The Impact of Text Messaging on Medication Adherence and Exercise Among Postmyocardial Infarction Patients: Randomized Controlled Pilot Trial

Pandey, Avinash Kumar; Krumme, Alexis A.; Patel, Tejal; Choudhry, Niteesh K.

doi:10.2196/mhealth.7144

Cited by 35 publications

(50 citation statements)

References 30 publications

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“…Interactive text dialogues provide an opportunity for patients and health plan members to tap into health care resources and get support for healthy behaviors and long-term behavior change. Several studies have found that text messaging may serve as a scalable and effective means to improve medication adherence in chronic disease populations [ 11 , 12 ]. While there has been an interest in developing health technologies such as reminder applications [ 13 - 16 ] or automated phone reminders for older populations [ 17 ], a review of the literature reveals that very few programs have explored using text messaging with seniors to improve medication refill adherence [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Improving Refill Adherence in Medicare Patients With Tailored and Interactive Mobile Text Messaging: Pilot Study

Prayaga

Jeong

Feger

et al. 2018

JMIR Mhealth Uhealth

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BackgroundNonadherence is a major concern in the management of chronic conditions such as hypertension, cardiovascular disease, and diabetes where patients may discontinue or interrupt their medication for a variety of reasons. Text message reminders have been used to improve adherence. However, few programs or studies have explored the benefits of text messaging with older populations and at scale. In this paper, we present a program design using tailored and interactive text messaging to improve refill rates of partially adherent or nonadherent Medicare members of a large integrated health plan.ObjectiveThe aim of this 3-month program was to gain an understanding of whether tailored interactive text message dialogues could be used to improve medication refills in Medicare patients with one or more chronic diseases.MethodsWe used the mPulse Mobile interactive text messaging solution with partially adherent and nonadherent Medicare patients (ie, over age 65 years or younger with disabilities) of Kaiser Permanente Southern California (KP), a large integrated health plan, and compared refill rates of the text messaging group (n=12,272) to a group of partially adherent or nonadherent Medicare patients at KP who did not receive text messages (nontext messaging group, n=76,068). Both groups were exposed to other forms of refill and adherence outreach including phone calls, secure emails, and robo-calls from December 2016 to February 2017.ResultsThe text messaging group and nontext messaging group were compared using an independent samples t test to test difference in group average of refill rates. There was a significant difference in medication refill rates between the 2 groups, with a 14.07 percentage points higher refill rate in the text messaging group (P<.001).ConclusionsThe results showed a strong benefit of using this text messaging solution to improve medication refill rates among Medicare patients. These findings also support using interactive text messaging as a cost-effective, convenient, and user-friendly solution for patient engagement. Program outcomes and insights can be used to enhance the design of future text-based solutions to improve health outcomes and promote adherence and long-term behavior change.

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Section: Introductionmentioning

confidence: 99%

Improving Refill Adherence in Medicare Patients With Tailored and Interactive Mobile Text Messaging: Pilot Study

Prayaga

Jeong

Feger

et al. 2018

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…Previously, reminders were shown to improve adherence. [22][23][24][25][26][27] According to our findings, these reminders could be more beneficial when better timed and personalized by end-users.…”

Section: Discussionmentioning

confidence: 53%

“…Text reminders have previously shown to be a simple and effective way to increase adherence. [23][24][25][26][27] On the other hand, a high frequency of reminders may introduce response fatigue. In this system, reminders are sent only when this information is relevant (ie when doses are not taken), which may even trigger the subjects to take the medication before the reminder time.…”

Section: Assessment Of Spbp Assetsmentioning

confidence: 99%

<p>User Acceptability and Technical Robustness Evaluation of a Novel Smart Pill Bottle Prototype Designed to Support Medication Adherence</p>

Zijp¹,

Touw²,

Boven³

2020

PPA

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Purpose: Smart medication adherence monitoring devices can provide objective and granular drug utilization data and help patients engaging with their treatment. In this proof-of-concept study, the acceptability and technical robustness of a novel smart pill bottle prototype (SPBP) were assessed in order to allow further optimization. Methods: The SPBP is an app-controlled automatic dispense system, capturing real-time data on a web-based platform, which sends text reminders and measures storage conditions. A heterogeneous group of ten volunteers was asked to dispense placebo capsules with the SPBP and to follow a predefined dosing schedule for a trial period of 2 weeks. Afterwards, a questionnaire was filled out during a short interview. Primary outcome was dispense adherence as measured by the bottle. Other study outcomes included system acceptability (System Usability Scale [SUS]), self-reported adherence (MARS) and technical robustness of the bottle's mechanics (electronic pill dispenser) and sensors (bottle temperature). Results: The overall dispense adherence rate as measured by the SPBP was 88%. All participants completed the study and four participants had an adherence rate of 100% during the study. The dispense adherence rates corresponded well with participants' self-reported adherence with an average MARS total score of 23.6 (out of 25). Participants judged the system easy to use, with a mean SUS score of 79.3 (range: 57.5-97.5). The overall mean temperature difference between the bottle sensor and calibrated external sensor was −0.82°C (range: −1.37°C to −0.21°C). Conclusion: The SPBP was well accepted and this study provides data for further optimization and follow-up studies. Smart adherence technologies such as these may change the way healthcare professionals, trialists and patients manage medication adherence.

