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British Medical Journal

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Clinical Articles, Lead Article

Text messages improve medication adherence

Text message prompts can help patients living with long term conditions (LTCs) stick to their treatment programmes in the short term, according to a review1 of the available evidence published online recently in the Journal of the American Medical Informatics Association.

The authors searched large and respected research databases looking for published trials on the use of electronic reminder services to improve adherence to medication in people with LTCs. They found 13 suitable studies, involving patients with HIV infection (5 studies), high blood pressure (3), asthma (2), glaucoma (2), and the pill (1).

Four studies reported on text messages (SMS); seven on audiovisual reminders provided by hand held devices; and two on pager services.
 In all, nine of the studies showed that electronic reminders boosted patients’ ability to stick to their drug dosing schedules. In eight, the differences were significant.
 Text messages in particular, but also audiovisual prompts, seemed to get the best results.

iStock_000010666043XSmallTen of the studies monitored the impact of these reminders on patients for less than six months, and only one of the three studies monitoring patients for longer than this reported a significant impact on adherence rates. 
It is important to look at the longer term effects, caution the authors: “Patients who are adherent at first can become non-adherent over time,” they write, adding: “automated reminders can become a routine, resulting in habituation”.

Nevertheless, they conclude their findings indicate that electronic reminders do seem to be helpful for patients with LTCs in the short term, and that this approach is both easy for healthcare professionals and patients to adopt.

“Reminders can be especially used to modify the behaviour of…patients who are willing to take their medication but who forget it or are inaccurate,” they write. And they may also provide a solution for those who deliberately don’t take their prescribed medication, “by stressing the importance of the intake in the message,” they suggest.

They suggest that advances in technology may offer the possibility of longer term benefits too. 
“The increasing opportunities of new technologies make it possible to tailor reminding both in timing (only when needed) and in content (tailored messages). In this way, long term improvements in medication adherence may be achieved,” they write.

References

1. Vervloet M, Linn AJ,  van Weert JCM.  The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature. J Am Med Inform Assoc 2012. doi:10.1136/amiajnl-2011-000748

Published on: June 25, 2012

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