Wednesday, June 27, 2018

Interventions delivered by mobile phone to help people adhere to medication to prevent cardiovascular disease

Cochrane: We reviewed the evidence on the effect of interventions delivered by mobile phone to help people in taking their medication to prevent cardiovascular disease (for example, heart attacks and strokes). We found four studies which included 2429 participants. Around 17.6 million people die from cardiovascular disease every year. Medications can help to prevent cardiovascular disease; however, many people who have been given these medications do not take them as often or as consistently as recommended. This means that the medication will not work as well as it could to prevent cardiovascular disease. Interventions delivered through mobile phones, for example, prompting by text messaging, may be a low cost way to help people to take their medication as recommended.

Study characteristics
The evidence is up to date to June 2017. We found four studies that tested interventions delivered at least partly by mobile phone, which followed up participants for at least 12 months.
Key results
We were not able to combine the results of the four trials because the interventions were very different. The studies were at high risk of bias and the effects of the interventions were inconsistent across studies, and so, we are not confident about their findings. The evidence suggests that interventions delivered by mobile phone may help people to take their medication, but the benefits are small, and some trials found that the interventions did not have any beneficial effect. There was no evidence to suggest that these types of interventions caused harm. The results of trials currently being conducted should tell us the effects of these types of interventions more accurately, and will tell us if they work in a wider range of contexts, including low-income countries.
Authors' conclusions: 
There is low-quality evidence relating to the effects of mobile phone-delivered interventions to increase adherence to medication prescribed for the primary prevention of CVD; some trials reported small benefits while others found no effect. There is low-quality evidence that these interventions do not result in harm. On the basis of this review, there is currently uncertainty around the effectiveness of these interventions. We identified six ongoing trials being conducted in a range of contexts including low-income settings with potential to generate more precise estimates of the effect of primary prevention medication adherence interventions delivered by mobile phone.