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Background: Rates of medication nonadherence are high, which can lead to disease progression, disability and death. objective: To test a potential solution to improve adherence to medications using a novel computer-based text message reminder system.
Methods: An automated computer program to send text messages to cell phones was developed. In phase 1, the reliability of the system was tested by sending text messages four times daily for two months to four volunteers. In phase 2, 20 healthy volunteers were asked to take a placebo at four prespecified times per day for one week with text message reminders and one week without. In Phase 3, 30 random, stable cardiac patients were recruited and instructed to take and record medications according to their own regimen for one month with text message reminders and one month without.
Results: In phase 1, the system accurately delivered 100% of reminder messages. In phase 2, the adherence to placebos improved with text message reminders in 88% of healthy volunteers, with a 65% relative risk reduction for nonadherence (P<0.01). In phase 3, adherence to medication with text message reminder improved in 100% of cardiac patients, with a 64% relative risk reduction for nonadherence (P<0.01). In all subgroups analyzed, text message reminders significantly improved medication adherence.
Conclusions: The system proved to be effective in improving adherence to placebo in healthy volunteers and to medications in cardiac patients over a two-month period. Further research is required to assess the effects of this system over longer periods of time and in more diverse populations.