title: Characterization of Apps and Other e-Tools for Medication Use: Insights Into Possible Benefits and Risks.
abstract: BACKGROUND
  In the past years, an enormous increase in the number of available health-related applications (apps) has occurred, from approximately 5800 in 2011 to over 23,000 in 2013, in the iTunes store. However, little is still known regarding the use, possible effectiveness, and risks of these applications. In this study, we focused on apps and other e-tools related to medicine use. A large subset of the general population uses medicines and might benefit from tools that aid in the use of medicine.
  
  
  OBJECTIVE
  The aim of the present study was to gain more insight into the characteristics, possible risks, and possible benefits of health apps and e-tools related to medication use.
  
  
  METHODS
  We first made an inventory of apps and other e-tools for medication use (n=116). Tools were coded by two independent researchers, based on the information available in the app stores and websites. Subsequently, for one type of often downloaded apps (aimed at people with diabetes), we investigated users' experiences using an online questionnaire.
  
  
  RESULTS
  Results of the inventory show that many apps for medication use are available and that they mainly offer simple functionalities. In line with this, the most experienced benefit by users of apps for regulating blood glucose levels in the online questionnaire was "information quick and conveniently available". Other often experienced benefits were improving health and self-reliance. Results of the inventory show that a minority of the apps for medication use has potentially high risks and for many of the apps it is unclear whether and how personal data are stored. In contrast, online questionnaire among users of apps for blood glucose regulation indicates that they hardly ever experience problems or doubts considering reliability and/or privacy. Although, respondents do mention to experience disadvantages of use due to incomplete apps and apps with poor ease of use. Respondents not using app(s) indicate that they might use them in the future if reliability of the apps and instructions on how to use them are more clear.
  
  
  CONCLUSIONS
  This study shows that for apps and e-tools related to medicine use a small subset of tools might involve relatively high risks. For the large group of nonmedical devices apps, risks are lower, but risks lie in the enormous availability and low levels of regulation. In addition, both users and nonusers indicated that overall quality of apps (ease of use, completeness, good functionalities) is an issue. Considering that important benefits (eg, improving health and self-reliance) are experienced by many of the respondents using apps for regulating blood glucose levels, improving reliability and quality of apps is likely to have many profits. In addition, creating better awareness regarding the existence and how to use apps will likely improve proper use by more people, enhancing the profits of these tools.
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Health Protection, Bilthoven, Netherlands. linda.van.kerkhof@rivm.nl.
authors.forename: Linda Wilhelmina Maria
authors.identifier: http://orcid.org/0000-0001-5742-2659
authors.initials: LW
authors.lastname: van Kerkhof
authors.forename: Catharina Walthera Egbertha
authors.initials: CW
authors.lastname: van der Laar
authors.forename: Charlie
authors.initials: C
authors.lastname: de Jong
authors.forename: Marjolein
authors.initials: M
authors.lastname: Weda
authors.forename: Ingrid
authors.initials: I
authors.lastname: Hegger
keywords: drugs; eHealth; mHealth; medication use; mobile apps