Volume 28, Issue 2 (9-2025)
jha 2025, 28(2): 90-108 |
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Malekzadeh S, Ayatollahi H, Toni E. Evaluation of functional and non-functional requirements of medication management applications developed in Iran. jha 2025; 28 (2) :90-108
URL: http://jha.iums.ac.ir/article-1-4575-en.html
URL: http://jha.iums.ac.ir/article-1-4575-en.html
1- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
2- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran. ,ayatollahi.h@iums.ac.ir
3- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
2- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran. ,
3- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
Keywords: Applications, Medication management, Functional requirements, Non-functional requirements, Mobile phone
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Functional and non-functional requirements of applications: In terms of functional requirements, the most common requirements were synchronization and the provision of medication and educational information (82%, nine applications). None of the applications supported user profile creation, and three (18%) allowed users to interact with healthcare professionals. More than half of the applications (72%, eight applications) included medication search feature either by specific categories or alphabetically. Seven applications (63%) were able to send medication reminders and alerts to users. The ability to record a medication list, including dosage, method and frequency of medication use, recommendations for users, and drug interaction identification, was available in six applications (54%). Four applications (36%) supported drug side effect reporting and medication use tracking. Data sharing (27%, three applications), sending notifications to patient's relatives (18%, two applications), and recording user’s clinical data (9%, one application) were considered in a few medication management applications. Table 1 shows a detailed comparison of the functional and non-functional requirements among the selected applications.
Table 1. Comparison of functional and non-functional requirements of medication management applications
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Introduction
Today, with the advancement of modern technologies and the widespread adoption of smartphone-based technologies, various mobile-based applications (apps) have been developed and are now as an integral part of daily life. Some of these applications are used in healthcare for a variety of purposes, such as personal lifestyle management, diagnosis, treatment, and medication management [1,2]. Among them, medication management applications aim to facilitate medication consumption, reduce medication errors, and improve patient adherence to prescribed regimens [3]. These applications play a significant role in improving patient care by offering features such as medication reminders, access to medication information, recording user clinical data, sending alerts, and reporting adverse effects [4]. Additionally, some applications allow users to synchronize data across multiple devices and create personalized profiles, thereby streamlining the use of individual data [2,5,6].
It is notable that medication management involves taking prescribed medications according to physicians' instructions, which can pose challenges such as forgetting medication schedules, taking incorrect medications or dosages, and experiencing drug interactions, particularly among patients taking multiple drugs simultaneously [7,8]. Even for experienced physicians, effective medication management for patients with multiple chronic conditions is challenging and requires enhanced physician-patient communication and education to improve medication adherence [2,3]. Therefore, the use of medication management applications tailored to patients' needs and conditions can help address these challenges [9].
Despite advancements in health information technology, the quality of some healthcare applications, such as medication management applications remains questionable, due to poor usability, inadequate data privacy and security, limited compatibility across various platforms, and accessibility issues [10,11]. These issues can undermine the trust of users and healthcare providers in such tools, thereby reducing their positive impact on the treatment process [12]. As a result, qualitative evaluations of these applications with a focus on their functional and non-functional requirements are necessary [5].
To address this gap, several studies have assessed the quality of medication management applications [5,9,13]. Some studies examined application usability from users' perspectives, investigated application security, or assessed compatibility and accessibility [2,6,14–17]. However, functional and non-functional requirements of medication management applications are key criteria for evaluating their quality and effectiveness [19]. Functional requirements refer to the primary operational capabilities and features of applications that ensure the accurate and proper execution of various tasks. In contrast, non-functional requirements include criteria such as security, speed, and reliability, which play a vital role in shaping user experience. Together, these two categories of requirements reflect the capabilities of an application to meet users' needs and deliver high-quality services [2,18]. Few studies have examined both functional and non-functional requirements in medication management applications. Tabi et al. [5] reviewed key features such as reminders, drug search, and platform compatibility. Carmody et al. [18] focused on pediatric apps, assessing usability, privacy, and response time. Diaz-Skeete et al. [19] evaluated content quality, user interaction, and adaptability of apps for older adults. These studies emphasized that core functionalities alone are insufficient; non-functional features such as security, accessibility, and customization for special populations are also crucial to ensure user acceptance and clinical impact.
As few studies have evaluated the functional and non-functional requirements of medication management applications developed in Iran, this study aimed to identify and compare these requirements. The findings of this study can serve as a basis for developing more effective applications. In addition, these insights can aid healthcare providers and patients in selecting and using suitable applications to manage medication adherence effectively.
