Design, implementation, and evaluation of web-based medication management application for polypharmacy adolescents: a mixed methods study

Poor medication adherence in adolescents is a recognized problem. Adolescents, desire independence and autonomy and require specific education compared to adults. Adolescents exhibit a strong inclination toward using mobile phones and related applications. The study aims to design, implement, and evaluate web-based medication management software for polypharmacy adolescents. This mixed-methods study was conducted in three phases: (1) Designing, based on the needs assessment of polypharmacy adolescents and a literature review, (2) Implementing: sampling was conducted using a purposeful method and the intervention group used a medication management application for six months, (3) Evaluation: it was done quantitatively and qualitatively. The application featured reminders, three user access levels, cross-browser compatibility, individualized and updatable medication plans, data export, secure messaging, medication history logs, adherence diagrams, and bilingual (Persian-English) support. Quantitative results demonstrated a significant improvement in medication adherence. The intervention group’s mean Morisky Medication Adherence Scale (MMAS) score decreased from 3.96 ± 0.95 at baseline to 1.09 ± 0.77 at six months, indicating higher adherence, whereas the control group showed no significant change (3.96 ± 0.96 to 3.86 ± 0.95; P < 0.001 for between-group difference). User satisfaction, measured by the Mobile App Rating Scale (MARS), also increased significantly over time, with the mean total score rising from 3.77 at two months to 4.04 at six months (P < 0.001). Qualitative analysis yielded three main categories: application strengths, application weaknesses, and user suggestions. Conclusions from the results showed that: (1) the effectiveness of a medication management application in improving adolescent medication adherence; (2) the importance of needs-based application design; (3) the importance of the ability to update medication schedules based on user conditions; and (4) the importance of application support by a specialist.