Mobile health interventions to improve adherence to oral anticoagulant treatment: A systematic review and critical analysis
- 1Centre for Health Economics and Medicines Evaluation, North Wales Medical School Bangor University Bangor UK
- 2Aparito, a wholly owned subsidiary of Eli Lilly and Company Wrexham UK
Abstract
Aims: Non‐adherence to oral anticoagulants (OACs) is associated with significant morbidity and mortality. Mobile health (mHealth) interventions have been used to improve medication adherence across the three phases of initiation, implementation and persistence. This review investigated the effectiveness of mHealth interventions in improving OAC adherence.
Methods: PubMed, Embase, Cochrane Register and Web of Science were searched from 1/1/2000 to 14/11/2025 using terms identifying mHealth, OACs, medication adherence and randomized controlled trials. Included studies were assessed using the Risk of Bias for Interventional Adherence Studies tool. A narrative synthesis of the findings was undertaken. The study protocol was published in PROSPERO (CRD42022372863).
Results: A total of 2571 studies were screened from which 24 randomized controlled trials met the criteria for inclusion. Adherence was most frequently assessed electronically using smart pill bottles and medication events monitoring systems. Nine of the 13 trials reporting statistically significant improvements in adherence tested smartphone‐based apps, telephone calls or text messages to support participants or as medication intake reminders. In terms of methodological quality, studies scored best with respect to randomization and blinding procedures, data analysis and interpretation. Studies scored worst in relation to study design and implementation of procedures and adherence outcome measurement and reporting.
Conclusions: mHealth interventions involving smartphone‐based apps or telephone and text messages may be effective in improving adherence to OACs. Future research should focus on optimizing the frequency of delivery, content of calls or messages and automation. Research should prioritize larger, longer‐term trials with emphasis placed on trial design, conduct and reporting.
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BibTeX
@article{davies2026mobile,
title = {{Mobile health interventions to improve adherence to oral anticoagulant treatment: A systematic review and critical analysis}},
author = {Non Davies and Elin Haf Davies and Dyfrig A. Hughes},
journal = {British Journal of Clinical Pharmacology},
year = {2026},
month = jul,
doi = {10.1002/bcp.70718},
url = {https://doi.org/10.1002/bcp.70718},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Mobile health interventions to improve adherence to oral anticoagulant treatment: A systematic review and critical analysis
AU - Non Davies
AU - Elin Haf Davies
AU - Dyfrig A. Hughes
PY - 2026
DA - 2026/07/31
JO - British Journal of Clinical Pharmacology
DO - 10.1002/bcp.70718
UR - https://doi.org/10.1002/bcp.70718
AB - Aims: Non‐adherence to oral anticoagulants (OACs) is associated with significant morbidity and mortality. Mobile health (mHealth) interventions have been used to improve medication adherence across the three phases of initiation, implementation and persistence. This review investigated the effectiveness of mHealth interventions in improving OAC adherence. Methods: PubMed, Embase, Cochrane Register and Web of Science were searched from 1/1/2000 to 14/11/2025 using terms identifying mHealth, OACs, medication adherence and randomized controlled trials. Included studies were assessed using the Risk of Bias for Interventional Adherence Studies tool. A narrative synthesis of the findings was undertaken. The study protocol was published in PROSPERO (CRD42022372863). Results: A total of 2571 studies were screened from which 24 randomized controlled trials met the criteria for inclusion. Adherence was most frequently assessed electronically using smart pill bottles and medication events monitoring systems. Nine of the 13 trials reporting statistically significant improvements in adherence tested smartphone‐based apps, telephone calls or text messages to support participants or as medication intake reminders. In terms of methodological quality, studies scored best with respect to randomization and blinding procedures, data analysis and interpretation. Studies scored worst in relation to study design and implementation of procedures and adherence outcome measurement and reporting. Conclusions: mHealth interventions involving smartphone‐based apps or telephone and text messages may be effective in improving adherence to OACs. Future research should focus on optimizing the frequency of delivery, content of calls or messages and automation. Research should prioritize larger, longer‐term trials with emphasis placed on trial design, conduct and reporting.
SN - 0306-5251
SN - 1365-2125
ER -