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Appl Clin Inform 2017; 08(02): 541-559
DOI: 10.4338/ACI-2016-12-RA-0203
Research Article
Schattauer GmbH

Improving Medication Adherence with Two-way Short Message Service Reminders in Sickle Cell Disease and Asthma

A feasibility randomized controlled trial
Brandi M. Pernell
1   Vanderbilt-Meharry-Matthew Walker Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville TN
2   University of Alabama at Birmingham, Department of Pediatrics, Division of Hematology, Birmingham, AL
,
Michael R. DeBaun
1   Vanderbilt-Meharry-Matthew Walker Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville TN
,
Kathleen Becker
3   Johns Hopkins University, School of Nursing, Baltimore, MD
,
Mark Rodeghier
4   Rodeghier Consultants, Chicago, IL
,
Valencia Bryant
1   Vanderbilt-Meharry-Matthew Walker Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville TN
,
Robert M. Cronin
5   Vanderbilt University Medical Center, Departments of Biomedical Informatics, Internal Medicine, and Pediatrics, Nashville, TN
› Author Affiliations Funding This work was supported by the Junior League of Nashville, HRSA grant number 5-U38-MC2222–0–04–00, and the Trans-Institutional Programs at Vanderbilt University Medical Center.
Further Information

Publication History

received: 04 December 2016

accepted: 08 March 2017

Publication Date:
21 December 2017 (online)

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Summary

Introduction: Sickle cell disease (SCD) is a childhood and adult disease that primarily affects African Americans, characterized by life threatening sequelae mitigated by medications. One-way and two-way short message service (SMS) medication reminders have differing efficacy in chronic diseases. There is limited literature about SMS medication reminders in SCD.

Objective: The goal of this study was to test the feasibility, defined by recruitment/acceptance, retention/attrition, and technology utilization, of two-way SMS medication reminders in individuals with SCD with and without asthma.

Materials and Methods: Participants were randomly allocated to standard care or reminders. Two-way SMS reminders were automated using Research Electronic Data Capture (REDCap) for hydroxyurea, fluticasone, budesonide and montelukast. Adherence was measured using the Morisky Medication Adherence Scale-8 (MMAS-8). Asthma control was assessed using the Childhood and Adult-Asthma Control Tests (ACT). Participants were enrolled 28 to 60 days with a common termination date.

Results: The recruitment rate was 95% (47/49) and 82.9% completed the study. Among the 47 study participants enrolled, 51.1% were male, 61.7% were adults, median age was 20 (range: 3 to 59), and 98% were African Americans. Of the 26 participants receiving messages, 20% responded on over 95% of the days and usage varied with an average response rate of 33%, ranging from 21% to 46%. Medication adherence scores improved significantly in the intervention group (3.42 before, 5.46 after; p=0.002), but not in the control group (3.90 before, 4.75 after; p=0.080). Childhood-ACT scores improved in the intervention group (19.20 before, 24.25 after). Adult-ACT scores within the intervention arm were unchanged (21.0 before, 22.0 after. ACT scores did not improve significantly.

Conclusion: This study demonstrated the feasibility for two-way SMS medication reminders to improve medication adherence in a high-risk population where daily medication adherence is critical to health outcomes and quality of life.

Citation: Pernell BM, DeBaun MR, Becker K, Rodeghier M, Bryant V, Cronin RM. Improving medication adherence with two-way short message service reminders in sickle cell disease and asthma: A feasibility randomized controlled trial. Appl Clin Inform 2017; 8: 541–559 https://doi.org/10.4338/ACI-2016-12-RA-0203

Keywords

Sickle cell anemia - asthma - medication adherence - short message service - text

Human Subjects Protection

This study was approved by the Vanderbilt University Medical Center Institutional Review Board


 

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