In an increasingly mobile world, physicians need tools that include media patients won’t ignore. One London-based study sent blood pressure or lipid-lowering medication reminders to patients via text messages that required participants to respond, with some success.
Over the six-month study, the research team divided patients into two groups, one receiving regular text messages and one not. Recruitment occurred using invitational text messages to patients prescribed either blood pressure or lipid-lowering medications and invitations at primary care sites.
The text message reminder group received messages daily for two weeks, every other day for two weeks and weekly for 22 weeks. Reminders were sent through a computer system. Texts asked patients whether they had taken their medication or not. If patients responded they had not, or they did not respond, they were phoned to determine why medication had ceased and help resolve issues with medication.
At six months, only 9 percent of patients receiving text messages had either stopped medication or took less than 80 percent of their prescribed regimen. For patients who did not receive text reminders, the rate was 25 percent. David S. Wald, BA, MBBS, MD, of the Wolfson Institute of Preventive Medicine at Queen Mary University of London, and colleagues noted that text messages reminded 65 percent of patients to take medication on at least one occasion and assisted an additional 13 percent in resuming medication who had stopped over concerns of efficacy or side effects.
The number of patients at the end of six months that stopped medication completely or took less than 80 percent of the prescribed regimen was 9 percent and 7 percent lower among those in the text intervention and those who did not receive texts.
They noted that similar to previous randomized trials where a response was required to a text message, significant improvements in medication adherence were seen among patients. However, questions such as whether patients would continue to have improved adherence prior to the end of the six months without reminders remained.
Wald et al suggested that the high rates of medication adherence seen in this study may be attributable to a more responsive group: They were recruited through their response to the text invitation, which made these patents more likely to adhere and to further respond when contacted. This may have confounded the study.
Wald et al suggested improving versions of the software to automatically adjust to patient response in future studies. They offered that this method may be successful with other types of long-term medications.
The study was published online Dec. 5 in PLOS One.