Archive \ Volume.16 2025 Issue 4

Effectiveness of Smartphone-Based Interventions on Medication Adherence in Type 2 Diabetes Mellitus: A Systematic Review

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  1. Department of Organization and Economics of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria.

Abstract

Medication non-adherence in patients with type 2 diabetes mellitus (T2DM) is a major contributor to poor glycaemic control and diabetes-related complications. Mobile applications offer a promising strategy to support adherence, yet evidence of their effectiveness remains limited. This systematic review examines the impact of mobile app interventions on medication adherence among adults with T2DM. A systematic search was conducted in PubMed, Cochrane Library, and Scopus databases. English-language studies published between 2013 and 2023 were included. Study quality was evaluated using the Mixed Methods Appraisal Tool. Seven clinical studies, comprising 717 participants (median age, 54.7 years), met the inclusion criteria. All studies reported improvements in medication adherence, although only four demonstrated statistically significant effects. Of these, three studies also observed significant reductions in HbA1c levels, indicating potential clinical benefit. Overall, study quality was generally high. Mobile applications show potential in enhancing medication adherence in adults with T2DM compared to standard care. However, the features driving these improvements remain unclear due to heterogeneity in study design and limited sample sizes. Future research should aim to identify key app components, optimize usability, and evaluate cost-effectiveness to maximize clinical outcomes.


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Vancouver
Ivanova S, Tenev D, Pavlova Z, Zagorchev P. Effectiveness of Smartphone-Based Interventions on Medication Adherence in Type 2 Diabetes Mellitus: A Systematic Review. Arch Pharm Pract. 2025;16(4):21-7. https://doi.org/10.51847/UhqbDvmsDV
APA
Ivanova, S., Tenev, D., Pavlova, Z., & Zagorchev, P. (2025). Effectiveness of Smartphone-Based Interventions on Medication Adherence in Type 2 Diabetes Mellitus: A Systematic Review. Archives of Pharmacy Practice, 16(4), 21-27. https://doi.org/10.51847/UhqbDvmsDV

