A text messaging intervention to promote medication adherence for patients with coronary heart disease: A randomized controlled trial

• Published in: Patient education and counseling 2014-02, Vol.94 (2), p.261-268
• Main Authors: Park, Linda G, Howie-Esquivel, Jill, Chung, Misook L, Dracup, Kathleen
• Format: Article
• Language: English
• Subjects: Adherence; Adult; Aged; Aged, 80 and over; Analysis of Variance; Antiplatelets; Cell Phone; Coronary Disease - drug therapy; Coronary heart disease; Dosage; Female; Heart diseases; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Internal Medicine; Male; Medication Adherence; Middle Aged; Mobile phone; Nursing; Patient Satisfaction; Platelet Aggregation Inhibitors - therapeutic use; Prospective Studies; Randomized controlled trials; Reminder Systems; Response rate; Statins; Text Messaging
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2013.10.027

Abstract Objective Pharmacologic treatment for secondary prevention of coronary heart disease (CHD) is critical to prevent adverse clinical outcomes. In a randomized controlled trial, we compared antiplatelet and statin adherence among patients with CHD who received: (1) text messages (TM) for medication reminders and education, (2) educational TM only, or (3) No TM. Methods A mobile health intervention delivered customized TM for 30 days. We assessed and analyzed medication adherence with electronic monitoring devices [Medication Event Monitoring System (MEMS)] by one-way ANOVA and Welch tests, two-way TM response rates by t -tests, and self-reported adherence (Morisky Medication Adherence Scale) by Repeated Measures ANOVA. Results Among 90 patients (76% male, mean age 59.2 years), MEMS revealed patients who received TM for antiplatelets had a higher percentage of correct doses taken ( p = 0.02), percentage number of doses taken ( p = 0.01), and percentage of prescribed doses taken on schedule ( p = 0.01). TM response rates were higher for antiplatelets than statins ( p = 0.005). Self-reported adherence revealed no significant differences among groups. Conclusion TM increased adherence to antiplatelet therapy demonstrated by MEMS and TM responses. Practice implications Feasibility and high satisfaction were established. Mobile health interventions show promise in promoting medication adherence.