Clinical Pharmacy and the Impact of Providing Smartphones to Patients to Manage Chronic Diseases: A Systematic Review

Introduction:

Approximately, 60% of Americans own a smartphone and 15% prefer using it to go online. Chronic disease management can be addressed via smartphones focusing on quality of care and reducing costs.

Objectives:

The objective of this study was to identify examples of patient use of smartphones to improve health outcomes. A secondary objective was to explore associated costs in the form of reduced hospitalizations and readmissions.

Study Design:

A systematic review was conducted using Pubmed, Medline, Cinahl Plus, Cochrane Library, Scopus, Trip and PsychInfo to identify studies between 2005-2015.  Key search terms included “mhealth”, “telehealth”, “smartphone”, “mobile applications”, “cost savings”, and “patient health outcomes”.  

Methods:

Abstracts were screened against inclusion criteria and selected based upon relevance and quality. The most significant eligibility criteria required was that a smartphone must have been provided to the patient. Risk of bias was assessed using the Cochrane Risk of Bias Tool. Use of Covidence facilitated the summary of selected articles.  Notable characteristics were summarized in tables.

Results:

The search yielded a total of 20 articles for review. Findings focused on three key areas: disease and medication management, personal fitness and wellness and remote patient monitoring. Seven of the ten studies related to disease management showed improvement in clinical outcomes measured. Studies in which smartphones were provided to remotely monitor patient data had the most impact in reducing emergency room visits, hospitalizations, and readmissions. The smartphone programs that featured mobile coaching and medication reminders had high levels of patient satisfaction and reported increased behavior change and medication adherence. Clinical pharmacists must consider patient factors that affect successful implementation of smartphones.  

Conclusions:

Providing smartphones to patients can improve disease state management and lower overall healthcare costs in clinical pharmacy settings. Several studies point toward decreases in readmissions, but more research is needed to explore the associated benefits and costs.