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Impact of mobile health and telehealth technology on medication adherence of stroke patients: a systematic review and meta-analysis of randomized controlled trials

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Abstract

Background Stroke patients have low medication adherence after discharge, which leads to a high recurrence rate and poor disease control. Various strategies have been explored to enhance medication adherence in this patient population. Aim To evaluate the effects of mobile health (mHealth) and telehealth technology on medication adherence in stroke patients. Method All English studies that met the inclusion criteria published before September 2021 were obtained from PubMed, EMBASE, Web of Science, and Cochrane Library. Two researchers independently screened articles, extracted data, and evaluated the quality of the included studies. All articles were about randomized controlled trials. Medication adherence was used as the outcome index of this review. Random or fixed-effect models were used in statistical methods. I2 statistics were used to evaluate heterogeneity. Results A total of ten studies met the inclusion criteria, covering 2151 stroke patients. Compared with the Usual Care group, the medication adherence scores of the mHealth technology group were better (standard mean deviation 0.67, 95% confidence interval, CI [0.49, 0.85], P < 0.001). The medication adherence ratio of the mHealth technology group was higher (odds ratio, OR, 2.81, 95% CI [1.35, 5.85], P = 0.006). Subgroup analysis showed that application and messaging interventions were more effective than the telephone call intervention (OR 4.05, 95% CI [2.10, 7.80], P < 0.001). The shorter the interval of the intervention, the better the medication adherence of patients (OR 4.24, 95% CI [2.30, 7.81], P < 0.001). Conclusion Compared with Usual Care, mHealth can effectively improve the medication adherence of stroke patients.

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Availability of data and materials

All the data were extracted from the included studies, and they were true and valid.

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Acknowledgements

ZZW and WTT initiated the study. ZZW, WTT, and LMN performed data extraction and analyses and drafted the first version of the manuscript. WTT, LMN, and ZJH critically reviewed the manuscript and revised it. All authors made a substantial contribution to the concept and design of the study, interpreted the data, and reviewed the manuscript.

Funding

This study was funded by the Natural Science Foundation of Fujian Province, China (2018Y0037), and the Fujian Provincial Health Technology Project, China (2019-CX-19).

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  1. Zhiwei Zeng, Tingting Wu and Meina Lv have contributed equally to the work.

Authors and Affiliations

  1. Department of Pharmacy, Fujian Medical University Union Hospital, #29 Xinquan Road, Fuzhou, China

    Zhiwei Zeng, Tingting Wu, Meina Lv, Jiafen Qian, Mingrong Chen, Zongwei Fang, Shaojun Jiang & Jinhua Zhang

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  1. Zhiwei Zeng
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Zeng, Z., Wu, T., Lv, M. et al. Impact of mobile health and telehealth technology on medication adherence of stroke patients: a systematic review and meta-analysis of randomized controlled trials. Int J Clin Pharm 44, 4–14 (2022). https://doi.org/10.1007/s11096-021-01351-x

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