Does Message-Based Communication Through Mobile Phones for Medication and Treatment Adherence Improve Health Outcomes? A Systematic Review

Medical non-adherence has been a pervasive issue in healthcare for far too long and consequences of medical non-adherence are far reaching. With the proliferation of mobile technology globally, there have been concerted efforts to improve adherence using mHealth both in developed and developing countries. The objective of this study was to evaluate through previous studies whether mobile phone innovations improve health outcomes through adherence messages to patients and how many of the studies mention and actually consider the content going out to patients as contributing to positive or negative health outcome. A systematic review was conducted using four search engines: PubMed, Mendley, Advanced Google, and Google Scholar. The publications were randomized clinical trials, cross-sectional studies, and pre and post interventional studies. The publications reviewed were considered to be eligible if they were based on use of mobile technology or smart phone applications in improving health outcomes through sending adherence messages. Forty one potential articles were retrieved based on the first search criteria and review of abstracts. Full text was not obtainable for 11 articles due to fees to access the document and/or a registration requirement for the websites making the full text inaccessible. Nine articles were published before the year 2009, 7 were systematic reviews, 1 was an SMS based study but was used by community health workers and did not necessarily address adherence, 3 were protocols for a study to be done, 10 articles met all the inclusion criteria. Mobile health technology has been proven to contribute towards improving adherence to treatment, medication and appointments. However it is crucial to consider the content and its development processes just as much as the technology in use as this might elevate the health outcomes even higher.