Text message reminders fail to boost long-term medication use

A new study published today by JAMA reveals text message reminders for patients who are late to refill their medications did not help improve their refills over a year.

The study enrolled more than 9,000 patients in a pragmatic clinical trial and included representation from a diverse population across subgroups, including women, Hispanics, and Spanish-speaking patients, all groups that would normally be represented by a limited method in clinical trials.

There are many studies that focus on using technology to improve health care behavior. However, it is unclear and poorly studied whether text message reminders are effective in the long term, as they have become a widely used practice in health care settings. That’s one of the reasons why we wanted to focus on text message reminders for medication refills in this study, which we hoped would also reduce serious health problems. “

Michael Ho, MD, first author, associate professor of medicine and cardiology, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus.

Researchers compared different types of messaging strategies to standard care to improve medication adherence for chronic heart disease. Messages were provided when patients had a refill gap of more than seven days and were sent in English or Spanish based on patient preference.

“An important aspect of our research was to include representation from different cultures since different cultures and experiences can shape the choice of communication methods and result in different technological behavior,” said the author. senior Sheana Bull, PhD, MPH, professor emerita and advisor to. mHealth Impact Laboratory at the Colorado School of Public Health on the CU Anschutz Medical Campus. The MHealth Impact Laboratory is a catalyst for new health technologies and disease control strategies.

The research found adherence to fillings in the first three months improved by five percent and the median length of first voids decreased by about five days, meaning patients had more days five of their medicine supplies. However, text message reminders were not effective in improving refill adherence at 12 months, regardless of the type of message: standard messages, messages using persuasive communication techniques called behavior or behavioral patterns as well as a chatbot. This was consistent across all genders and races, and there was no difference between different text messaging styles.

“Chronic health conditions are on the rise and managing these conditions often requires patients to take medications for a long time. It is important to know ways to help patients take their medications regularly to prevent these medical conditions. to not get worse. Our study shows adherence to chronic heart medications. 12 months, so we need to try new strategies to improve this, especially in people many still have chronic health conditions,” added Ho.

Researchers will next study if advanced digital technologies including machine learning and artificial intelligence can improve long-term behavior related to medication refills.

The research was conducted by a team at the CU Anschutz Medical Campus, including faculty from the CU School of Medicine, the Skaggs School of Pharmacy and Pharmaceutical Sciences and the Colorado School of Public Health.