A recent study published in JAMA indicates that text message reminders are not effective in improving long-term medication refill adherence for patients on chronic cardiovascular medications. The randomized clinical trial, involving over 9,000 patients, found that while there were initial improvements in adherence, these benefits did not sustain over a 12-month period. This research highlights the need for exploring alternative strategies to support patients in managing their chronic conditions.
The study, led by Dr. Michael Ho from the University of Colorado School of Medicine, aimed to determine if text message reminders could improve medication refill adherence for chronic cardiovascular medications. Patients with a refill gap of more than seven days received text messages in either English or Spanish, tailored to their language preference. The study included a diverse patient population, with representation from traditionally underrepresented groups, such as females and Hispanic individuals.
Initial Improvements Fade Over Time
The research showed that during the first three months, refill adherence improved by five percentage points, and the median length of initial gaps was reduced by approximately five days. However, these improvements did not persist at the 12-month mark. The type of message—generic, behaviorally nudged, or behaviorally nudged with a chatbot—did not impact the long-term outcome. According to the researchers, the lack of sustained effectiveness was consistent across all genders and races.
The Need for New Strategies
Dr. Ho emphasized the increasing prevalence of chronic medical conditions and the importance of medication adherence in managing these conditions. "Chronic medical conditions are increasing and controlling these conditions often requires patients to take medications long term," he stated. "It’s important to identify strategies to help patients take their medications regularly to prevent these medical conditions from worsening."
The researchers suggest that future studies should explore more advanced digital technologies, such as machine learning and artificial intelligence, to improve long-term medication adherence. These technologies may offer more personalized and adaptive approaches to supporting patients in managing their medications.
