The impact of digital interventions on medication adherence in paediatric populations with attention deficit hyperactivity disorder, depression, and/or anxiety: A rapid systematic review and meta-analysis

Abstract

Background The growing prevalence of mental health disorders in children and adolescents coupled with poor medication adherence in the paediatric population is a major problem within healthcare systems affecting patient outcomes. Digital health interventions (DHIs) are primed to optimise medication adherence given the expansion of digital health markets and the increased usage of digital technologies by children and adolescents. Objective This rapid systematic review evaluates the impact of DHIs on optimising medication adherence amongst children and adolescents with mental health disorders compared to treatment as usual (TAU). Methods A rapid systematic search in electronic databases CINAHL Plus, Cochrane Library, MEDLINE, PubMed, and Scopus was conducted. The scope of the rapid systematic search included randomised controlled trials and quasi-experimental studies (non-randomised controlled trials) evaluating DHIs optimising medication adherence in children and adolescents with attention deficit hyperactivity disorder (ADHD), depression and/or anxiety. Meta-analyses were conducted based on estimating pooled odds ratio (OR) and mean difference (MD) with 95% confidence interval using a random-effects model. Thematic analysis identified key avenues DHIs offer to optimise medication adherence. Results Four studies were found, with 502 participants included in the meta-analysis. An improvement in medication adherence was observed following DHIs for studies measuring dichotomous and continuous outcomes. However, the effect was not significant for the former. DHIs were shown to help bridge the gaps between patients and healthcare professionals, allowing for more frequent monitoring, communication, and assessments. Conclusions Medication adherence amongst children and adolescents with acute or chronic ADHD, anxiety or depression may be positively impacted by DHIs, but better-powered studies with a lower risk of bias are necessary. The evidence currently remains inconclusive on DHIs improving medication adherence in children and adolescents.