Texting improves compliance

Text messages improve compliant use of prescribed blood pressure and cholesterol-lowering medications, according to new research from Queen Mary University of London.¹

Researchers studied 303 patients who had been prescribed blood pressure and-or lipid-lowering medication. They randomly divided subjects to a 'text message' group or a 'no text' group, which received no text intervention. Those in the text message group received daily text reminders for two weeks; alternate day text reminders for two weeks; followed by weekly text reminders for six months. The texts asked patients if they had taken their medications that day. Researchers followed up with phone calls, offering to help those who had not taken their medications or did not reply to the text messages.

They found a quarter of the patients in the no text group completely stopped their medications or took less than four fifths of their prescribed treatment. That was compared to 9 percent in the text message group. In essence, the text messaging prevented one in six patients from forgetting or stopping prescribed medicines.

The findings of this study confirm that reaching out to patients can improve their use of medication, according to Steven R. Feldman, M.D., Ph.D., professor of dermatology, Wake Forest University School of Medicine. Dr. Feldman is not an author of this study but is chief science officer for Causa Research, a company that offers programs to improve patients' adherence to treatment. He points to a study published in 2009 looking at texting reminders to improve sunscreen use. 

Authors of the study in the Archives of Dermatology, concluded: “Short-term data demonstrate that using existing cellular telephone text-message technology offers an innovative, low-cost, and effective method of improving adherence to sunscreen application.”²

“Adherence problems are huge, and the potential for improving outcomes is enormous.  Tens of millions of dollars, perhaps more, could be invested to develop a drug that would give 10 percent better efficacy. But, if we could just get patients to fill their prescriptions and take the currently available medications better, we could probably get much more improvement in outcomes for far lower cost,” Dr. Feldman says.

Medication compliance is an important and overlooked problem in medicine, according to Professor David Wald, consultant cardiologist at Queen Mary University and lead author of the new study.

“The results of this trial show that text message reminders help prevent this in a simple and effective way. More than just a reminder, the texts provided the link to identify patients who needed help," Dr. Wald says in a press release.

1 Wald DS, Bestwick JP, Raiman L, Brendell R, Wald NJ. Randomized Trial of Text Messaging on Adherence to Cardiovascular Preventive Treatment (INTERACT Trial). PLoS One. 2014 Dec 5;9(12):e114268.eCollection 2014.

2 Armstrong AW, Watson AJ, Makredes M, Frangos JE, Kimball AB, Kvedar JC. Text-message reminders to improve sunscreen use: a randomized, controlled trial using electronic monitoring. Arch Dermatol. 2009 Nov;145(11):1230-6.

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Part 3: Incentives to encourage adherence