Using SMS Texting for Adverse Drug Reaction Surveillance: Evaluation of New Medication Prescriptions in Primary Care

Adverse drug reactions (ADRs) and their timely recognition are major patient safety concerns. Earlier detection of ADRs can improve outcomes through more timely medication management thereby minimizing harm. The research team has conducted studies to proactively monitor patients prescribed medications to identify potential ADRs, through pharmacist phone calls, interactive voice response (IVR) calls, and patient portal messaging. Because many patients regularly use SMS texting, the authors sought to leverage this technology to improve convenience and response rates.

The team designed and deployed SMS text-based pharmacosurveillance coupled with live pharmacist support at three primary care clinics to identify potential ADRs among patients newly prescribed medication(s). Descriptive data were collected on response rates, medications prescribed, medication initiation, reasons for non-initiation, and types of potential ADR symptoms.

More than 42% of patients opted-in to receive text messages related to their new medication(s). A total of 884 unique patients prescribed 1,369 new medications were contacted. Most prescriptions were filled and started (52.2%), while 11.0% were not started-primarily due to insurance coverage issues and drug unavailability-and 36.9% did not respond to text/phone call. Overall, 110 patients (20.0%, 95% confidence interval [CI] 16.7%-23.3%) reported new potential ADR symptoms. Most patients reported that the text messaging service was helpful and easy to use.

An automated SMS texting platform for ADR surveillance achieved higher response rates than prior outreach efforts using phone IVR and patient portal messaging. One in five respondents report potential ADRs to newly prescribed medications.