Given the sheer number of medical apps available these days, it is important to find evidence-based guidance for which apps to choose. Santo et al from the University of Sydney evaluated medication adherence apps from the Australian Google Play store and Apple iTunes store using a systematic stepwise approach based on the features described for each medical app.

Medication adherence is an important issue with the increasing elderly population, as it is one of the key factors to empowering patients to manage their own chronic diseases. Ironically, in order for these medical apps to help improve medication adherence, patients have to use and adhere to these apps regularly. With so many apps available from diverse sources, identifying those that are high quality, and easy to use apps is therefore a critical first step.

A total of 272 medical apps were included using the search terms medication reminder, medication pill reminder, pill reminder, meds reminder, medication tracker, medication management, Rx, and medication, of which 152 were exclusive to the Google Play store, 87 were exclusive to iTunes, and 33 were available in both stores. Less than half of these (n=109) were freely available, and more than half (n=148) have not been updated by the developer in the last couple of years.

Using the descriptions and reviews available from the app stores, each app was scored against 3 practical features and 17 functional features, and the top 5 apps were downloaded and further assessed for quality using the Mobile App Rating Scale (MARS; 23-item scale). Practical features included the availability of the app in both app stores, availability for free without ads, and a recent update in 2015 or 2016.

Functionality features included the availability of medication tracking history, snooze option, flexible scheduling, medication database, refill reminders, reminders with no Internet connectivity, data exportation and sharing, supporting multiple users, notification for other people, data security, password protection, multilingual options, time zone support, adherence statistics, adherence rewards, customizable alert sounds, and visual aids. Unfortunately, only 18 apps had 9 or more of the desired features listed. Interestingly, more than half of the apps had the features flexible scheduling and medication history tracking (the latter was the only criteria for classification as an advanced app). The snooze option, visual aids, customizable alert sounds, multiple users support, data exporting and sharing, and languages other than English were available in a third of the apps included in the study.

The advanced medical app with the most functionalities was the Medisafe and Pill Reminder app (Google Play | iTunes) by Drugs.com (14 functionalities), while AlarMeds (Google Play) had the most functionalities amongst the basic apps (7 functionalities). The My Heart My Life app (Google Play | iTunes) was evaluated to be intuitive, easy to use and to navigate, while the MedicineList+ app (Google Play | iTunes) provided high quality information from the accredible National Prescribing Service MedicineWise Australia. The MARS tool revealed that Medisafe and Pill Reminder and My Heart My Life were the best advanced and basic apps available, respectively. It should be noted that MedicineList+ and My Heart My Life are only available in Australia.

This way of evaluating the quality of apps seems to be an effective methodology that could be adopted for other areas beyond medication adherence, though the list of specific features evaluated will have to be adjusted accordingly. Moreover, evaluation of the effectiveness of the top apps in a subsequent study proposed by the authors will provide further evidence to assess the validity of this methodology. Nevertheless, this study reiterates the importance of evaluating medical apps so that we can identify quality apps and help patients choose wisely.

Medisafe Pill Reminder & Medication Tracker (Free)

Available for iOS and Android


AlarMeds

Available for Android


My Heart My Life

Available for iOS and Android


MedicineList+

Available for iOS and Android