“Text messaging support programs have immense potential in health care,” said lead researcher Clara Chow, director of the cardiovascular division at The George Institute for Global Health, in Sydney, Australia.
Chow and her team reviewed the results of 16 randomized clinical trials that assessed the effect of text messaging on the adherence of taking medication by those with chronic diseases.
The problem of medication adherence is well known, Chow said, with many patients not sticking to the schedule. As a result, their disease may not be under good control.
“It is difficult to remain committed to long-term medication therapy for patients with chronic disease, and as many as half of patients can be non-adherent in a year,” she said.
The studies evaluated by Chow’s team used various methods and frequency of messaging to remind patients about taking medication. Some used two-way communication, some used daily reminders to smartphones.
Overall, however, the messages doubled the chances that people followed their medication schedule, the researchers found.
The studies involved more than 2,700 patients with a median age of about 39.
The results were published online Feb. 1 in the journal JAMA Internal Medicine
Chow added a caveat to the findings: The median length of the studies was 12 weeks (half longer, half shorter), so they don’t document long-term effectiveness. Larger studies with longer duration are needed, she said.
Chow can’t yet explain what it is about the messaging that seems to help. “We still need to better understand what feature of the text message programs make them most effective,” she said.
Also, “we don’t know yet whether greater personalization of the program will make them more effective,” Chow said.
When patients gave feedback, they said they found the messages useful and felt as if they were being supported, she said.
Dr. Brian Haynes, a professor of clinical epidemiology and medicine at McMaster University, in Hamilton, Canada, is the author of a commentary that accompanied the study. He wrote that while texting has the potential to overcome the medication adherence problem, it is too soon to say if it has “real, enduring and patient-important benefits that are worth the investment.
“Our main message is that text messages to promote adherence in patients have not been tested properly, so it is not possible to tell whether they do anything useful,” he said. The studies in the new review were brief, he noted, and some used self-reporting, which he said is not always valid.
The best one could say, Haynes said, is that “some studies showed some promise that text messaging might be helpful.” To work effectively, he said, a patient must want to adhere to the medication schedule and have a cellphone (with a text plan) that they keep with them.
He said such a text program should not be pursued by doctors, hospitals or institutes until it has been documented to improve outcomes.
By Kathleen Doheny, HealthDay
Copyright © 2016 HealthDay. All rights reserved.