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Treatment Adherence Increases With Text Message Reminders, Pilot Study Finds

By Warren Tong

June 13, 2012

Text message reminders can improve adherence to oral medications taken for chronic diseases, according to a U.S. study published last month in Clinical Therapeutics.

The study, conducted by OptumRx, a California-based pharmacy management company, found that participants who received text message reminders to take medications for their chorinc diseases had a higher adherence rate than those who did not -- 85 percent vs. 77 percent. The difference was even more statistically significant for participants taking chronic anti-diabetes medication -- 91 percent vs. 82 percent. The measurement of adherence was based on proportion of days covered (PDC), a measurement that, according to the OptumRx press release, "examines each day in period to determine if the patient has the drug on hand."

This was reportedly the first large-scale study in the U.S. to examine the impact of text message reminders on adherence. It analyzed data from 580 employer-sponsored and Medicare members of a national pharmacy benefit manager program operated by OptumRx. Previous studies suggested similar adherence improvements, OptumRx said, but were smaller and often focused on groups taking treatment for the same disease.

The Star Tribune reported:

"Text messages and emerging technologies offer new opportunities to educate and engage patients so they can improve their health and ultimately rein in their health costs," Kalee Foreman of OptumRx, the study's lead author, said in a statement.

Nearly 70 percent of medication-related hospital admissions arise when patients don't take their prescriptions as recommended, at a cost of about $100 billion a year, according to the New England Journal of Medicine.

As a result, the health care industry is increasingly turning to technology -- using mobile phones, electronic prescriptions and claims data -- to help patients with chronic conditions stay on top of prescription drug routines.

The researchers studied the results of OptumRx's text messaging adherence program, called My Medication Reminders, from between Sept. 15, 2010, and Aug. 31, 2011. They noted that future research is needed to determine if text message reminders improve adherence in people who are known to be non-adherent, as well as the long-term results.


The significance of these study results is limited by a number of factors, among them: the research was conducted by the company offering the very reminder service utilized in the study; adherence was measured by "proportion of days covered" as opposed to more direct pill counting or measurement of a patient's drug levels; and the study was neither randomized nor prospective. It is also unclear how many of the participants were taking HIV medications, making the study's applicability to HIV/AIDS uncertain.

All that being said, this study is worth noting due to the lack of large-scale studies exploring innovative strategies to improve poor adherence, which is often cited as the most common reason for HIV treatment failure in the U.S. Text message reminders show promise for those struggling to keep up with their meds, but further research is needed to more conclusively determine the impact of such tools.

Warren Tong is the research editor for and

Follow Warren on Twitter: @WarrenAtTheBody.

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