Background: Emerging health care strategies addressing medication adherence include the use of direct-to-patient incentives or elements adapted from computer games. However, there is currently no published evidence synthesis on the use of gamification or financial incentives in mobile apps to improve medication adherence. Objective: The aim of this scoping review is to synthesize and appraise the literature pertaining to the use of mobile apps containing gamification or financial incentives for medication adherence. There were two objectives: to explore the reported effectiveness of these features and to describe and appraise the design and development process, including patient involvement. Methods: The following databases were searched for relevant articles published in English from database inception to September 24, 2020: Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science. The framework by Arksey and O’Malley and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist guided this scoping review. Using a systematic screening process, studies were included if incentives or game features were used within mobile apps to specifically address medication adherence. An appraisal using risk of bias tools was also applied to their respective study design. Results: A total of 11 studies from the initial 691 retrieved articles were included in this review. Across the studies, gamification alone (9/11, 82%) was used more than financial incentives (1/11, 9%) alone or a combination of the two (1/11, 9%). The studies generally reported improved or sustained optimal medication adherence outcomes; however, there was significant heterogeneity in the patient population, methodology such as outcome measures, and reporting of these studies. There was considerable variability in the development process and evaluation of the apps, with authors opting for either the waterfall or agile methodology. App development was often guided by a theory, but across the reviewed studies, there were no common theories used. Patient involvement was not commonly evident in predevelopment phases but were generally reserved for evaluations of feasibility, acceptance, and effectiveness. Patient perspectives on gamified app features indicated a potential to motivate positive health behaviors such as medication adherence along with critical themes of repetitiveness and irrelevance of certain features. The appraisal indicated a low risk of bias in most studies, although concerns were identified in potential confounding. Conclusions: To effectively address medication adherence via gamified and incentivized mobile apps, an evidence-based co-design approach and agile methodology should be used. This review indicates some adoption of an agile approach in app development; however, patient involvement is lacking in earlier stages. Further research in a generalized cohort of patients living with chronic conditions would facilitate the identification of barriers, potential opportunities, and the justification for the use of gamification and financial incentives in mobile apps for medication adherence.

Measurement instruments are used to collect data about respondents. In social pharmacy, measurement instruments are often used to measure latent constructs, such as attitudes, among healthcare professionals and patients. This paper aims to describe the fundamental aspects of designing and validating instruments, which aim to measure latent constructs. The main focus of this manuscript is to describe the considerations and processes relating to exploratory and confirmatory factor analyses, when used to develop measures of latent psychosocial constructs. However, it also presents a detailed summary of the current evidence and suggestions for item generation and sample selection, as well as, an in-depth description of approaches to content and face validation. Suggestions for further reading are also provided.

Factors influencing pharmacy students’ attitudes towards pharmacy practice research and strategies for promoting research interest in pharmacy practice

Objective There is a lack of knowledge regarding recipients' experiences with, perceptions of, and willingness to reuse the Home Medicines Review (HMR) programme in Australia. In addition, little is known about eligible non-recipients' awareness of and willingness to use the HMR service. The aim of the study was therefore to explore perceptions of, and willingness to use, HMRs. Methods A cross-sectional questionnaire was conducted with recipients and eligible non-recipients of HMRs. Eligible non-recipients were defined as those who had not had an HMR and were at risk of medication misadventure. The questionnaire was distributed by 264 practising pharmacists throughout Australia. Results A total of 595 out of 1893 (31%) HMR recipients and 293 out of 1829 (16%) eligible non-recipients completed the questionnaires. Overall, 91% of recipients were satisfied with the service. Compared with eligible non-recipients, recipients were more willing to have an HMR if their general practitioner (GP) suggested it (91% versus 71%, P < 0.001) and more willing to ask for an HMR if they were having concerns about their medicines (82% versus 63%, P < 0.001). Among eligible non-recipients, 23% were aware of HMRs. Predominantly pharmacists (68%) and GPs (36%) provided awareness of HMRs, which was associated with increased willingness to have an HMR if their GP suggested it (83% versus 67%, P < 0.014). Conclusions An overwhelming majority of patients were satisfied with the HMR programme. Experience with HMR, and to a lesser extent, prior awareness, increased willingness to use HMR. Therefore, pharmacists and GPs who introduce HMR to eligible non-recipients may increase their willingness to use this service.