Text messages help patients with long term conditions stick to their meds

A key issue for people living with long term conditions is their ability to stick to their drug schedule, and numerous attempts have been made to come up with an effective solution.

One of the most common reasons patients give for not taking their medicines is that they simply forgot, say the authors.

They trawled large and respected research databases looking for published trials on the use of electronic reminder services to improve adherence to medication in people with long term conditions.

They found 13 studies that fitted the bill, 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.

Ten 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 long term conditions 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.

More information: The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature Online First, doi:10.1136/amiajnl-2011-000748

Journal reference: Journal of the American Medical Informatics Association

Provided by British Medical Journal