Impact of digital health interventions on medication adherence: A systematic review and meta-analysis

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Abstract
Background: Digital health interventions for self-management have reported improvement in medication adherence, but further studies have reported that this is not sustained. Clarity is needed on the effectiveness of digital health interventions (DHIs) for medication adherence and the characteristics of successful DHIs. Objective: This review aimed to evaluate the effectiveness of DHIs versus standard care in supporting medication adherence in community-based adults. Methods: Studies of DHIs that included community-based adults (18 + years) that required prescribed medications and either used, or have access to, technology to manage their illness were included for review. A literature search was conducted across eight key databases. Studies were pooled in statistical meta-analysis using a random effects model. Pooled results were estimated by subgroup analyses defined by study design, intervention duration and intervention type (platform). Results: Thirteen studies were included in the final meta-analysis ( N = 1320). There was no statistically significant effect of DHIs on medication adherence. Subgroup analyses showed no increase in medication adherence observed in the intervention group. However, a small significant increase in medication adherence was observed in the control group in studies of 6-month duration. Conclusions: The impact of DHIs on medication adherence is unclear. More rigorous clinical evidence is required to understand the impact of DHIs on medication adherence over longer durations, and further studies exploring the impact of platform type on medication adherence are required, with consideration given to the potential of Artificial Intelligence (AI)-driven diagnostics and analytics in the future.

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