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“…In particular, the ubiquity of mobile phone technology has incentivized industries to create smartphone-based apps for health monitoring [ 9 ]. Previous trials [ 10 , 11 ] have evaluated the efficacy and effectiveness of such tools in the context of secondary prevention. For example, among patients receiving cardiac rehabilitation after hospitalization for myocardial infarction, daily text message reminders led to greater medication adherence and exercise capacity compared with patients receiving usual care [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Previous trials [ 10 , 11 ] have evaluated the efficacy and effectiveness of such tools in the context of secondary prevention. For example, among patients receiving cardiac rehabilitation after hospitalization for myocardial infarction, daily text message reminders led to greater medication adherence and exercise capacity compared with patients receiving usual care [ 10 ]. The utility extends to general populations; a Finnish trial [ 11 ] demonstrated both short- and long-term weight loss among people who were overweight and who logged weight daily and received dietary management instructions over a period of 1 year.…”

Section: Introductionmentioning

confidence: 99%

Effect of Smartphone-Based Lifestyle Coaching App on Community-Dwelling Population With Moderate Metabolic Abnormalities: Randomized Controlled Trial

Cho¹,

Lee²,

Shim³

et al. 2020

J Med Internet Res

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Background Metabolic disorders are established precursors to cardiovascular diseases, yet they can be readily prevented with sustained lifestyle modifications. Objective We assessed the effectiveness of a smartphone-based weight management app on metabolic parameters in adults at high-risk, yet without physician diagnosis nor pharmacological treatment for metabolic syndrome, in a community setting. Methods In this 3-arm parallel-group, single-blind, randomized controlled trial, we recruited participants aged 30 to 59 years with at least 2 conditions defined by the Third Report of the National Cholesterol Education Program expert panel (abdominal obesity, high blood pressure, high triglycerides, low high-density lipoprotein cholesterol, and high fasting glucose level). Participants were randomly assigned (1:1:1) by block randomization to either the nonuser group (control), the app-based diet and exercise self-logging group (app only), or the app-based self-logging and personalized coaching from professional dieticians and exercise coordinators group (app with personalized coaching). Assessments were performed at baseline, week 6, week 12, and week 24. The primary outcome was change in systolic blood pressure (between baseline and follow-up assessments). Secondary outcomes were changes in diastolic blood pressure, body weight, body fat mass, waist circumference, homeostatic model of assessment of insulin resistance, triglyceride level, and high-density lipoprotein cholesterol level between baseline and follow-up assessments. Analysis was performed using intention-to-treat. Results Between October 28, 2017 and May 28, 2018, 160 participants participated in the baseline screening examination. Participants (129/160, 80.6%) who satisfied the eligibility criteria were assigned to control (n=41), app only (n=45), or app with personalized coaching (n=43) group. In each group, systolic blood pressure showed decreasing trends from baseline (control: mean –10.95, SD 2.09 mmHg; app only: mean –7.29, SD 1.83 mmHg; app with personalized coaching: mean –7.19, SD 1.66 mmHg), yet without significant difference among the groups (app only: P=.19; app with personalized coaching: P=.16). Instead, those in the app with personalized coaching group had greater body weight reductions (control: mean –0.12, SD 0.30 kg; app only: mean –0.35, SD 0.36 kg, P=.67; app with personalized coaching: mean –0.96, SD 0.37 kg; P=.08), specifically by body fat mass reduction (control: mean –0.13, SD 0.34 kg; app only: mean –0.64, SD 0.38 kg, P=.22; app with personalized coaching: mean –0.79, SD 0.38 kg; P=.08). Conclusions Simultaneous diet and exercise self-logging and persistent lifestyle modification coaching were ineffective in lowering systolic blood pressure but effective in losing weight and reducing body fat mass. These results warrant future implementation studies of similar models of care on a broader scale in the context of primary prevention. Trial Registration ClinicalTrials.gov NCT03300271; http://clinicaltrials.gov/ct2/show/NCT03300271

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The Impact of Text Messaging on Medication Adherence and Exercise Among Postmyocardial Infarction Patients: Randomized Controlled Pilot Trial

Cited by 35 publications

References 30 publications

Improving Refill Adherence in Medicare Patients With Tailored and Interactive Mobile Text Messaging: Pilot Study

Improving Refill Adherence in Medicare Patients With Tailored and Interactive Mobile Text Messaging: Pilot Study

<p>User Acceptability and Technical Robustness Evaluation of a Novel Smart Pill Bottle Prototype Designed to Support Medication Adherence</p>

Effect of Smartphone-Based Lifestyle Coaching App on Community-Dwelling Population With Moderate Metabolic Abnormalities: Randomized Controlled Trial

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