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Using daily text-message reminders to improve adherence with oral contraceptives: a randomized controlled trial
Melody Y Hou1, Shelley Hurwitz, Erin Kavanagh
1From the Boston University School of Medicine; the Planned Parenthood League of Massachusetts; and Brigham and Women's Hospital, Boston, Massachusetts.
Obstetrics and Gynecology
|August 25, 2010
Summary
Daily text messages did not improve oral contraceptive pill adherence in new users. Objective tracking revealed high rates of missed pills in both reminder and control groups, despite no resulting pregnancies.
Area of Science:
- Reproductive Health
- Contraception
- Digital Health Interventions
Background:
- Oral contraceptive pill (OCP) adherence is crucial for efficacy.
- Text message reminders are a potential digital health tool to improve adherence.
- Previous studies on reminder systems have yielded mixed results.
Purpose of the Study:
- To evaluate the effectiveness of daily text-message reminders on improving oral contraceptive pill adherence among new users.
- To compare adherence rates between women receiving daily text reminders and a control group.
Main Methods:
- A randomized controlled trial involving new oral contraceptive pill users.
- Pill-taking was objectively monitored for 3 months using electronic devices with wireless data collection.
- Participants were randomized to receive daily text message reminders or standard care.
Main Results:
- No significant difference in the mean number of missed pills per cycle between the text-message group (4.9±3.0) and the control group (4.6±3.5).
- Objective adherence monitoring showed significantly poorer pill-taking than patient diaries.
- Despite high rates of missed pills, no pregnancies occurred in either group.
Conclusions:
- Daily text-message reminders were not effective in improving oral contraceptive pill adherence.
- High rates of missed pills were observed objectively in both intervention and control groups.
- The widespread use of alternative reminder systems in the control group may have confounded results.
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