Pilot usability study of a personalized mobile application to monitor medication adherence in hypertense patients

The World Health Organization identifies low medication adherence as one of the main issues for increased morbidity and mortality rates among hypertense patients. Mobile applications aimed at monitoring medication adherence adopt a one-fits-all solution that is not tailored towards the needs and requirements of the final users.

The aim of this study was to develop and evaluate the usability of a personalized mobile application as part of the InTakeCare platform to monitor medication adherence in chronic patients.

InTakeCare is a modular and scalable platform composed by a cloud database, an online server, a mobile application developed for Android devices, and a web dashboard that enabled physicians’ access and management of the therapies of their patients. Personalization was implemented through the use of Personas, fictional archetypes of potential patients, identifying their most relevant needs. Enrolled participants to the pilot study were requested to complete a survey containing information about their sociodemographic characteristics and the eHealth Literacy Scale (IT-eHEALS) questionnaire, that was used to assign them the corresponding Persona. Then, the physician created an account for them on the platform, inserting the posology and timing of the prescribed medications. For the duration of the study, participants received reminders at the defined time and 55 minutes later, with a 120 minute interval around the time set to confirm medicine intake. Based on the assigned Persona, personalized messages were automatically sent to the patient’s device to foster positive behavioral changes. After seven days, participants participated in a semi-structured interview including the System Usability Scale (SUS) questionnaire.

Fifteen subjects (8M; 7F), with median (25th; 75th) age 61 (58; 69) years old participated in the study. IT-eHEALS scores ranged from 8 to 33, with a median value of 25 (16; 29). Overall, medium adherence to therapy was self-reported before the experiment. Post-experiment SUS questionnaire resulted in median score of 82.5 (61.25; 95.625). Semi-structured interview reported high interest and perceived innovation, with personalized messages being identified as useful and interesting, even though the information was usually already known to patients.

Participants were highly satisfied with the usability of the developed skill, with the median SUS score above the scientific literature score of 68 required for good usability. Participants perceived the solution as interesting and interactive, highlighting the presence of a doctor and the personalized messages as the most relevant features that could help them in maintaining interest towards their therapies. Further studies are required to asses the capabilities of the proposed solution on a broader population, with a longer use period to evaluate long term retention of positive behavioral changes