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References
  1. Abbafati C, Abbas KM, Abbasi M, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet. 2020;396(10258):1204–22.
  2. Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF diabetes atlas: global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271–81.
  3. Chaudhury A, Duvoor C, Reddy Dendi VS, Kraleti S, Chada A, Ravilla R, et al. Clinical review of antidiabetic drugs: implications for type 2 diabetes mellitus management. Front Endocrinol. 2017;8:6.
  4. de Vries ST, Keers JC, Visser R, de Zeeuw D, Haaijer-Ruskamp FM, Voorham J, et al. Medication beliefs, treatment complexity, and non-adherence to different drug classes in patients with type 2 diabetes. J Psychosom Res. 2014;76(2):134–8.
  5. Wibowo MINA, Yasin NM, Kristina SA, Prabandari YS. Exploring of determinants factors of anti-diabetic medication adherence in several regions of Asia – a systematic review. Patient Prefer Adherence. 2022;16:197–215.
  6. American Diabetes Association. Standards of medical care in diabetes - 2013. Diabetes Care. 2013;36(Suppl 1):S11–66.
  7. Dayer L, Heldenbrand S, Anderson P. Smartphone medication adherence apps: potential benefits to patients and providers: response to Aungst. J Am Pharm Assoc. 2013;53(2):345.
  8. Farmer A, Allen J, Bartlett K, Bower P, Chi Y, French D, et al. Supporting people with type 2 diabetes in effective use of their medicine through mobile health technology integrated with clinical care (SuMMiT-D feasibility): a randomised feasibility trial protocol. BMJ Open. 2019;9(12):e033504.
  9. He Q, Zhao X, Wang Y, Xie Q, Cheng L. Effectiveness of smartphone application–based self-management interventions in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. J Adv Nurs. 2022;78(2):348–62.
  10. Tawpik NHNM, Mizher HAA, Zaini S. Mobile application intervention effectiveness in improving hypertensive patients medication adherence: a systematic review. J Pharm. 2025;5(1):115–31.
  11. Enricho Nkhoma D, Jenya Soko C, Joseph Banda K, Greenfield D, Li Y-CJ, Iqbal U. Impact of DSMES app interventions on medication adherence in type 2 diabetes mellitus: systematic review and meta-analysis. BMJ Health Care Inform. 2021;28(1):e100291.
  12. Moher D, Liberati A, Tetzlaff J, Altman DG, Antes G, Atkins D, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.
  13. Hong QN, Pluye P, Fábregues S, Bartlett G, Boardman F, Cargo M, et al. Mixed methods appraisal tool (MMAT): version 2018. Montreal: Department of Family Medicine, McGill University; 2018.
  14. Hong QN, Fábregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, et al. The mixed methods appraisal tool (MMAT) version 2018 for information professionals and researchers. Educ Inf. 2018;34(4):285–91.
  15. Opoku R, Ackon SK, Kumah E, Botchwey COA, Appiah NE, Korsah S, et al. Self-care behaviors and associated factors among individuals with type 2 diabetes in Ghana: a systematic review. BMC Endocr Disord. 2023;23(1):1–11.
  16. Batch BC, Spratt SE, Blalock DV, Benditz C, Weiss A, Dolor RJ, et al. General behavioral engagement and changes in clinical and cognitive outcomes of patients with type 2 diabetes using the Time2Focus mobile app for diabetes education: pilot evaluation. J Med Internet Res. 2021;23(1):e17537.
  17. Yang Y, Lee EY, Kim H-S, Lee S-H, Yoon K-H, Cho J-H. Effect of a mobile phone-based glucose-monitoring and feedback system for type 2 diabetes management in multiple primary care clinic settings: cluster randomized controlled trial. JMIR Mhealth Uhealth. 2020;8(2):e16266.
  18. Kleinman NJ, Shah A, Shah S, Phatak S, Viswanathan V. Improved medication adherence and frequency of blood glucose self-testing using an m-health platform versus usual care in a multisite randomized clinical trial among people with type 2 diabetes in India. Telemed J E Health. 2017;23(9):733–40.
  19. Kjos AL, Vaughan AG, Bhargava A. Impact of a mobile app on medication adherence and adherence-related beliefs in patients with type 2 diabetes. J Am Pharm Assoc. 2019;59(2):S44–51.
  20. Huang Z, Tan E, Lum E, Sloot P, Boehm BO, Car J. A smartphone app to improve medication adherence in patients with type 2 diabetes in Asia: feasibility randomized controlled trial. JMIR Mhealth Uhealth. 2019;7(9):e14914.
  21. Chao DYP, Lin TMY, Ma WY. Enhanced self-efficacy and behavioral changes among patients with diabetes: cloud-based mobile health platform and mobile app service. JMIR Diabetes. 2019;4(2):e11017.
  22. Orozco-Beltrán D, Morales C, Artola-Menéndez S, Brotons C, Carrascosa S, González C, et al. Effects of a digital patient empowerment and communication tool on metabolic control in people with type 2 diabetes: the DeMpower multicenter ambispective study. JMIR Diabetes. 2022;7(4):1–13.
  23. Thacharodi A, Singh P, Meenatchi R, Tawfeeq Ahmed ZH, Kumar RRS, V N, Kavish S, et al. Revolutionizing healthcare and medicine: the impact of modern technologies for a healthier future—a comprehensive review. Health Care Sci. 2024;3(5):329–49.
  24. Chan AHY, Horne R, Hankins M, Chisari C. The medication adherence report scale: a measurement tool for eliciting patients’ reports of non-adherence. Br J Clin Pharmacol. 2020;86(7):1281–8.
  25. Nguyen TMU, La Caze A, Cottrell N. What are validated self-report adherence scales really measuring? A systematic review. Br J Clin Pharmacol. 2014;77(3):427–45.
  26. Stirratt MJ, Dunbar-Jacob J, Crane HM, Simoni JM, Czajkowski S, Hilliard ME, et al. Self-report measures of medication adherence behavior: recommendations on optimal use. Transl Behav Med. 2015;5(4):470–82.
  27. Chan AHY, Vervloet M, Lycett H, Brabers A, van Dijk L, Horne R. Development and validation of a self-report measure of practical barriers to medication adherence: the medication practical barriers to adherence questionnaire (MPRAQ). Br J Clin Pharmacol. 2021;87(11):4197–211.
  28. Brenner PS, DeLamater J. Lies, damned lies, and survey self-reports? Identity as a cause of measurement bias. Soc Psychol Q. 2016;79(4):333–54.
  29. Tan X, Patel I, Chang J. Review of the four item Morisky medication adherence scale (MMAS-4) and eight item Morisky medication adherence scale (MMAS-8). Innov Pharm. 2014;5(3):5.

 

 

 


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