A medication reminder app improved adherence but did not lead to improved blood pressure control in people with uncontrolled hypertension, a study has found.
The trial involved 411 people with uncontrolled hypertension who were randomly assigned to either a control group or the intervention group who received instructions to download and use the app.
After 12 weeks, the researchers found that the intervention group had significantly better self-reported adherence than the control group. However, the change in mean systolic blood pressure was not significantly difference between the two, at -10.6mmHg in the intervention group and -10.1mmHg in the control group.
The researchers, who reported the results in JAMA Internal Medicine
 (online, 16 April 2018), say the fact that improved adherence in the intervention group did not translate into better blood pressure control could indicate that the improvement in adherence was too small to result in a clinical benefit. It could also be that a longer trial duration is needed to see a benefit.
They also suggest that, as both groups were required to take periodic blood pressure readings throughout the study, this self-monitoring could have led to improvements in blood pressure control within the control group.
The smartphone app, Medisafe, provides patients with reminders to take their medication and keeps a record of their adherence. It also allows them to enter their blood pressure and have a designated companion alerted to missed doses.
The researchers, led by Niteesh Choudhry, professor of medicine at Harvard Medical School, Massachusetts, say that although there are over 160 medication adherence apps available, most have not been rigorously evaluated, and that this is the first clinical trial to explore the efficacy of a standalone blood pressure/adherence app.
The team suggest that effective medication adherence apps may need to be more tailored to specific conditions to address those patients’ needs or to link the app to clinical care, such as support from their primary care doctor or nurse.
 Morawski K, Ghazinouri R, Krumme A et al. Association of a smartphone application with medication adherence and blood pressure control. The MedISAFE-BP randomized clinical trial. JAMA Internal Medicine 2018. doi: 10.1001/jamainternmed.2018.0447