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DOI: 10.4338/ACI-2016-12-RA-0203
Improving Medication Adherence with Two-way Short Message Service Reminders in Sickle Cell Disease and Asthma
A feasibility randomized controlled trial 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.Publication History
received:
04 December 2016
accepted:
08 March 2017
Publication Date:
21 December 2017 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035026/201702/lookinside/thumbnails/10-4338-aci-2016-12-ra-0203-1.jpg)
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
Human Subjects Protection
This study was approved by the Vanderbilt University Medical Center Institutional Review Board
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