Methods
Study design: This two-phase study was conducted in 2024.
Scoping review: A scoping review was coundcuted to identify and extract functional and non-functional requirements for mobile-based medication management applications. To identify relevant articles, PubMed, Scopus, Web of Science, ProQuest, Persian-language databases (SID, Magiran), as well as Google Scholar were searched for studies from 2010 to 2022 (Supplement). Papers published in English or Persian with an available full text, and any design were eligible. Papers were also eligible if they reviewed, designed or evaluated medication management apps from the patients’ or users’ perspetives (not healthcare providers). Papers related to disease-specific apps, letter to editors, narrative reviews and organizational guidelines were also excluded. A total of 32 relevant studies were included in the scoping review. Content analysis was applied to extract functional and non-functional requirements. Then, an evaluation checklist containing nine functional and eight non-functional requirements was developed.
Evaluation of apps: In this phase, 11 free medication management applications were evaluated.
Search strategy: To search apps in app stores, keywords such as “medication reminder”, “medication management”, and “medication tracking” were used, and applications developed until the end of 2023 were reviewed. The search terms were selected based on the keywords identified in the related literature.
Inclusion criteria: The applications were required to be developed in Iran, available in Persian language, free of charge, and specifically designed for medication management.
Exclusion criteria: Applications not developed in Persian, primarily targeting healthcare providers as their main users, or lacking a focus on medication management were excluded.
Evaluation checklist: A checklist was developed based on the literature review (first phase) to evaluate functional and non-functional requirements. The checklist included two options (Yes/No), and three experts in health information technology and medical informatics were asked to assess its face/content validity. For reliability assessment, three researchers independently applied the checklist to evaluate five medication management applications and the Cohen’s Kappa coefficient was 0.81.
Application selection process: After identifying and downloading medication management applications, they were evaluated based on the functional and non-functional requirements defined in the checklist. Three experts in health information technology and medical informatics were involved in identifying the functional and non-functional requirements of medication management applications.
Data extraction and analysis: The data were extracted using the checklist. Only those applications deemed ineligible by all researchers were excluded from further review. In case of any discrepancies among the reviewers, disagreements were resolved through discussion. The functional and non-functional features of applications were reported separately for each app. The data obtained from the comparison of these features were then used to rank the applications.
Results
Application selection: An initial search in app stores, including Bazaar, Myket, and the Google Play Store, identified 217 applications. Among these, only 11 applications meeting the inclusion criteria were selected for evaluation. The identified applications included “Etelaat Daroo (Drug and Disease Reference)” [20], “Yadavar Daroo” [21], “Daroo Yad” [22], “Doze Imen Daroo” [23], “In Daroo Chiye?” [24], “Alodaroo” [25], “Daroonet” [26], “Daroo Yab” [27], “Darookhaneh Farsi (Dr. Taheri)” [28], “Rahat Daroo” [29], and “Darookhaneh Banafsh” [30]. All selected applications were completely free of charge and contained no third-party advertisements or in-app purchases. Figure 1 illustrates the selection and review process of the applications.
Today, with the advancement of modern technologies and the widespread adoption of smartphone-based technologies, various mobile-based applications (apps) have been developed and are now as an integral part of daily life. Some of these applications are used in healthcare for a variety of purposes, such as personal lifestyle management, diagnosis, treatment, and medication management [1,2]. Among them, medication management applications aim to facilitate medication consumption, reduce medication errors, and improve patient adherence to prescribed regimens [3]. These applications play a significant role in improving patient care by offering features such as medication reminders, access to medication information, recording user clinical data, sending alerts, and reporting adverse effects [4]. Additionally, some applications allow users to synchronize data across multiple devices and create personalized profiles, thereby streamlining the use of individual data [2,5,6].
It is notable that medication management involves taking prescribed medications according to physicians' instructions, which can pose challenges such as forgetting medication schedules, taking incorrect medications or dosages, and experiencing drug interactions, particularly among patients taking multiple drugs simultaneously [7,8]. Even for experienced physicians, effective medication management for patients with multiple chronic conditions is challenging and requires enhanced physician-patient communication and education to improve medication adherence [2,3]. Therefore, the use of medication management applications tailored to patients' needs and conditions can help address these challenges [9].
