Medication Adherence and Use of Technology

Medication adherence continues to be a major concern in health care. A growing body of evidence indicates that patients with chronic conditions have poor long-term adherence to therapy despite the positive safety profile and reduced risk of complications.  For instance, as many as 50% to 80% of patients treated for hypertension are non-adherence to their therapy. In addition, it should not come as a surprise that adherence to therapy carries an economic burden. The direct cost of non-adherence is estimated at $100 billion to $289 billion annually with a cost of $2000 per patient in physician visits annually.

In the recent March publication of JAMA Internal Medicine  a meta-analysis of randomized clinical trials to assess the effect of mobile telephone text messaging on medication adherence in chronic disease revealed that mobile phone text doubled the odds of medication adherence. Adherence rates improved from 50% to 67.8% an absolute increase of 17.8%.
While the studies reviewed were limited by a 12-week duration, and self-reporting as the most commonly used method to assess medication adherence, nevertheless, mobile text messaging can provide patients with yet another reminder tool.

The Medication Adherence Time Tool provided by American College of Preventive Medicine suggests in its use of the acronym SIMPLE (S-simplify the regimen, I-Impart knowledge, M-modify patient beliefs and behavior, P-provide communication and trust, L-leave the bias and E- evaluate adherence) the development of patient-centered communication style.

Who can benefit from these reminder? What text features and content is patients preferred? At what frequency should these text messages be sent out? In a smaller controlled population such as those in an assisted-living facility, or psychiatric therapy centers can benefit tremendously from such features.