Impact of a Text Messaging Pilot Program on Patient Medication Adherence
Impact of a Text Messaging Pilot Program on Patient Medication Adherence
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DOI：
10.1016/j.clinthera.2012.04.007
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发表时间：
2012-05-01
影响因子：
3.2
通讯作者：
Curtis, Bradford S.
中科院分区：
文献类型：
--
作者：
Foreman, Kalee F.;Stockl, Karen M.;Curtis, Bradford S.
背景资料：药物不依从性是一个公认的挑战，与不良的健康结果和医疗保健资源的利用率增加。虽然有许多不同的行为和教育策略可用于提高患者的药物依从性，但包括手机短信在内的技术进步代表了提高依从性和整体健康结局的新的创新模式。目的：评估选择接收短信药物提醒的患者和匹配良好的对照队列的药物依从性。这次回顾展，观察性队列分析比较了选择-使用来自成员门户数据库的数据和具有商业和医疗保险的国家药房福利经理的电子药房索赔，会员资格纳入了连续入组的成员，这些成员选择接受至少1次关注的慢性口服药物的药物特定剂量提醒，并且至少有1次关注的相同慢性口服药物的药房声明。匹配基于药物治疗类别，然后基于倾向评分（包括年龄、性别、健康计划、慢性病评分、不同药物计数、平均基线药物依从性和治疗持续时间等变量）。主要结局是2011年1月1日至2011年8月31日期间的长期口服药物依从性，以覆盖天数比例（PDC）衡量。采用配对t检验和McNemar检验对队列进行比较分析。结果：实施短信程序后，短信队列（n = 290）的平均（SD）PDC显著高于对照队列（n = 290）（分别为0.85 [0.20] vs 0.77 [0.28]; P < 0.001）。在长期口服降糖药物的患者中，短信队列的平均PDC显著高于对照队列（0.91 [0.14] vs 0.82 [0.21]; P = 0.029）。与对照组相比，选择接受β受体阻滞剂治疗短信提醒的成员的平均PDC也有显著差异（0.88 [0.18] vs 0.71 [0.29]; P = 0.006）。结论：研究结果表明，选择短信提醒程序的成员与不选择短信提醒程序的成员相比，接收药物特定的文本消息提醒，并且文本消息提醒程序的使用有助于随着时间的推移保持较高的依从率。(Clin Ther. 2012;34：1084-1091）（C）2012 Elsevier HS Journals，Inc. All rights reserved.
Background: Medication nonadherence is a well-recognized challenge associated with poor health outcomes and increased utilization of health care resources. Although many different behavioral and educational strategies are available to improve patient medication adherence, technological advances, including cell phone text messaging, represent new and innovative modalities to improve adherence and overall health outcomes.Objective: To evaluate medication adherence among patients opting to receive text message medication reminders and a well-matched control cohort.Methods: This retrospective, observational cohort analysis compared medication adherence of members who opted-in to the text message medication reminder program and a matched control cohort using data from a member portal database and electronic pharmacy claims of a national pharmacy benefit manager with commercial and Medicare membership. Continuously enrolled members who opted to receive at least 1 medication-specific dosage reminder for a chronic oral medication of interest and had at least 1 pharmacy claim for the same chronic oral medication of interest were included. Matching was based on medication therapeutic class, then on propensity score (including variables of age, sex, health plan, Chronic Disease Score, distinct medication count, average baseline medication adherence, and duration of therapy). The primary outcome was chronic oral medication adherence, measured as the proportion of days covered (PDC), between January 1, 2011, and August 31, 2011. Analyses comparing cohorts were conducted using paired t tests and the McNemar test.Results: After implementation of the text messaging program, the mean (SD) PDC was significantly higher for the text message cohort (n = 290) than for the control cohort (n = 290) (0.85 [0.20] vs 0.77 [0.28], respectively; P < 0.001). Of those members identified with a chronicoral antidiabetes medication, the mean PDC was significantly higher in the text message cohort than in the control cohort (0.91 [0.14] vs 0.82 [0.21]; P = 0.029). Significant differences in mean PDC were also seen in members who opted to receive text message reminders for beta-blocker therapy over members in the control cohort (0.88 [0.18] vs 0.71 [0.29]; P = 0.006).Conclusions: Findings suggest that members opting into a text message reminder program have significantly higher chronic oral medication adherence compared with members not opting to receive medication-specific text message reminders, and that the use of a text message reminder program assists in preserving higher rates of adherence over time. (Clin Ther. 2012;34:1084-1091) (C) 2012 Elsevier HS Journals, Inc. All rights reserved.