Improving medication adherence in stroke patients through Short Text Messages (SMS4Stroke)-study protocol for a...

Area of Science:

• Neurology
• Public Health
• Health Informatics

Background:

• Stroke is a leading cause of death and disability, particularly in low and middle-income countries.
• Effective medical management is crucial for preventing recurrent strokes.
• Current medication adherence rates are suboptimal, with only 1 in 6 patients following schedules perfectly.

Purpose of the Study:

• To evaluate the effectiveness of Short Message Service (SMS) reminders in improving medication adherence among stroke patients.
• To assess the acceptability of using SMS technology for medication adherence in this population.
• To explore the potential of SMS interventions in reducing stroke recurrence in low and middle-income countries.

Main Methods:

• A randomized, controlled, assessor-blinded superiority trial involving adult stroke patients with cell phone access.
• Participants randomized to receive standard care or standard care plus tailored SMS reminders for medications, lifestyle, and motivation.
• Medication adherence measured using the Morisky Medication Adherence Scale (MMAS) at baseline and 2 months; acceptability assessed via a custom tool.

Main Results:

• The study aims to determine if SMS reminders significantly increase medication compliance compared to standard care.
• It will also evaluate patient acceptance of the SMS intervention.
• Statistical power is set at 90% to detect a 1-point difference in MMAS scores.

Conclusions:

• The SMS for Stroke Study is expected to provide evidence on the feasibility and effectiveness of SMS interventions for improving medication adherence post-stroke.
• Findings will be particularly relevant for low and middle-income country settings.
• This research could inform future strategies for secondary stroke prevention.