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Randomized Controlled Trial
. 2017 Dec;19(12):1276-1284.
doi: 10.1111/jch.13098. Epub 2017 Sep 21.

Mobile phone text messaging improves antihypertensive drug adherence in the community

Paola Varleta  1   2 , Mónica Acevedo  1   3 , Carlos Akel  1   4 , Claudia Salinas  1 , Carlos Navarrete  5 , Ana García  6 , Carolina Echegoyen  7 , Daniel Rodriguez  8 , Lissette Gramusset  9 , Sandra Leon  10 , Pedro Cofré  11 , Raquel Retamal  12 , Katerine Romero  13
Affiliations
Randomized Controlled Trial

Mobile phone text messaging improves antihypertensive drug adherence in the community

Paola Varleta et al. J Clin Hypertens (Greenwich). 2017 Dec.

Abstract

Antihypertensive drug adherence (ADA) is a mainstay in blood pressure control. Education through mobile phone short message system (SMS) text messaging could improve ADA. The authors conducted a randomized study involving 314 patients with hypertension with <6 months of antihypertensive treatment from the Preventive Health Program of 12 different primary care centers in Santiago, Chile. Patients were randomly assigned to receive or not receive SMS related to ADA and healthy lifestyle. Adherence was assessed by the self-reported four-item scale Morisky-Green-Levine questionnaire at baseline and after 6 months of follow-up, with four of four positive questions classified as good adherence. Group comparison for adherence was performed by means of a logistic regression model, adjusting by baseline adherence, age older than 60 years, and sex. A total of 163 patients were randomized to receive and 151 to not receive SMS. After 6 months of follow-up, ADA in the non-SMS group decreased from 59.3% to 51.4% (P=.1). By contrast, adherence increased from 49% to 62.3% (P=.01) in the SMS group. Text messaging intervention improved ADA (risk ratio, 1.3; 95% confidence interval, 1.0-1.6 [P<.05]). At 6-month follow-up, text messaging resulted in an increase in reporting ADA in this hypertensive Latino population. This approach could become an effective tool to overcome poor medication adherence in the community.

Keywords: hypertension; medication adherence; patient compliance; text messaging.

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Conflict of interest statement

Paola Varleta has received speaker fees for MSD and TEVA Pharmaceuticals, has participated in an advisory board of Boehringer Ingelheim, and has received an unrestrictive grant from TEVA Pharmaceuticals for a project in Ideal Cardiovascular Health in Women. Monica Acevedo has been a speaker for Novartis on sacubitril/valsartan and for Ferrer Pharmaceuticals on polypill, and has received an unrestrictive grant by TEVA Pharmaceuticals for a project in Cardiovascular Health in women. Carlos Akel has been speaker for SAVAL Pharmaceuticals. All other authors have no conflicts of interest to disclose.

This study was supported by the Foundation of the Chilean Society of Cardiology and by an unrestricted grant from Novartis.

Figures

Figure 1
Figure 1
Study flow chart. BP indicates blood pressure; SMS, short message service
Figure 2
Figure 2
Effect of short message service (SMS) on adherence to antihypertensive treatment after 6 months. (A) Adherence rates in adherent baseline patients receiving SMS versus those with no SMS; (B) adherence rates in nonadherent baseline patients receiving SMS versus those with no SMS; (C) adherence rates in patients receiving SMS versus those with no SMS
Figure 3
Figure 3
Adherence for the overall population and for prespecified subgroups. CI indicates confidence interval; SMS, short message system
See this image and copyright information in PMC

Comment in

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