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

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.

Keywords: Antiplatelets; Coronary heart disease; Medication adherence; Mobile phone; Statins; Text messaging.