Development of a Mobile App for Medication Adherence Monitoring and Support

Thesis Abstract

Non-adherence to prescribed medication regimens remains a significant barrier to optimal health outcomes, contributing to increased hospitalizations, higher healthcare costs, and elevated morbidity and mortality rates worldwide. Despite advances in healthcare delivery, many patients fail to maintain consistent medication routines due to forgetfulness, complex dosing schedules, side effects, or lack of proper understanding. The proliferation of mobile technology presents an opportunity to address these challenges through innovative, accessible solutions. This study aims to develop a user-centered mobile application designed to monitor, promote, and support medication adherence among adult patients with chronic illnesses. Specific objectives include designing the app based on behavioral change theories, evaluating its usability and acceptability, and assessing its impact on adherence rates over a three-month pilot implementation. Employing a pragmatic mixed-methods research design, the study integrates qualitative and quantitative approaches to generate comprehensive insights. The research population comprises adult patients diagnosed with hypertension or diabetes attending outpatient clinics at a tertiary healthcare facility, with an estimated total of 300 patients fitting inclusion criteria. A stratified random sampling technique is employed to select 150 participants for the quantitative phase, while purposive sampling is used to collect qualitative data from 20 healthcare providers and 20 patients for usability testing and thematic analysis. Data collection instruments include structured questionnaires, semi-structured interview guides, and app usability assessment tools such as the System Usability Scale (SUS). The app's development framework is grounded in the Health Belief Model and the Theory of Planned Behavior, providing theoretical underpinning for behavioral interventions embedded within the application. Quantitative data are analyzed using descriptive statistics, paired t-tests, and multiple regression analysis to assess pre- and post-intervention adherence rates and identify predictors of adherence. Qualitative data from interviews are transcribed verbatim and analyzed thematically using NVivo software, allowing for the exploration of user perceptions, barriers, and facilitators of app adoption. The usability data are scored and interpreted to measure user satisfaction, with benchmark thresholds guiding acceptability judgments. Expected findings indicate that the mobile application significantly improves medication adherence, evidenced by increased adherence scores from baseline to three months, and that users perceive the app as user-friendly and motivating. The qualitative data are anticipated to reveal critical insights into user engagement, perceived benefits, and areas for app refinement. The study hypothesizes that integrating behavioral theories within app design enhances user motivation and sustained use, aligning with existing literature on technology-based health interventions. This research contributes to the body of knowledge by demonstrating the feasibility, usability, and preliminary efficacy of a tailored mobile intervention aimed at improving medication adherence. It underscores the potential of mobile health (mHealth) solutions to bridge gaps in medication management, particularly in resource-limited settings. The findings advocate for broader implementation and integration of such apps within routine care pathways, emphasizing the importance of user-centered design and behavioral theory application. Recommendations include scaling the app for wider deployment, conducting long-term randomized controlled trials, and integrating app data with electronic health records for seamless monitoring. Future studies should also explore adaptation for other chronic conditions and diverse populations to enhance generalizability and impact.