Despite advancements in health information technology, the quality of some healthcare applications, such as medication management applications remains questionable, due to poor usability, inadequate data privacy and security, limited compatibility across various platforms, and accessibility issues [10,11]. These issues can undermine the trust of users and healthcare providers in such tools, thereby reducing their positive impact on the treatment process [12]. As a result, qualitative evaluations of these applications with a focus on their functional and non-functional requirements are necessary [5].
To address this gap, several studies have assessed the quality of medication management applications [5,9,13]. Some studies examined application usability from users' perspectives, investigated application security, or assessed compatibility and accessibility [2,6,14–17]. However, functional and non-functional requirements of medication management applications are key criteria for evaluating their quality and effectiveness [19]. Functional requirements refer to the primary operational capabilities and features of applications that ensure the accurate and proper execution of various tasks. In contrast, non-functional requirements include criteria such as security, speed, and reliability, which play a vital role in shaping user experience. Together, these two categories of requirements reflect the capabilities of an application to meet users' needs and deliver high-quality services [2,18]. Few studies have examined both functional and non-functional requirements in medication management applications. Tabi et al. [5] reviewed key features such as reminders, drug search, and platform compatibility. Carmody et al. [18] focused on pediatric apps, assessing usability, privacy, and response time. Diaz-Skeete et al. [19] evaluated content quality, user interaction, and adaptability of apps for older adults. These studies emphasized that core functionalities alone are insufficient; non-functional features such as security, accessibility, and customization for special populations are also crucial to ensure user acceptance and clinical impact.
As few studies have evaluated the functional and non-functional requirements of medication management applications developed in Iran, this study aimed to identify and compare these requirements. The findings of this study can serve as a basis for developing more effective applications. In addition, these insights can aid healthcare providers and patients in selecting and using suitable applications to manage medication adherence effectively.
Methods
Study design: This two-phase study was conducted in 2024.
Scoping review: A scoping review was coundcuted to identify and extract functional and non-functional requirements for mobile-based medication management applications. To identify relevant articles, PubMed, Scopus, Web of Science, ProQuest, Persian-language databases (SID, Magiran), as well as Google Scholar were searched for studies from 2010 to 2022 (Supplement). Papers published in English or Persian with an available full text, and any design were eligible. Papers were also eligible if they reviewed, designed or evaluated medication management apps from the patients’ or users’ perspetives (not healthcare providers). Papers related to disease-specific apps, letter to editors, narrative reviews and organizational guidelines were also excluded. A total of 32 relevant studies were included in the scoping review. Content analysis was applied to extract functional and non-functional requirements. Then, an evaluation checklist containing nine functional and eight non-functional requirements was developed.
Evaluation of apps: In this phase, 11 free medication management applications were evaluated.
Search strategy: To search apps in app stores, keywords such as “medication reminder”, “medication management”, and “medication tracking” were used, and applications developed until the end of 2023 were reviewed. The search terms were selected based on the keywords identified in the related literature.
Inclusion criteria: The applications were required to be developed in Iran, available in Persian language, free of charge, and specifically designed for medication management.
Exclusion criteria: Applications not developed in Persian, primarily targeting healthcare providers as their main users, or lacking a focus on medication management were excluded.
Evaluation checklist: A checklist was developed based on the literature review (first phase) to evaluate functional and non-functional requirements. The checklist included two options (Yes/No), and three experts in health information technology and medical informatics were asked to assess its face/content validity. For reliability assessment, three researchers independently applied the checklist to evaluate five medication management applications and the Cohen’s Kappa coefficient was 0.81.
Application selection process: After identifying and downloading medication management applications, they were evaluated based on the functional and non-functional requirements defined in the checklist. Three experts in health information technology and medical informatics were involved in identifying the functional and non-functional requirements of medication management applications.
Data extraction and analysis: The data were extracted using the checklist. Only those applications deemed ineligible by all researchers were excluded from further review. In case of any discrepancies among the reviewers, disagreements were resolved through discussion. The functional and non-functional features of applications were reported separately for each app. The data obtained from the comparison of these features were then used to rank the applications.
