Abstract MP38: INTERACT Investigation of Text Message Reminders on Adherence to Cardiac Treatment - Pilot Study
Background About half of all patients prescribed blood pressure, and cholesterol lowering drugs for the prevention of ischaemic heart disease and stroke do not adhere to their treatment. This carries a significant health risk for the individual, and financially burdens the health service. Simple interventions are needed that can be broadly applied. About 90% of individuals own a mobile telephone. Text Messaging is a potential means of improving adherence but has not been tested.
Intervention Text Message Support (TMS) involves a programme of automated scheduled text messages asking whether patients have taken their medication, that reduce in frequency over time (daily for two weeks, alternate days for 2 weeks, then weekly) providing a response is received confirming that medication has been taken. The intervention aims to remind, train and identify individuals who are not-adhering, so action can be taken to correct problems as they arise.
Methods A six month randomised controlled trial was conducted in 64 participants to determine the effect of text message reminders on adherence to cardiac treatment. Patients prescribed either simvastatin, amlodipine or both were randomly allocated to either the control arm, receiving standard care, or the intervention arm, receiving TMS plus standard care. Adherence to treatment was assessed in the clinic by questionnaire. Blood pressure and plasma cholesterol measurements were undertaken as direct measures of drug effect.
Results One patient out of 32 in the TMS arm discontinued their medication compared with 5 out of 29 in the control arm (3 patients were lost to follow-up). Among those who continued their medication, the reported number of days medications were missed in the four weeks prior to follow-up were 0.7 in the TMS arm and 4.1 in the control arm; a difference of 3.4 days (1.7 to 5.1), p<0.001. LDL cholesterol and systolic blood pressure were lower in the TMS arm compared with control; mean differences (TMS minus control) of 23 mg/dl (4 to 42), p<0.027 and 14 mmHg (1 to 27), p<0.042 respectively.
Conclusion The results of this pilot study indicate a potentially important effect of TMS on adherence to cardiac treatment. The observed difference in adherence and consequent reduction in cholesterol and blood pressure means that TMS would be expected to reduce the risk of ischaemic heart disease by 48% and stroke by 47%. These results now need to be confirmed in a larger trial.
- © 2013 by American Heart Association, Inc.