Electronic Pill Bottles or Bidirectional Text Messaging to Improve Hypertension Medication Adherence (Way 2 Text): a...

Area of Science:

• Cardiovascular Medicine
• Health Services Research
• Digital Health

Background:

• Poor medication adherence is a significant barrier to effective hypertension management.
• The clinical utility of monitoring adherence using digital tools remains unclear.

Purpose of the Study:

• To assess the impact of electronic pill bottles and bidirectional text messaging on hypertension control.
• To evaluate if adherence monitoring improves systolic blood pressure (BP).

Main Methods:

• A pragmatic randomized controlled trial involving 149 primary care patients with hypertension.
• Participants were assigned to usual care, electronic pill bottle monitoring, or bidirectional text messaging for 4 months.
• Systolic blood pressure change from baseline was the primary outcome measure.

Main Results:

• No significant difference in systolic blood pressure reduction was observed between the usual care group and either the electronic pill bottle group (p=0.94) or the text messaging group (p=1.00).
• The two intervention groups also showed no significant difference when compared to each other (p=0.93).
• Measured adherence was good, but did not translate to improved blood pressure control.

Conclusions:

• Neither electronic pill bottle feedback nor bidirectional text messaging effectively improved blood pressure control in this hypertensive patient cohort.
• Adherence monitoring via these methods may not be sufficient to overcome barriers to blood pressure control or may not address the primary drivers of uncontrolled hypertension.