and cost effectiveness remain unclear.

The previous study reviewed existing research and found that 47% of the articles reported significant improvement in adherence. However, most of the studies were of low or moderate quality and the interventions varied across studies.

In the new viewpoint article, the authors wrote that more research is needed to explore how adolescents view technology-based interventions and what role they should play. To better understand the role of technology to improve adherence, medical providers must identify how their organization can incorporate mobile technology into the practice.

“Adolescents are frequent users of technology and engaging adolescents with chronic illnesses in their self-management could be invaluable for improving long-term outcomes,” the authors concluded. “The use of technology-based interventions to improve medication adherence has shown promising results, and seeking adolescents’ perspectives could enhance uptake and long-term engagement, and minimize patient fatigue.”

References

1. Badawy SM, Thompson AA, Kuhns LM. Medication adherence and technology-based interventions for adolescents with chronic health conditions: a few key considerations. JMIR Mhealth Uhealth. 2017;5(12):e202. doi: 10.2196/mhealth.8310.

2. Badawy SM, Barrera L, Sinno MG, Kaviany S, O’Dwyer LC, Kuhns LM. Text messaging and mobile phone apps as interventions to improve adherence in adolescents with chronic health conditions: a systematic review. JMIR Mhealth Uhealth. 2017;5(5):e66. doi: 10.2196/mhealth.7798.