Results
Application selection: An initial search in app stores, including Bazaar, Myket, and the Google Play Store, identified 217 applications. Among these, only 11 applications meeting the inclusion criteria were selected for evaluation. The identified applications included “Etelaat Daroo (Drug and Disease Reference)” [20], “Yadavar Daroo” [21], “Daroo Yad” [22], “Doze Imen Daroo” [23], “In Daroo Chiye?” [24], “Alodaroo” [25], “Daroonet” [26], “Daroo Yab” [27], “Darookhaneh Farsi (Dr. Taheri)” [28], “Rahat Daroo” [29], and “Darookhaneh Banafsh” [30]. All selected applications were completely free of charge and contained no third-party advertisements or in-app purchases. Figure 1 illustrates the selection and review process of the applications.
Functional and non-functional requirements of applications: In terms of functional requirements, the most common requirements were synchronization and the provision of medication and educational information (82%, nine applications). None of the applications supported user profile creation, and three (18%) allowed users to interact with healthcare professionals. More than half of the applications (72%, eight applications) included medication search feature either by specific categories or alphabetically. Seven applications (63%) were able to send medication reminders and alerts to users. The ability to record a medication list, including dosage, method and frequency of medication use, recommendations for users, and drug interaction identification, was available in six applications (54%). Four applications (36%) supported drug side effect reporting and medication use tracking. Data sharing (27%, three applications), sending notifications to patient's relatives (18%, two applications), and recording user’s clinical data (9%, one application) were considered in a few medication management applications. Table 1 shows a detailed comparison of the functional and non-functional requirements among the selected applications.
Table 1. Comparison of functional and non-functional requirements of medication management applications
Discussion
This study indicated that Iranian mobile-based medication management applications fulfilled only some of the identified functional requirements. These applications provided reliable medication information including name, dosage, side effects, and indications, in a simple and accessible format for users, and included features such as medication reminders and searchable medication lists. Reminders and alerts, which play a significant role in improving medication adherence and preventing drug interactions, were present in all applications [31]. However, weaknesses were observed in key areas, such as clinical data recording, and direct communication with physicians, which require more attention from the applications developers [2,6,9,32].
Regarding non-functional requirements, these applications generally exhibit good usability and reliability; however, concerns related to security and user privacy remained insufficiently addressed. Adherence to security standards, especially for those related to protecting sensitive data, is often overlooked in many Iranian applications. Therefore, to improve the overall quality of these applications, developers should focus on improving security mechanisms, facilitating interaction with healthcare providers, and enhancing management functionalities [2,16]. Furthermore, providing suitable infrastructures to implement international standards for security and privacy protection is essential for the development of these applications [5,33].
Limitations
This study had several limitations that could affect the interpretation and generalizability of its findings. First, the analysis was restricted to free Android-based applications available in three major marketplaces (Google Play, Café Bazaar, and Myket). Consequently, iOS-based applications or those distributed solely through company websites or secondary marketplaces may have been missed. Second, applications with in-app purchases were excluded due to the inability to access their full features. Third, certain technical specifications such as application size, minimum Android version requirements, and offline versus online functionality, which may influence user decision-making, were not assessed. Another limitation pertained to the evaluation of accuracy and currency of drug-related information,which was conducted solely based on in-app information without the involvement of an independent clinical pharmacist as an assessor. As a result, the evaluation relied on general, publicly available drug information, enabling judgments based only on non-specialized resources. This may have influenced the precision of the final assessment in this regard. Finally, the lack of unified national standards for medication management applications in Iran complicated direct comparisons between the current findings and those of international studies.
It is therefore recommended that future research incorporate real-world user data and apply broader evaluation indicators aligned with relevant technical standards to provide more comprehensive results. In light of these limitations, future studies should consider a wider range of assessment criteria to ensure accuracy and completeness in evaluating medication management applications. Further research on identifying users' perspectives and evaluating the effectiveness of these applications could contribute to future advancements in this field.
Conclusion
Iranian mobile-based medication management applications partially met the functional and non-functional requirements. Many of these applications contributed to improving medication management by focusing on providing accurate and reliable medication information. Regarding non-functional requirements, although usability and reliability were adequately addressed during development, further improvements were needed in areas such as data security and compliance with international standards. These results can provide practical guideline for system developers to improve medication management applications.
Online supplement: Search strategy
Declarations
Ethical considerations: This study was approved by the Ethics Committee of Iran University of Medical Sciences (Approval code: IR.IUMS.REC.1400.790). All ethical principles, including confidentiality of participants’ identity and clinical information were maintained.
Funding: None.
Conflicts of interests: The authors declare no competing interests.
