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Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease: A Meta-analysis
Jay Thakkar1, Rahul Kurup2, Tracey-Lea Laba3
1Department of Cardiology, Westmead Hospital, Sydney, Australia2The George Institute for Global Health, The University of Sydney, Sydney, Australia3The University of Sydney, Sydney, Australia.
JAMA Internal Medicine
|February 3, 2016
Summary
Mobile phone text messaging approximately doubles medication adherence for chronic disease patients. This intervention shows promise for improving adherence rates, though further research is needed on optimal features and long-term effects.
Area of Science:
- Digital Health
- Health Behavior
- Evidence-Based Medicine
Background:
- Poor adherence to long-term therapies is a significant challenge in chronic disease management.
- Traditional adherence interventions often lack widespread effectiveness and scalability.
- Mobile phone text messaging presents a potentially scalable solution to support medication adherence.
Purpose of the Study:
- To conduct a meta-analysis of randomized clinical trials to evaluate the impact of mobile telephone text messaging on medication adherence in individuals with chronic diseases.
Main Methods:
- A comprehensive search of multiple databases (MEDLINE, EMBASE, Cochrane, PsycINFO, CINAHL) was performed up to January 2015.
- Sixteen randomized clinical trials involving adults with chronic diseases were included in the meta-analysis.
- Data were extracted independently, and pooled analyses were conducted using random-effects models to calculate odds ratios.
Main Results:
- Mobile phone text messaging significantly improved medication adherence, nearly doubling the odds (OR, 2.11; 95% CI, 1.52-2.93).
- The positive effect on adherence was consistent across various study and text message characteristics, including intervention duration, disease type, personalization, and communication frequency.
- Sensitivity analyses confirmed the robustness of the findings, even after adjusting for study quality and publication bias, with moderate heterogeneity observed (I2 = 62%).
Conclusions:
- Mobile phone text messaging interventions can effectively double the odds of medication adherence, potentially increasing adherence rates from 50% to 67.8%.
- While promising, the findings should be interpreted cautiously due to the short trial durations and reliance on self-reported adherence.
- Future research should focus on identifying specific text messaging features, optimal patient populations, sustained effects, and clinical outcome impacts.
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