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. 2020 Oct;28(10):1889-1901.
doi: 10.1002/oby.22930. Epub 2020 Sep 9.

Improving Adherence to Weight-Loss Medication (Liraglutide 3.0 mg) Using Mobile Phone Text Messaging and Healthcare Professional Support

Ang Li  1   2 , Michelle Cunich  1   2 , Nicholas Fuller  1 , Katrina Purcell  3 , Allanah Flynn  3 , Ian Caterson  1
Affiliations

Improving Adherence to Weight-Loss Medication (Liraglutide 3.0 mg) Using Mobile Phone Text Messaging and Healthcare Professional Support

Ang Li et al. Obesity (Silver Spring). 2020 Oct.

Abstract

Background: Adherence to weight-loss medication is suboptimal, leading to poor health outcomes. Short message service (SMS) can potentially improve adherence.

Methods: A total of 3,994 participants with overweight or obesity in Australia receiving Saxenda® (liraglutide 3.0 mg) were enrolled from September 1, 2017, to February 28, 2018, through doctors, pharmacists, or websites and were randomly assigned to receive none, three, or five SMS per week. Participants were additionally offered a face-to-face consultation with a diabetes educator or a call from a dietitian. Medication adherence was measured as whether the total scripts claimed were at least as many as the total claims expected by March 31, 2018, and was modeled adjusting for age, sex, baseline BMI, residential region, enrolment channel, the total number of SMS, and additional patient support.

Results: Participants receiving five SMS (OR, 6.25; 95% CI: 4.28-9.12) had greater adherence than those receiving three SMS (OR, 3.67; 95% CI: 2.67-5.03) or zero SMS per week. The effectiveness of SMS on adherence decreased as participants received more SMS over time. Moreover, the odds of adhering to liraglutide were higher for participants enrolled with pharmacists compared with those enrolled with doctors (OR, 2.28; 95% CI: 1.82-2.86) and for participants who received a face-to-face consultation (OR, 3.10; 95% CI: 1.82-5.29) or a call (OR, 1.31; 95% CI: 1.02-1.68) compared with those who received no extra support.

Conclusions: Integration of SMS into routine clinical practice should consider not only the frequency and content of reminders but also additional patient support to achieve higher and more sustained adherence to medication and health behavior changes.

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Conflict of interest statement

NF and IC have received research grants for clinical trials funded by Bristol‐Myers Squibb, Rhythm Pharmaceuticals, Novo Nordisk, Australian Eggs Corporation, Zafgen, GlaxoSmithKline, Millendo, and Pfizer. NF is the author of Interval Weight Loss (Penguin Random House; 2017), Interval Weight Loss for Life (Penguin Random House; 2018), and Interval Weight Loss for Women (Penguin Random House; 2020) and has received payments for lectures and consultancy from Australian Eggs Corporation, Novo Nordisk, and Ausmed Education. IC has performed clinical trials for SFI, Eli Lilly, and Boerhinger Ingelheim, received payment for lectures from Novo Nordisk, and chairs the ACTION IO Steering Committee (sponsored by Novo Nordisk). KP and AF are employed by Novo Nordisk and owns shares in Novo Nordisk. AL and MC declared no conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Adjusted prediction on medication adherence across the number of SMS received.
See this image and copyright information in PMC

References

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