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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

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Engagement With Text Messaging Improves Cardiovascular Medication Adherence: Secondary Analysis of a Randomized

Rowan Shore-Plavec¹, Rachel Zucker², Thomas J Glorioso³

¹College of Natural Sciences and Mathematics, University of Denver, Denver, CO, United States.

Journal of Medical Internet Research

|November 24, 2025

Summary

Greater engagement with text messaging interventions was linked to better cardiovascular medication adherence over 12 months. This study highlights the potential of digital health tools for improving long-term treatment compliance.

Keywords:

behavioral nudges cardiovascular disease interactive chatbot medication adherence texting

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Area of Science:

Cardiovascular medicine
Digital health interventions
Public health

Background:

Medication non-adherence is a significant barrier to effective cardiovascular disease management.
Text messaging interventions show promise for improving health behaviors.
Understanding engagement levels is crucial for optimizing digital health tools.

Purpose of the Study:

To determine if higher engagement with a text messaging intervention correlates with improved cardiovascular medication adherence.
To analyze the association between text message interaction frequency and adherence rates at the 12-month mark.

Main Methods:

Secondary analysis of existing trial data.
Assessment of participant engagement metrics with the text messaging intervention.
Measurement of cardiovascular medication adherence using validated methods at 12 months.

Main Results:

A positive association was observed between greater engagement with the text messaging intervention and improved medication adherence.
Higher levels of interaction with the intervention predicted better adherence outcomes at 12 months.

Conclusions:

Increased engagement with text messaging interventions may enhance long-term cardiovascular medication adherence.
Digital health strategies, particularly text messaging, offer a viable approach to support patient treatment compliance.
Optimizing user engagement is key to maximizing the effectiveness of mobile health interventions in chronic disease management.