Impact of a Text Messaging Pilot Program on Patient Medication Adherence

• Published in: Clinical therapeutics 2012-05, Vol.34 (5), p.1084-1091
• Main Authors: Foreman, Kalee F., PharmD, Stockl, Karen M., PharmD, Le, Lisa B., MS, Fisk, Eric, MBA, Shah, Sameer M., MBA, Lew, Heidi C., PharmD, Solow, Brian K., MD, FAAFP, Curtis, Bradford S., MD
• Format: Article
• Language: English
• Subjects: Administration, Oral; Aged; Biological and medical sciences; Cohort Studies; Databases, Factual; Drug therapy; Female; Humans; Insurance, Pharmaceutical Services; Internal Medicine; Male; Medical Education; Medical sciences; Medicare; Medication Adherence; medication reminder; Middle Aged; Pharmacology. Drug treatments; Pharmacy benefit management; Pilot Projects; Prescription drugs; Prescription Drugs - administration & dosage; Prescription Drugs - therapeutic use; Reminder Systems; Retrospective Studies; Studies; text message; Text Messaging; Time Factors; United States
• ISSN: 0149-2918; 1879-114X
• DOI: 10.1016/j.clinthera.2012.04.007

Abstract Background Medication nonadherence is a well-recognized challenge associated with poor health outcomes and increased utilization of health care resources. Although many different behavioral and educational strategies are available to improve patient medication adherence, technological advances, including cell phone text messaging, represent new and innovative modalities to improve adherence and overall health outcomes. Objective To evaluate medication adherence among patients opting to receive text message medication reminders and a well-matched control cohort. Methods This retrospective, observational cohort analysis compared medication adherence of members who opted-in to the text message medication reminder program and a matched control cohort using data from a member portal database and electronic pharmacy claims of a national pharmacy benefit manager with commercial and Medicare membership. Continuously enrolled members who opted to receive at least 1 medication-specific dosage reminder for a chronic oral medication of interest and had at least 1 pharmacy claim for the same chronic oral medication of interest were included. Matching was based on medication therapeutic class, then on propensity score (including variables of age, sex, health plan, Chronic Disease Score, distinct medication count, average baseline medication adherence, and duration of therapy). The primary outcome was chronic oral medication adherence, measured as the proportion of days covered (PDC), between January 1, 2011, and August 31, 2011. Analyses comparing cohorts were conducted using paired t tests and the McNemar test. Results After implementation of the text messaging program, the mean (SD) PDC was significantly higher for the text message cohort (n = 290) than for the control cohort (n = 290) (0.85 [0.20] vs 0.77 [0.28], respectively; P < 0.001). Of those members identified with a chronic oral antidiabetes medication, the mean PDC was significantly higher in the text message cohort than in the control cohort (0.91 [0.14] vs 0.82 [0.21]; P = 0.029). Significant differences in mean PDC were also seen in members who opted to receive text message reminders for β-blocker therapy over members in the control cohort (0.88 [0.18] vs 0.71 [0.29]; P = 0.006). Conclusions Findings suggest that members opting into a text message reminder program have significantly higher chronic oral medication adherence compared with members not opting to receive medication-specific text messag