Text messages could be the latest solution to the very old problem of getting patients with chronic diseases to take their medications.
Researchers at the George Institute for Global Health in Sydney, Australia, demonstrated that a simple text message reminder can double the odds that a patient will take their medications as prescribed. This is especially important for those with chronic illnesses that require multiple medications over long periods of time.
Clara Chow, director of the cardiovascular division at the George Institute of Global Health and cardiologist at Westmead Hospital, who led the study, observed that roughly half of patients with chronic diseases will have trouble adhering to medication protocols within a year, often leading to more hospitalizations and greater need for medical attention. Her team was searching for an intervention that would be more effective.
In the previous “TEXT ME” study published in Journal of the American Medical Association in 2015, Chow showed that lifestyle-focused text messaging could help improve cardiovascular health factors such as blood pressure, physical activity and cholesterol in patients with coronary heart disease. “Text messaging has immense potential in healthcare,” she said.
The current study, also published in JAMA, reviewed 16 randomized clinical trials that evaluated text message interventions with varying characteristics. In some studies, patients were sent personalized messages or nonmedical information including quotes and jokes. Other messages were only sent when the patient failed to open special automated medication dispensers. Although the systems differed in many respects, text messages were found to be cost-effective, practical and adaptable.
In a commentary published with the study, Dr. R. Brian Haynes, professor of clinical epidemiology and biostatistics at McMaster University in Ontario, Canada, cautioned against over-interpretation, due to the short duration of the trials and the self-reporting nature of the statistics.
The study also noted that improving medication adherence can have a greater positive effect on the health of a population than improvements to the medical treatments themselves. “If text message-based support improves medical adherence, it has the potential to prevent major clinical events such as heart attacks, strokes and premature death,” Chow said.
In the future, Chow hopes to test the long-term effectiveness of text-message interventions and to better understand which features make them the most effective.
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