Need help managing medications? Try text message reminders

The Bottom Line

  • Up to 50% of adults with serious chronic health conditions don’t take their medications as prescribed. Consequences can be severe and even fatal.
  • Reminders delivered through text messages can help adults adhere to doctors’ orders when it comes to taking the correct drug doses at the right times.

People of all ages have embraced text messaging as an easy, efficient way to communicate. Even many adults who originally thought they’d never get the hang of thumbing messages on tiny little keyboards, are now effortlessly texting as part of their daily routine. This comfort with cell phones and technology can also come in handy when it comes to managing medications.


Many of us have trouble keeping track of our meds, sometimes forgetting to take them regularly or as prescribed. As many as half of people with serious chronic conditions begin skipping doses – or stop taking the pills altogether – within a year of starting them (1, 2). That’s worrisome: it can result in complications, hospitalization, even more debilitating illness and premature death (3). It’s also expensive: “medication non-adherence” in North America is estimated to cost billions of dollars each year for additional doctor visits and treatments (4).


A possible solution may be to try cell phone text messages as a way to remind and encourage people to take their medication. That idea prompted a systematic review of 16 randomized controlled trials involving more than 2,700 participants aged 31 to 64 who had at least one chronic condition (e.g. HIV, heart disease, diabetes and epilepsy) (5).


People in the study groups received text messages on their cell phones reminding them to take their medications, sometimes accompanied by motivational or humorous messages. Their “adherence” scores were compared with those in control groups, who did not receive text messages.


What the research tells us

(Text) message received loud and clear! According to the review studies – 10 of which were of high quality – people were significantly more likely to take their medications as directed when prompted via their cell phones.


Further research is needed to determine the best frequency, timing and content of the messages. More research is also needed to determine if text reminders are effective in the long term (more than 12 months).  


There are several advantages to using cell phones to promote better health: messages are received instantly; it’s a well-used and trusted technology; it’s a relatively low cost and low maintenance approach; and cell phones (they don’t need to be “smart” phones) have become much more affordable for many people.


Text message reminders may not be the perfect solution to what is a major health concern, and their use may not be appropriate for everyone. But if this approach can benefit a majority of chronic disease sufferers and help ease pressure on healthcare systems, it’s an option worth pursuing.



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References

  1. World Health Organization. Adherence to long-term therapies: Evidence for action. [Internet] 2003. [cited January 2017]. Available from http://apps.who.int/iris/bitstream/10665/42682/1/9241545992.pdf
  2. Bowry AD, Shrank WH, Lee JL et al. A systematic review of adherence to cardiovascular medications in resource-limited settings. J Gen Intern Med. 2011; 26(12):1479–1491. doi: 10.1007/s11606-011-1825-3.
  3. Ho PM, Magid DJ, Shetterly SM et al. Medication nonadherence is associated with a broad range of adverse outcomes in patients with coronary artery disease. Am Heart J. 2008; 155(4):772-779. doi: 10.1016/j.ahj.2007.12.011.
  4. Chisholm-Burns MA, Spivey CA. The “cost” of medication nonadherence: Consequences we cannot afford to accept. J Am Pharm Assoc (2003). 2012; 52(6):823:826. doi: 10.1331/JAPhA.2012.11088.
  5. Thakkar J, Kurup R, Laba T-L et al. Cell telephone text messaging for medication adherence in chronic disease. A meta-analysis. JAMA. 2016; 176:340-349.

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