NorthPoint Domain

Chronic Disease Patients Benefit from e-Intervention

Medication adherence increased

The Internet is a promising tool for improving medication adherence in patients with chronic disease, according to a study published recently in the Journal of Medical Internet Research.

So many people turn to the Internet for a variety of purposes today -- news and information, lifestyle tips, and cooking presentations. The great number of  health programs being developed is just one of the top reasons people turn more and more to the web. An important area of potential is medication adherence, and especially adherence in those with chronic conditions, as therapy is particularly critical in this group. Further, an estimated 30 to 50 percent of chronic disease sufferers do not adhere to their prescribed medications.

The authors of the current study decided to investigate if and how tailored e-interventions could address this problem. They conducted a systematic literature review with the following criteria for inclusion: a patient-centered Internet intervention, participants had a chronic condition and prescribed medication, at least one of the outcome measures was adherence, the study was quantitative, and it was written in English or Dutch. Adherence was defined as the extent to which the patient’s behavior matched the agreed recommendations of the prescriber. Clinical trials were reviewed for methodological quality by two researchers. Ultimately, 13 studies met inclusion criteria.

The included studies focused on a variety of conditions, including asthma and diabetes, and were all rated as moderately or highly sophisticated in terms of their computer tailoring methods. Five showed a significant effect on patient adherence, six reported a moderate effect, and two reported no effect. Most of the studies used self-report to assess adherence, while some used more objective methods such as pill counts and prescription refills. Interestingly, the authors found no relationship between study quality and effectiveness of the intervention. They note that this may be due to the wide variety of methods used. Seven out of 13 studies looked at long-term adherence, and results were positive, indicating that more research should be done in this area. Overall, “there is evidence that tailored Internet interventions can be an effective method to improve medication adherence. Health providers, who want to enhance patients’ adherence, are encouraged to use tailored websites or reminder systems.”

Source: Linn AJ, Vervloet M, van Dijk L, et al. 2011. Effects of eHealth interventions on medication adherence: a systematic review of the literature. Journal of Medical Internet Research 13(4):e103.