MHealth for chronic disease management

Effects on adherence in Ghanaian patients with diabetes and hypertension

Bibliographic Data

ID19551071
AuthorsPearl Aovare (0000-0002-9667-2076, University of Ghana), Felix P Chilunga (0000-0003-4083-001X, Department of Public), Amos Laar (0000-0001-5557-0164, University of Ghana), N Moens (0000-0001-6601-2926, Vrije Universiteit Amsterdam), Eric P Moll Van Charante (0000-0002-1489-5218, Johns Hopkins University), Charles Agyemang (0000-0002-3882-7295, Amsterdam UMC, Department of Public & Occupational Health, Amsterdam, the Netherlands), C O Agyemang (Johns Hopkins University)
Year2026
Volume16
Pages04203-04203
Publication date2026-06-12
Open AccessYes
TypeARTICLE
VenueJournal of Global Health (JOURNAL)
Journal identifiersISSN: 2047-2978 • E-ISSN: 2047-2986
PublisherInternational Society of Global Health (PUBLISHER • GB)
DOI10.7189/jogh.16.04203
PMID42281489
OpenAlexW7164492329
LanguageEN
References cited33

Background: Medication non-adherence remains a major barrier to effective chronic disease management, particularly in low- and middle-income countries. In Ghana, limited access to continuous care and patient engagement tools contributes to poor adherence among individuals living with type 2 diabetes and hypertension. Mobile health interventions, including smartphone applications, may offer scalable solutions to support long-term medication use and self-management. Here, we assess the effect of a smartphone-based intervention on medication adherence among adults with these conditions. Methods: We conducted a quasi-experimental study among 874 adults with type 2 diabetes or hypertension in Ghana. Participants were assigned to either a smartphone-based intervention, which included medication reminders, educational content, and self-monitoring tools, or standard care involving routine outpatient management and follow-up without access to the smartphone-based intervention. We measured medication adherence at baseline and six months using the Medication Adherence Rating Scale and assessed it through generalised estimating equations and difference-in-differences analyses, adjusting for baseline adherence, age, sex, and treatment setting. Results: Use of the smartphone application was associated with a greater improvement in medication adherence over six months in the overall study population (adjusted beta coefficient (aβ) = 0.062; 95% confidence interval (CI) = 0.010-0.123). Similar improvements were observed among participants with type 2 diabetes (aβ = 0.067; 95% CI = 0.012-0.135) and hypertension (aβ = 0.068; 95% CI = 0.005-0.134). However, there was no statistically significant difference in adherence between the intervention and control groups at six months. Conclusions: Smartphone-based interventions were associated with modest improvements in medication adherence over time, although between-group differences at follow-up were not statistically significant. As access to mobile technology expands across Africa, such interventions may provide scalable strategies to support chronic disease management

Confidence interval · Diabetes mellitus · Intervention (counseling) · Medication adherence · mHealth · Outpatient clinic · Population · Psychological intervention · Type 2 diabetes · Diabetes Management and Education · Medication Adherence and Compliance · Mobile Health and mHealth Applications

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