Can mHealth Help with Medication Adherence?

For health care providers, getting some patients to adhere to their medication schedules can be a bit of a headache. And this lack of adherence is a costly problem: it is the cause of 10 percent of all hospital admissions and approximately 125,000 patient deaths annually, and the reason behind as many as $289 billion in health care costs each year. But could receiving text message alerts help people to stay on top of their medications? As mHealth Intelligence first reported, a team of researchers sought to test just that. Their results, published in the Journal of Medical Internet Research (JMIR), not only showed that the program could help patients stay on track, but that it also could help researchers understand some of the reasons why people fail to take their medication as directed.

Beyond the staggering costs (in human lives and dollars) of non-adherence, the problem is widespread, with researchers estimating that 50 to 80 percent of people fail to follow their health care providers’ instructions regarding their medication. With these statistics in mind, the study’s authors, who are based at the Washington University School of Medicine in St. Louis, set out to design a study using an “SMS-based medication adherence system.” The program, called EpxMedTracking, sends regular text messages to patients, asking whether or not they have taken their medication as prescribed. For those who respond that they have not, the system then asks follow-up questions to determine why; certain responses, including a patient reporting being out of medication or having adverse side effects, will trigger provider follow-up, while others give the option of sending a reminder to the patient.

The researchers tested the program on 25 patients over the course of 11 weeks. The results? Patients’ level of engagement with the program was high, at 85.9 percent each week. They also self-reported high levels of medication adherence. Beyond that, the researchers explain, the study offered insights into why people fail to take their medication; of the 109 missed doses reported, most were due to forgetting, with feeling better and running out of medication also ranking high on the list. Overall, while cautioning that further research is needed, the study’s authors are optimistic about the future use of tools like this. In their view, EpxMedTracking “is a feasible tool that remains reliable over time and is useful for tracking self-reported medication adherence and identifying actionable problems with medication adherence in real time.”

Click here for the article from mHealth Intelligence on the medication adherence study.

Click here for the study from JMIR on medication adherence. 


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