Evaluating Mobile App Interventions to Improve Medication Adherence in Elderly Patients

Thesis Abstract

The increasing prevalence of chronic diseases among elderly populations underscores the urgent need for effective medication management strategies, as non-adherence to prescribed regimens remains a significant barrier to optimal health outcomes and increased healthcare costs. Despite the proliferation of digital health technologies, there is limited empirical evidence on the efficacy of mobile app interventions specifically tailored to improve medication adherence among senior citizens. This study aims to evaluate the impact of a mobile health application designed to enhance medication adherence in elderly patients aged 60 years and above, residing in urban healthcare settings. The specific objectives include assessing the usability and acceptability of the app, measuring changes in medication adherence rates post-intervention, and exploring factors influencing user engagement and adherence behavior. Employing a mixed-methods research design, the study integrates quantitative and qualitative data to provide a comprehensive evaluation of the intervention. The quantitative component adopts a quasi-experimental pre-test and post-test control group design involving 200 elderly participants randomly assigned to an intervention group (n=100) using the mobile app and a control group (n=100) receiving standard care. Data collection instruments include the Morisky Medication Adherence Scale-8 (MMAS-8), a usability questionnaire based on the System Usability Scale (SUS), and demographic and health status questionnaires. The qualitative component comprises semi-structured interviews with a purposive sample of 20 app users from the intervention group to explore perceived barriers, facilitators, and overall user experience. Data analysis involves descriptive statistics to characterize the sample, paired t-tests and ANCOVA to evaluate differences in adherence scores before and after the intervention while controlling for confounders, and regression analysis to identify predictors of adherence improvement. Thematic analysis, following Braun and Clarke’s framework, is employed to interpret qualitative interview data, providing contextual insights into user experiences and engagement factors. The theoretical underpinnings of the study draw upon the Health Belief Model (HBM) to understand behavioral determinants and the Technology Acceptance Model (TAM) to assess technology adoption factors affecting app usage. Expected findings suggest a statistically significant improvement in medication adherence rates among app users compared to controls, alongside high usability ratings and positive user acceptability. Qualitative data are anticipated to reveal key facilitators such as personalized reminders and ease of use, as well as barriers like technological literacy challenges and skepticism about app efficacy. The integration of quantitative and qualitative findings aims to delineate the mechanisms through which mobile app interventions influence adherence behaviors within this demographic. This study contributes to the existing body of knowledge by providing rigorous empirical evidence on the effectiveness of tailored mobile health applications in promoting medication adherence among elderly patients. It advances understanding of user-centered design factors, behavioral influences, and technology acceptance among seniors. The main conclusion emphasizes that user-friendly, personalized mobile apps are a viable adjunct to conventional care for improving medication management in older adults, thereby potentially reducing adverse health events and optimizing resource utilization. Based on these findings, the study recommends wider integration of mobile app solutions into elderly care protocols, emphasizes the importance of digital literacy programs to enhance engagement, and advocates for ongoing usability testing to adapt interventions to diverse user needs. Future research directions include longitudinal studies to assess long-term adherence sustainability and the development of culturally adaptable app features to cater to diverse elderly populations. Overall, this research aims to inform policymakers, healthcare providers, and developers about designing effective, acceptable, and accessible mobile health interventions tailored for elderly populations to improve medication adherence and health outcomes.