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A new study published in JAMA has found that text message reminders aimed at improving medication refills for patients with chronic cardiovascular conditions were only marginally effective in the short term, with no significant long-term impact. The research, which involved over 9,000 patients in a randomized clinical trial, casts doubt on the common practice of using text messages to promote medication adherence.
The study, which spanned a full year, included a diverse group of patients from various backgrounds, including females, Hispanic individuals, and Spanish-speaking patients—groups that are often underrepresented in clinical trials. According to Dr. Michael Ho, first author of the study and professor at the University of Colorado School of Medicine, the goal was to explore whether text messages could provide sustained benefits.
“While many studies have looked into using technology to improve healthcare behaviors, there is still uncertainty about the long-term effectiveness of text message reminders,” said Dr. Ho. “We aimed to investigate whether these reminders could help patients stay on track with their medications, potentially reducing serious health complications.”
The study compared different types of text message reminders to usual care, targeting patients who had delayed refilling their medications. Messages were sent when patients had a gap of more than seven days between refills, and they were delivered in English or Spanish, depending on the patient’s preference. The team tested a variety of message types, including generic reminders, persuasive messages (known as behavioral nudges), and a combination of nudges with a chatbot.
While initial results were promising—patients showed a 5% improvement in refill adherence over the first three months, and the average gap between refills decreased by about five days—these benefits did not persist after one year. Regardless of the message format, there was no significant improvement in medication refill rates after 12 months.
“The findings suggest that while text messages may offer some short-term benefit, they do not result in sustained improvements in medication adherence over a longer period,” said Dr. Sheana Bull, senior author of the study and professor at the Colorado School of Public Health. “Given the rising rates of chronic conditions, it is crucial to explore more effective strategies for promoting long-term adherence to medication regimens.”
The study’s results have prompted the researchers to consider more advanced technologies, such as machine learning and artificial intelligence, to better understand and influence patient behavior over time. These next steps aim to discover new methods that may more effectively improve medication adherence and prevent the worsening of chronic conditions.
As chronic diseases continue to rise, the need for better solutions to help patients manage their health is becoming increasingly urgent. The research emphasizes the importance of exploring novel approaches, beyond basic text reminders, to enhance the long-term health outcomes for those with chronic conditions.
For more information, visit JAMA (2024).
