MOBILE HEALTH APPLICATIONS FOR MEDICATION ADHERENCE IN CHRONIC DISEASE MANAGEMENT: A REVIEW OF EFFECTIVENESS, BEHAVIOURAL MECHANISMS, AND SOCIOECONOMIC BARRIERS

Natalia Zienkiewicz; Jarosław Rachoń; Adela Dzwonkowska; Jakub Dzwonkowski; Alicja Kozłowska; Daria Trocka; Karolina Przybysz; Luiza Stadnik; Natalia Woroniecka; Nicol Szerenos

doi:10.31435/ijitss.3(51).2026.6023

Authors

Natalia Zienkiewicz Szpital Morski im. PCK, Gdynia, Poland https://orcid.org/0009-0009-3380-0470
Jarosław Rachoń Uniwersyteckie Centrum Kliniczne, Gdańsk, Poland https://orcid.org/0009-0007-9691-2221
Adela Dzwonkowska Szpitale Tczewskie S.A., Tczew, Poland https://orcid.org/0009-0004-7026-7437
Jakub Dzwonkowski Szpital Wojewódzki im. Mikołaja Kopernika, Koszalin, Poland https://orcid.org/0009-0006-5087-0698
Alicja Kozłowska Szpital Morski im. PCK, Gdynia, Poland https://orcid.org/0009-0000-5991-7401
Daria Trocka COPERNICUS Podmiot Leczniczy Sp. z o.o., Szpital św. Wojciecha, Gdańsk, Poland https://orcid.org/0000-0001-9684-5881
Karolina Przybysz Szpital Morski im. PCK, Gdynia, Poland https://orcid.org/0009-0002-9001-829X
Luiza Stadnik COPERNICUS Podmiot Leczniczy Sp. z o.o., Szpital św. Wojciecha, Gdańsk, Poland https://orcid.org/0009-0009-6854-4905
Natalia Woroniecka Samodzielny Publiczny Zakład Opieki Zdrowotnej MSWiA w Gdańsku, Poland https://orcid.org/0009-0006-4713-4526
Nicol Szerenos Szpital Morski im. PCK, Gdynia, Poland https://orcid.org/0009-0009-2754-8344

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6023

Keywords:

mHealth; Medication Adherence; Chronic Disease; Behaviour Change; Digital Health Equity; European Health Data Space

Abstract

Medication non-adherence is a major challenge in modern healthcare, with approximately half of patients with chronic conditions failing to take medications as prescribed and global economic costs exceeding US$100 billion annually in the United States alone. Mobile health (mHealth) applications, of which over 97,000 are currently available on commercial platforms, offer a scalable approach to supporting adherence behaviours. This narrative review synthesises evidence published between 2018 and 2025 on the effectiveness of mHealth applications in chronic disease management, the behavioural mechanisms underpinning observed effects, and the socioeconomic barriers shaping equitable access, with particular attention to the European context. Peer-reviewed literature was identified through structured searches of MEDLINE, Scopus, and the Cochrane Library. Recent meta-analyses demonstrate consistent, moderate improvements in adherence, with pooled mean differences of 0.57 on the 8-item Morisky Medication Adherence Scale (95% CI 0.33–0.80) and absolute improvements of 15–20% on percentage-based measures across hypertension, type 2 diabetes, HIV, cardiovascular disease, and other chronic conditions. Effectiveness is mediated by reminder mechanisms, self-monitoring, social-support features, gamification, and educational content informed by behaviour change theory. However, populations with the highest baseline non-adherence — older adults, individuals with low health literacy, those of lower socioeconomic status, and patients in low- and middle-income countries — remain underserved by current applications, reflecting a persistent digital health equity gap. Within the European Union, the German Digital Health Applications framework and the forthcoming European Health Data Space provide important precedents for statutory reimbursement and interoperable digital health infrastructure.

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