Use of a smartphone app in people with poorly controlled or uncontrolled hypertension has been linked to a “small improvement” in self-reported medication adherence, according to research published in JAMA Internal Medicine.1,2

Participants in the MedISAFE-BP (Medication Adherence Improvement Support App for Engagement – Blood Pressure; Identifier: NCT02727543) were randomly assigned 1:1 to either the intervention or control groups. Participants in the intervention group (n=209) used the Medisafe app, which included reminder alerts, adherence reports, and optional peer support, while participants in the control group (n=202) received care as usual.

Researchers found that after 12 weeks, the mean medication adherence score improved by 0.4±1.5 among participants in the intervention group vs those in the control group (between group difference: 0.4; 95% CI, 0.1-0.7; P =.01).

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A slight decrease in mean systolic blood pressure was noted in both groups (decrease of 106 and 10.1 mm Hg in the intervention and control groups, respectively; between group difference: -0.5; 95% CI, -3.7 to 2.7; P =.78).

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Study researchers acknowledged several possible explanations for the improvement in medication adherence without a corresponding reduction in blood pressure, including the possibility that, despite significant adherence improvements, “the magnitude of change was likely too small to translate into improvements in blood pressure.”

In an invited commentary also published in JAMA Internal Medicine3, Alexander G. Logan, MD, and S. Vainta Jassal, MD, of the Department of Nephrology at the University of Toronto in Toronto, Ontario, note that the rapid growth of mobile health (mHealth) technologies highlight the challenges that hinder integration into the current healthcare system. However, they remain optimistic.

“We believe, as many do, that mHealth developments will continue to grow and play an exciting role in empowering individuals to become more knowledgeable consumers and active decision-makers in finding safe, efficient, and cost-effective solutions that strengthen the care loop between patients and their healthcare professionals,” they concluded.


  1. Morawski K, Ghazinouri R, Krumme A, et al. Association of smartphone application with medication adherence and blood pressure control. The MedISAFE-BP randomized clinical trial [published online April 16, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed/2018.0447
  2. Is smartphone app associated with medication adherence, blood pressure control? [news release]. Chicago, IL: American Medical Association. Published April 16, 2018. Accessed April 16, 2018.
  3. Logan AG, Jassal SV. Building a stronger care loop through mHealth technology [published online April 16, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.1168