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 .
Randomised Trial of Text Messaging on Adherence to Cardiovascular Preventive Treatment (INTERACT Trial)
Background About one third of patients prescribed blood pressure or lipid-lowering drugs for the prevention of coronary heart disease and stroke do not take their medication as prescribed . We conducted a r and omized trial to evaluate text messaging as a means of improving adherence to cardiovascular disease preventive treatment . Methods 303 patients taking blood pressure and /or lipid-lowering medications were r and omly assigned to being sent text messages ( Text group , 151 ) or not being sent them ( No text group , 152 ) . Texts were sent daily for 2 weeks , alternate days for 2 weeks and weekly thereafter for 22 weeks ( 6 months overall ) , using an automated computer programme . Patients were asked to respond on whether they had taken their medication , whether the text reminded them to do so if they had forgotten , and if they had not taken their medication to determine if there was a reason for not doing so . At 6 months , use of medication was assessed . Results Two patients were lost to follow-up , providing data on 301 for analysis . In the No text group 38/151 ( 25 % ) took less than 80 % of the prescribed regimen ( ie . stopped medication completely or took it on fewer than 22 of the last 28 days of follow-up ) compared to 14/150 patients ( 9 % ) in the Text group – an improvement in adherence affecting 16 per 100 patients ( 95 % CI 7 to 24 ) , p<0.001 . The texts reminded 98/151 patients ( 65 % ) to take medication on at least one occasion and lead to 20/151 ( 13 % ) who stopped taking medication because of concern over efficacy or side-effects , resuming treatment . Conclusions In patients taking blood pressure or lipid-lowering treatment for the prevention of cardiovascular disease , text messaging improved medication adherence compared with no text messaging . Trial Registration Controlled-Trials.com IS RCT
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 .