This study aims to evaluate the impact of using a mobile application-based medication reminder on medication adherence among patients diagnosed with chronic diseases and memory impairment. Adherence to prescribed therapy is a significant challenge for this patient population, often leading to poor health outcomes and increased healthcare costs. From a nursing leadership perspective, innovative digital solutions can play a crucial role in supporting patient self-management. Using a quasi-experimental design, the study will investigate whether a customized mobile reminder system can effectively improve adherence rates and support patients in managing their therapeutic regimens.
Patients diagnosed with one or more chronic diseases requiring regular long-term medication.
Patients exhibiting mild-to-moderate memory impairment or cognitive decline as screened by the Mini-Mental State Examination (MMSE).
Patients who personally own and are capable of operating a smartphone or have a primary caregiver willing to manage the mobile application.
Patients aged 18 years and older.
Patients with severe cognitive impairment or advanced dementia who cannot interact with mobile technology even with caregiver assistance.
Patients with severe acute clinical complications or unstable psychiatric conditions.
Patients participating in another concurrent clinical trial or study targeting medication adherence
Single group
Mobile Application-Based Medication Reminder
DeviceThe intervention consists of a mobile application specifically designed to support medication adherence. It features automated push notifications, customized reminder alerts matching prescribed medication schedules, and tracking logs. Participants will be instructed on how to install, configure, and use the application on their personal smartphones. The system is designed to provide immediate prompts to overcome memory-related adherence barriers.
Medication Adherence (MMAS-8)
Medication adherence will be assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). This self-reported tool evaluates patients' behaviors regarding taking their prescribed chronic medications. Total scores range from 0 to 8, where a score of 8 indicates high adherence, 6 to \<8 indicates medium adherence, and \<6 indicates low adherence.
Objective Medication Adherence: Medication Possession Ratio (MPR)
Medication Possession Ratio (MPR) will be calculated using pharmacy refill records to determine the proportion of time the patient has access to their prescribed medication during the study period. Total scores will range from 0 to 1 (or 0% to 100%), with higher values indicating better adherence.
Objective Medication Adherence: Proportion of Days Covered (PDC)
Proportion of Days Covered (PDC) will be assessed using pharmacy refill records to measure the percentage of days the patient covered their prescribed medication dosage over the study duration. Total scores will range from 0 to 1 (or 0% to 100%), where higher values reflect superior medication adherence.
Cognitive Function Status (MMSE)
Cognitive impairment levels will be screened using the Mini-Mental State Examination (MMSE) to classify the severity of cognitive/memory impairment among participants.
Perceived Nursing Care and Leadership Support
Evaluated using the Nursing Care and Leadership Support Assessment Tool to measure patient satisfaction and perception of the supportive role played by nursing leadership during the application-based program.
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Mansoura University
Lead sponsor
Al-Azhar University
Collaborator
Delta University for Science and Technology
Collaborator
