What is the effect of mobile phone text message reminders on medication adherence among adult type 2 diabetes mellitus patients: a systematic review and meta-analysis of randomized controlled trials

Abstract

Background Globally, type 2 diabetes has become increasing. As little is known about the effect of educational intervention on this population, this systematic review and meta-analysis evaluated the effectiveness of mobile phone text message reminders versus usual care to improve medication adherence among type 2 diabetes mellitus patients. Methods PubMed, Google Scholar, Cochrane Library, Scopus, and African Journals Online, were searched. A random-effects model was employed to estimate combined effect sizes. Subgroup analyses were employed to investigate possible sources of heterogeneity between studies. The overall certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results A total of 9 trials with 1,121 participants were included in the review. The pooled estimated impact of mobile phone text message reminders on medication adherence was (SMD: 0.36; 95%CI; 0.14, 0.59) compared to usual care groups among patients with type 2 diabetes mellitus. In addition, subgroup analyses revealed greater medication adherence levels in those studies with intervention durations of more than six months and with self-report/refill adherence scale measurement (SMD: 0.21; 95%CI: 0.02, 0.40) and (SMD: 0.45; 95%CI: 0.22, 0.68), respectively. Conclusion Mobile phone text messages can potentially lead to improved medication adherence levels in patients with Type 2 diabetes despite heterogeneity across the studies. Therefore, mobile phone text messaging when delivered in addition to usual care, have the potential to produce significant improvements in medication adherence.

Effectiveness of DiabeText, a mHealth intervention to support diabetes self-management: randomized controlled trial in primary care

“…Available evidence shows that telehealth interventions are an effective method to increase medication adherence in patients with T2D. In regard to effectiveness of SMS on medication adherence, a recent meta-analysis 5 , which included nine studies and 1,121 participants, showed a pooled effect size of 0.36 (p=0.001). In our study, which included 742 participants, the intervention effect on self-reported medication adherence was very similar (OR=1.41; p=0.03).…”

“…Regarding the active ingredients of SMS interventions we reviewed 5,20,21 , DiabeText exhibited similarities in terms of intervention duration (ranging from 3 to 24 months) and message frequency (ranging from daily to twice a week). Moreover, the content of the messages closely resembled that of DiabeText, with only two exceptions where the content focused on medication adjustments in response to blood glucose levels.…”

“…Hence, there is an urgent need to find highly implementable and effective interventions to promote adherence to treatments in this population. Over the last decade, advances in technology and connectivity have led to a boom of mobile health (mHealth) interventions, as they constitute a low-cost and highly scalable approach to support behavior changes in terms of lifestyle [1][2][3][4] and medication taking 5 . However, as highlighted by the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA), while the available studies of m-Health interventions show promise for promoting healthy behaviour and managing complex diseases, such as T2D, they are very limited in both quantity and quality.…”

Effectiveness of Nurse-led Educational Interventions on Glycemic Control and Self-care Behaviors of Type 2 Diabetics: A Systematic Review

“…The authors reveal that educational interventions have a promising effect on glycemic control and diabetes knowledge. A meta-analysis by Belete et al (2023) tested the effect of mobile phone text message reminders on medication adherence in adults with type 2 diabetes. This meta-analysis gathered the results of nine randomized controlled trials and demonstrated the beneficial effect of mobile phone text messaging on medication adherence in patients with T2DM.…”