While the results of this systematic review are promising , there is insufficient evidence to draw conclusions on the effectiveness of text message-based interventions for adherence to medications for secondary prevention of CVD .
BACKGROUND Worldwide at least 100 million people are thought to have prevalent cardiovascular disease ( CVD ) .
This population has a five times greater chance of suffering a recurrent cardiovascular event than people without known CVD .
Secondary CVD prevention is defined as action aim ed to reduce the probability of recurrence of such events .
Drug interventions have been shown to be cost-effective in reducing this risk and are recommended in international guidelines .
However , adherence to recommended treatments remains sub-optimal .
In order to influence non-adherence , there is a need to develop scalable and cost-effective behaviour-change interventions .
OBJECTIVES To assess the effects of mobile phone text messaging in patients with established arterial occlusive events on adherence to treatment , fatal and non-fatal cardiovascular events , and adverse effects .
A randomized controlled behavioral intervention trial to improve medication adherence in adult stroke patients with prescription tailored Short Messaging Service (SMS)-SMS4Stroke study
Background The effectiveness of mobile technology to improve medication adherence via customized Short Messaging Service ( SMS ) reminders for stroke has not been tested in re source poor areas . We design ed a r and omized controlled trial to test the effectiveness of SMS on improving medication adherence in stroke survivors in Pakistan . Methods This was a parallel group , assessor-blinded , r and omized , controlled , superiority trial . Participants were central ly r and omized in fixed block sizes . Adult participants on multiple medications with access to a cell phone and stroke at least 4 weeks from onset ( Onset as defined by last seen normal ) were eligible . The intervention group , in addition to usual care , received reminder SMS for 2 months that contained a ) Personalized , prescription tailored daily medication reminder(s ) b ) Twice weekly health information SMS . The Health Belief Model and Social Cognitive theory were used to design the language and content of messages . Frontline SMS software was used for SMS delivery . Medication adherence was self-reported and measured on the vali date d Urdu version of Morisky Medication Adherence Question naire . Multiple linear regression was used to model the outcome against intervention and other covariates . Analysis was conducted by intention-to-treat principle . Results Two hundred participants were enrolled . 38 participants were lost to follow-up . After 2 months , the mean medication score was 7.4 ( 95 % CI : 7.2–7.6 ) in the intervention group while 6.7 ( 95 % CI : 6.4–7.02 ) in the control group . The adjusted mean difference ( Δ ) was 0.54 ( 95 % CI : 0.22–0.85 ) . The mean diastolic blood pressure in the intervention group was 2.6 mmHg ( 95 % CI ; −5.5 to 0.15 ) lower compared to the usual care group . Conclusion A short intervention of customized SMS can improve medication adherence and effect stroke risk factors like diastolic blood pressure  in stroke survivors with complex medication regimens living in re source poor areas .Trial registration Clinical trials.gov NCT01986023 last accessed at https:// clinical
While the results of this systematic review are promising , there is insufficient evidence to draw conclusions on the effectiveness of text message-based interventions for adherence to medications for secondary prevention of CVD .
BACKGROUND Worldwide at least 100 million people are thought to have prevalent cardiovascular disease ( CVD ) .
This population has a five times greater chance of suffering a recurrent cardiovascular event than people without known CVD .
Secondary CVD prevention is defined as action aim ed to reduce the probability of recurrence of such events .
Drug interventions have been shown to be cost-effective in reducing this risk and are recommended in international guidelines .
However , adherence to recommended treatments remains sub-optimal .
In order to influence non-adherence , there is a need to develop scalable and cost-effective behaviour-change interventions .
OBJECTIVES To assess the effects of mobile phone text messaging in patients with established arterial occlusive events on adherence to treatment , fatal and non-fatal cardiovascular events , and adverse effects .