In the treatment of chronic diseases such as asthma, heart failure or hypertension, pharmacology plays a key role, but medication alone is not enough. It is estimated that between 20% and 50% of patients take their medications inappropriately. This leads to increased morbidity and ineffective therapy1. Increasing adherence to treatment is a priority goal of healthcare systems1. The physician's role in dealing with such conditions is extremely complex. While choosing the appropriate pharmacotherapy, at the same time he must provide the patient with emotional support and education about the drug, the treatment or the disease itself2. A single, time-limited medical visit is not enough to fully care for the patient. When questions or worries arise during treatment, the patient must wait, often for several weeks, to consult with the doctor about his or her concerns.
Therefore, in this article you will learn what therapy support applications are and how they can become the golden means to solve the problems of maintaining the effectiveness of treatment.
What is a "therapy companion app" ?
Therapy companion app is a mobile application designed for patients struggling with chronic diseases. It provides medication reminders, medication instructions, disease-specific educational content, recommendations for healthy habits, and symptom recording1. It can also support patients in monitoring therapy through notifications to medical caregivers.
How therapy companion app affects treatment effectiveness
The World Health Organization (WHO, World Health Organization) recognizes non-adherence to treatment recommendations as a widespread international problem1. Lack of adherence to treatment regimens can lead to high health costs resulting from repeat hospitalizations. In turn, medications used in contravention of a doctor's instructions lose theireffectiveness3.
Previous analysis of the effectiveness of mobile apps to support drug therapies confirms their significant impact on adherence to treatment recommendations1. These studies covered a broad spectrum of conditions, such as asthma, heart failure, hypertension andHIV1. In 7 of 11 of these studies, participants reported that they were more satisfied with functionalities such as reminders and symptom recording and medication information that helped them adhere to treatment1. A reduction in medication-related errors was observed. Three studies showed that mobile apps significantly reduced the risk of misseddoses1.
Contrary to popular belief, one study confirmed that using the app was not a problem for older patients, who were able to use the mobile app at a comparable level to younger users1. In addition, learning to use had a positive impact on patients who had previously reported numerous difficulties in using the mobile app.1
Despite these positive results, the apps studied did not include features to enable daily contact with the doctor. This significantly limited monitoring of patient adherence to therapy. According to the study, healthcare professionals should recommend that their patients install the apps and then monitor usage, as downloading alone does not guarantee full use of the app1.
The importance of thepatient-doctor relationship.
Another study of patients with chronic myelogenous leukemia (CML) highlights the importance of developing open communication and a professional, long-term relationship between patient and physician2. The authors of the study, based on their personal experiences as patients struggling with CML, indicated that collaborative decision-making during treatment and increased patient education are key to better health outcomes, treatment adherence and lower healthcarecosts2. Patients identified that the most important aspects in choosing a doctor were experience in treating their condition, the doctor's character traits (empathy, sense of humor) and accessibility, such as through virtual meetings or phone calls2.
Also, in vascular and cardiovascular diseases, nonadherence can occur when the treatment regimen is complex, resulting in inappropriate timing of drug administration or administration of multiple drugs at unusual times of the day4. These patient behavioral factors may or may not be noticed by the doctor during the visit. Another study found that more than 60% of patients interviewed immediately after a doctor's visit misunderstood recommendations for prescribed medications4. Incomplete understanding of the condition and the seriousness of the risk is one of the biggest barriers physicians face in treating cardiovascular diseases.
"I need a consultation. I need to talk to someone. If I knew about my medications, their side effects and my diet; maybe I would manage my illness better. Doctors are always in a hurry; they don't ask about the patient's condition, they don't answer our questions." 4
Summary
The treatment of chronic diseases requires a comprehensive approach that includes not only pharmacology, but also constant contact with the doctor and his emotional support. Mobile apps can be an effective tool to support therapy, but their effectiveness depends on regular monitoring and interaction by healthcare professionals. Creating open and systematic communication between patient and doctor is essential to achieve higher patient adherence to therapy. To learn more about the implementation of mobile apps in the care of patients with chronic diseases in Poland, we encourage you to read this article https://www.doctor.one/blog/koordynacja-sm
- Pérez-Jover, V., Sala-González, M., Guilabert, M., & Mira, J. J. (2019). Mobile Apps for Increasing Treatment Adherence: a Systematic Review. Journal of medical Internet research, 21(6), e12505. https://doi.org/10.2196/12505
- Clements, J., Fleischman, A., Lerner, V., & Ruiz, C. (2023). The Importance of Developing Open Communication and a Professional, Long-Term Relationship Between Patients with Chronic Myeloid Leukemia and their Oncologist. Future Oncology, 19(17), 1197-1208. https://doi.org/10.2217/fon-2022-1267
- Jimmy, B., & Jose, J. (2011). Patient medication adherence: measures in daily practice. Oman medical journal, 26(3), 155-159. https://doi.org/10.5001/omj.2011.38
- Kalantarzadeh, M., Yousefi, H., Alavi, M., & Maghsoudi, J. (2022). Adherence Barriers to Treatment of Patients with Cardiovascular Diseases: A Qualitative Study. Iranian journal of nursing and midwifery research, 27(4), 317-324. https://doi.org/10.4103/ijnmr.ijnmr_307_21
