Figure 9. Forest plot of rejection. Risk Rate (RR) with 95% confidence interval (CI) between eHealth intervention group and control groups.
6.Patientsatisfaction
Patient satisfaction was measured in only three of nine reviewed studies. McGillicuddy et al. (19 ) assessed the effect of text reminders and electronic medication tray with reminder function on Medication Compliance. Participants reported high overall satisfaction with the mHealth system (average score 4.8/5 point Likert scale: 1= strongly disagree-5 = strongly agree). In Fleming et al(22 ) study, the mHealth app has personalized reminders, including timely medication reminders, automated messages triggered by missed doses or scheduled health monitoring. 93% of participants were satisfied with the simple use of mHealth app. Jung et al. (23 ) assessed the effect of with texts and pill box alarms on medication adherence and their research suggested that overall satisfaction with the information and communication technology (ICT)-based centralized monitoring system was higher than neutral, even though most users were in their 50s or older.
Cost-EffectivenessEconomic evaluations were carried out in only two of nine reviewed studies. Two studies have shown that eHealth intervention can improve medication compliance(25 ) and reduce rejection(27 ), with significant cost saving by, for example, fewer admission rates and shorter lengths of unplanned hospitalization(25 ), and reductions the cost of diagnosis and treatment of rejection(27 ). It is important to note that neither study fully assessed direct and indirect costs, which limits the reliability of the conclusions.