JAMIA:Text messages can potentially help patient's adherence
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Marcia Vervloet, PhD candidate, from the Netherlands Institute for Health Services Research in Utrecht, the Netherlands, and colleagues examined the effectiveness of interventions using electronic reminders in improving patients' adherence to chronic medication.
The researchers conducted a literature search in PubMed, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials. Electronic searches were supplemented by manual searching of reference lists and reviews. Two reviewers independently screened all citations. Full text was obtained from selected citations and screened for final inclusion. They assessed the methodological quality of studies.
Thirteen studies met the inclusion criteria. Four studies evaluated SMS reminders, seven audiovisual reminders from electronic reminder devices (ERD) and two pager messages.
“Best evidence synthesis revealed evidence for the effectiveness of electronic reminders, provided by eight (four high, four low quality) studies showing significant effects on patients' adherence, seven of which measured short-term effects (follow-up period less than six months),” the authors wrote. “Improved adherence was found in all but one study using SMS reminders, four studies using ERD and one pager intervention. In addition, one high quality study using an ERD found subgroup effects.”
After providing patients with the electronic reminders, no additional effort is needed from healthcare providers, making this an intervention easy to implement in daily practice, according to the authors. “[E]lectronic reminders and especially SMS reminders appear to be easily integrated into patients' lives. As such, this seems to be a simple intervention for both patient and professional for enhancing medication adherence. However, the healthcare system needs to be ready to include the use of electronic reminders in usual care for patients using chronic medication.”
The authors acknowledged a methodological limitation of their review by using a ‘top-down’ approach in their search strategy, relying on existing databases and their search terms for identifying relevant studies. “This may lead to missing relevant studies due to miscoding of search terms,” they stated.
However, they still touted the use of IT for their effectiveness in patient outcomes. “The increasing opportunities of new technologies make it possible to tailor reminding both in timing (only when needed) and in content (tailored messages),” the authors concluded. “In this way, long-term improvements in medication adherence may be achieved.”