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Heart. 2018 Aug 27. pii: heartjnl-2018-313479. doi: 10.1136/heartjnl-2018-313479. [Epub ahead of print]

Medication reminder applications to improve adherence in coronary heart disease: a randomised clinical trial.

Santo K1,2,3, Singleton A1,3, Rogers K2,4, Thiagalingam A1,3,5,6, Chalmers J1,2,4, Chow CK1,5,2,3, Redfern J1,2,3.

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Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
The George Institute for Global Health, Sydney, New South Wales, Australia.
Westmead Applied Research Centre, Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Cardiology Department, Westmead Hospital, Sydney, New South Wales, Australia.
Cardio-respiratory Division, Westmead Institute for Medical Research, Sydney, New South Wales, Australia.



The aim of the MEDication reminder APPs to improve medication adherence in Coronary Heart Disease Study was to evaluate the effectiveness and feasibility of using publicly available high-quality medication reminder applications (apps) to improve medication adherence compared with usual care in patients with coronary heart disease (CHD). An additional aim was to examine whether an app with additional features improved adherence further.


Patients with CHD (n=163) were randomised to one of three groups: (1) usual care, (2) a basic app or (3) an advanced app with interactive/customisable features. The primary analysis compared usual care versus app use on the primary outcome of the 8-item Morisky Medication Adherence Scale (MMAS-8) at 3 months. Secondary outcomes included blood pressure and cholesterol levels.


The mean age was 57.9 years and 87.7% were male. At 3 months, patients using an app had higher adherence (mean MMAS-8 score 7.11) compared with the usual care group (mean MMAS-8 score 6.63) with a mean difference between groups of 0.47 (95% CI 0.12 to 0.82, p=0.008). There was no significant difference in patients using the basic app versus the advanced app (mean difference -0.16, 95% CI -0.56 to 0.24, p=0.428). There were no significant differences in secondary clinical outcome measures.


Patients with CHD who used medication reminder apps had better medication adherence compared with usual care, and using apps with additional features did not improve this outcome further. These data suggest medication apps are likely to help patients with chronic health conditions adhere to medicines, but further examination of whether such benefits are sustained is warranted.


ACTRN12616000661471; Results.


apps; coronary heart disease; medication adherence; mhealth; smartphone

Conflict of interest statement

Competing interests: None declared.

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