Smart About Meds (SAM): a pilot randomized controlled trial of a mobile application to improve medication adherence following hospital discharge

Bettina Habib; David Buckeridge; Melissa Bustillo; Santiago Nicolas Marquez; Manish Thakur; Thai Tran; Daniala L Weir; Robyn Tamblyn

doi:10.1093/jamiaopen/ooab050

Smart About Meds (SAM): a pilot randomized controlled trial of a mobile application to improve medication adherence following hospital discharge

Bettina Habib, David Buckeridge, Melissa Bustillo, Santiago Nicolas Marquez, Manish Thakur, Thai Tran, Daniala L Weir, Robyn Tamblyn

McGill University and Genome Quebec Innovation Centre

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective: The objectives of this pilot study were (1) to assess the feasibility of a larger evaluation of Smart About Meds (SAM), a patient-centered medication management mobile application, and (2) to evaluate SAM's potential to improve outcomes of interest, including adherence to medication changes made at hospital discharge and the occurrence of adverse events.

Materials and Methods: We conducted a pilot randomized controlled trial among patients discharged from internal medicine units of an academic health center between June 2019 and March 2020. Block randomization was used to randomize patients to intervention (received access to SAM at discharge) or control (received usual care). Patients were followed for 30 days post-discharge, during which app use was recorded. Pharmacy claims data were used to measure adherence to medication changes made at discharge, and physician billing data were used to identify emergency department visits and hospital readmissions during follow-up.

Results: Forty-nine patients were eligible for inclusion in the study at hospital discharge (23 intervention, 26 control). In the 30 days of post-discharge, 15 (65.2%) intervention patients used the SAM app. During this period, intervention patients adhered to a larger proportion of medication changes (83.7%) than control patients (77.8%), including newly prescribed medications (72.7% vs 61.7%) and dose changes (90.9% vs 81.8%). A smaller proportion of intervention patients (8.7%) were readmitted to hospital during follow-up than control patients (15.4%).

Conclusion: The high uptake of SAM among intervention patients supports the feasibility of a larger trial. Results also suggest that SAM has the potential to enhance adherence to medication changes and reduce the risk of downstream adverse events. This hypothesis needs to be tested in a larger trial.

Trial registration: Clinicaltrials.gov, registration number NCT04676165.

Original language	English
Article number	ooab050
Pages (from-to)	1-14
Journal	JAMIA Open
Volume	4
Issue number	3
DOIs	https://doi.org/10.1093/jamiaopen/ooab050
Publication status	Published - 1 Jul 2021

Bibliographical note

Funding Information:
This work was supported by the Quebec Ministry of Economy, Science and Innovation (MESI) through the Fonds de soutien? l'innovation en sant? et services sociaux (FSISSS)-grant number 2-53.

Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Keywords

adverse events
medication adherence
mobile application
pilot randomized controlled trial

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10.1093/jamiaopen/ooab050Licence: CC BY

ooab050Final published version, 764 KBLicence: CC BY

Cite this

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title = "Smart About Meds (SAM): a pilot randomized controlled trial of a mobile application to improve medication adherence following hospital discharge",

abstract = "Objective: The objectives of this pilot study were (1) to assess the feasibility of a larger evaluation of Smart About Meds (SAM), a patient-centered medication management mobile application, and (2) to evaluate SAM's potential to improve outcomes of interest, including adherence to medication changes made at hospital discharge and the occurrence of adverse events.Materials and Methods: We conducted a pilot randomized controlled trial among patients discharged from internal medicine units of an academic health center between June 2019 and March 2020. Block randomization was used to randomize patients to intervention (received access to SAM at discharge) or control (received usual care). Patients were followed for 30 days post-discharge, during which app use was recorded. Pharmacy claims data were used to measure adherence to medication changes made at discharge, and physician billing data were used to identify emergency department visits and hospital readmissions during follow-up.Results: Forty-nine patients were eligible for inclusion in the study at hospital discharge (23 intervention, 26 control). In the 30 days of post-discharge, 15 (65.2%) intervention patients used the SAM app. During this period, intervention patients adhered to a larger proportion of medication changes (83.7%) than control patients (77.8%), including newly prescribed medications (72.7% vs 61.7%) and dose changes (90.9% vs 81.8%). A smaller proportion of intervention patients (8.7%) were readmitted to hospital during follow-up than control patients (15.4%).Conclusion: The high uptake of SAM among intervention patients supports the feasibility of a larger trial. Results also suggest that SAM has the potential to enhance adherence to medication changes and reduce the risk of downstream adverse events. This hypothesis needs to be tested in a larger trial.Trial registration: Clinicaltrials.gov, registration number NCT04676165.",

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author = "Bettina Habib and David Buckeridge and Melissa Bustillo and Marquez, {Santiago Nicolas} and Manish Thakur and Thai Tran and Weir, {Daniala L} and Robyn Tamblyn",

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AU - Marquez, Santiago Nicolas

AU - Thakur, Manish

AU - Tran, Thai

AU - Weir, Daniala L

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N2 - Objective: The objectives of this pilot study were (1) to assess the feasibility of a larger evaluation of Smart About Meds (SAM), a patient-centered medication management mobile application, and (2) to evaluate SAM's potential to improve outcomes of interest, including adherence to medication changes made at hospital discharge and the occurrence of adverse events.Materials and Methods: We conducted a pilot randomized controlled trial among patients discharged from internal medicine units of an academic health center between June 2019 and March 2020. Block randomization was used to randomize patients to intervention (received access to SAM at discharge) or control (received usual care). Patients were followed for 30 days post-discharge, during which app use was recorded. Pharmacy claims data were used to measure adherence to medication changes made at discharge, and physician billing data were used to identify emergency department visits and hospital readmissions during follow-up.Results: Forty-nine patients were eligible for inclusion in the study at hospital discharge (23 intervention, 26 control). In the 30 days of post-discharge, 15 (65.2%) intervention patients used the SAM app. During this period, intervention patients adhered to a larger proportion of medication changes (83.7%) than control patients (77.8%), including newly prescribed medications (72.7% vs 61.7%) and dose changes (90.9% vs 81.8%). A smaller proportion of intervention patients (8.7%) were readmitted to hospital during follow-up than control patients (15.4%).Conclusion: The high uptake of SAM among intervention patients supports the feasibility of a larger trial. Results also suggest that SAM has the potential to enhance adherence to medication changes and reduce the risk of downstream adverse events. This hypothesis needs to be tested in a larger trial.Trial registration: Clinicaltrials.gov, registration number NCT04676165.

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Smart About Meds (SAM): a pilot randomized controlled trial of a mobile application to improve medication adherence following hospital discharge

Abstract

Bibliographical note

Keywords

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