A pilot investigation of a mobile phone application and progressive reminder system to improve adherence to daily prevention treatment in adolescents and young adults with migraine

Cephalalgia. 2018 Dec;38(14):2035-2044. doi: 10.1177/0333102418756864. Epub 2018 Apr 10.

Abstract

Background: Effective management of migraine requires adherence to treatment recommendations; however, adolescents with migraine take their daily medications only 75% of the time. Low-cost adherence-focused interventions using technology may improve adherence, but have not been investigated.

Methods: Thirty-five adolescents and young adults (13-21 years) with migraine participated in an AB-design pilot study to assess the use of a mobile phone adherence-promotion application ("app") and progressive reminder system. Adherence was calculated using electronic monitoring during the baseline period and medication adherence intervention.

Results: Relative to baseline, adherence significantly improved during the first month of the intervention. Specifically, improvements existed for older participants with lower baseline adherence. Self-reported app-based adherence rates were significantly lower than electronically monitored adherence rates. Participants rated the intervention as acceptable and easy to use.

Conclusions: "Apps" have the potential to improve medication adherence and are a promising intervention for adolescents and young adults with low adherence. Involving parents in the intervention is also helpful. Providers should assess barriers to adherence and use of technology-based interventions, encourage parents to incorporate behavioral incentives, and provide referrals for more intensive interventions to improve long-term outcomes. Further, tracking adherence in an app may result in an underestimation of adherence. Future full-scale studies should be conducted to examine adherence promotion app interventions.

Keywords: Pediatric; adherence; headache; intervention; mHealth; mobile phone; technology.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Cell Phone
  • Female
  • Humans
  • Male
  • Medication Adherence*
  • Migraine Disorders / prevention & control*
  • Mobile Applications*
  • Pilot Projects
  • Reminder Systems / instrumentation*
  • Young Adult