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

Shivan J Mehta1,2,3, Kevin G Volpp4,5,6,7, Andrea B Troxel8

  • 1Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. shivan.mehta@uphs.upenn.edu.

Journal of General Internal Medicine
|August 10, 2019
PubMed

Insights

Monitoring medication adherence with electronic pill bottles or text messages did not improve blood pressure control in hypertensive patients. These interventions did not significantly impact systolic blood pressure compared to usual care.

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.
Abstract

Keywords:
health behaviorhypertensionmedication adherenceprimary care

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