Authors’ contribution: SM: Conceptualization, study design, data curation, methodology, software, validation, data analysis, data management, writing– original draft, writing– review & editing, final approval. HA: Conceptualization, data curation, study design, writing– original draft, writing– review & editing, supervision, project administration, methodology, validation, final approval. ET: writing– review & editing, validation, methodology, data curation, final approval. All authors read and approved the final manuscript.
Consent for publication: Not applicable.
Data availability: Data are available from the corresponding author upon reasonable request.
AI declaration: Artificial intelligence (AI) tools were not used for writing the article.
Acknowledgements: This study was supported by Iran University of Medical Sciences.
This study indicated that Iranian mobile-based medication management applications fulfilled only some of the identified functional requirements. These applications provided reliable medication information including name, dosage, side effects, and indications, in a simple and accessible format for users, and included features such as medication reminders and searchable medication lists. Reminders and alerts, which play a significant role in improving medication adherence and preventing drug interactions, were present in all applications [31]. However, weaknesses were observed in key areas, such as clinical data recording, and direct communication with physicians, which require more attention from the applications developers [2,6,9,32].
Regarding non-functional requirements, these applications generally exhibit good usability and reliability; however, concerns related to security and user privacy remained insufficiently addressed. Adherence to security standards, especially for those related to protecting sensitive data, is often overlooked in many Iranian applications. Therefore, to improve the overall quality of these applications, developers should focus on improving security mechanisms, facilitating interaction with healthcare providers, and enhancing management functionalities [2,16]. Furthermore, providing suitable infrastructures to implement international standards for security and privacy protection is essential for the development of these applications [5,33].
Limitations
This study had several limitations that could affect the interpretation and generalizability of its findings. First, the analysis was restricted to free Android-based applications available in three major marketplaces (Google Play, Café Bazaar, and Myket). Consequently, iOS-based applications or those distributed solely through company websites or secondary marketplaces may have been missed. Second, applications with in-app purchases were excluded due to the inability to access their full features. Third, certain technical specifications such as application size, minimum Android version requirements, and offline versus online functionality, which may influence user decision-making, were not assessed. Another limitation pertained to the evaluation of accuracy and currency of drug-related information,which was conducted solely based on in-app information without the involvement of an independent clinical pharmacist as an assessor. As a result, the evaluation relied on general, publicly available drug information, enabling judgments based only on non-specialized resources. This may have influenced the precision of the final assessment in this regard. Finally, the lack of unified national standards for medication management applications in Iran complicated direct comparisons between the current findings and those of international studies.
It is therefore recommended that future research incorporate real-world user data and apply broader evaluation indicators aligned with relevant technical standards to provide more comprehensive results. In light of these limitations, future studies should consider a wider range of assessment criteria to ensure accuracy and completeness in evaluating medication management applications. Further research on identifying users' perspectives and evaluating the effectiveness of these applications could contribute to future advancements in this field.
Conclusion
Iranian mobile-based medication management applications partially met the functional and non-functional requirements. Many of these applications contributed to improving medication management by focusing on providing accurate and reliable medication information. Regarding non-functional requirements, although usability and reliability were adequately addressed during development, further improvements were needed in areas such as data security and compliance with international standards. These results can provide practical guideline for system developers to improve medication management applications.
Online supplement: Search strategy
Declarations
Ethical considerations: This study was approved by the Ethics Committee of Iran University of Medical Sciences (Approval code: IR.IUMS.REC.1400.790). All ethical principles, including confidentiality of participants’ identity and clinical information were maintained.
Funding: None.
Conflicts of interests: The authors declare no competing interests.
Authors’ contribution: SM: Conceptualization, study design, data curation, methodology, software, validation, data analysis, data management, writing– original draft, writing– review & editing, final approval. HA: Conceptualization, data curation, study design, writing– original draft, writing– review & editing, supervision, project administration, methodology, validation, final approval. ET: writing– review & editing, validation, methodology, data curation, final approval. All authors read and approved the final manuscript.
Consent for publication: Not applicable.
Data availability: Data are available from the corresponding author upon reasonable request.
AI declaration: Artificial intelligence (AI) tools were not used for writing the article.
Acknowledgements: This study was supported by Iran University of Medical Sciences.
Type of Study: Review |
Subject:
Health Information Management
Received: 2025/01/31 | Accepted: 2025/10/7 | Published: 2025/10/20
Received: 2025/01/31 | Accepted: 2025/10/7 | Published: 2025/10/20
supplement [PDF 107 KB] (31 Download)
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