The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature

J Am Med Inform Assoc. Sep-Oct 2012;19(5):696-704. doi: 10.1136/amiajnl-2011-000748. Epub 2012 Apr 25.

Abstract

Background: Many patients experience difficulties in adhering to long-term treatment. Although patients' reasons for not being adherent are diverse, one of the most commonly reported barriers is forgetfulness. Reminding patients to take their medication may provide a solution. Electronic reminders (automatically sent reminders without personal contact between the healthcare provider and patient) are now increasingly being used in the effort to improve adherence.

Objective: To examine the effectiveness of interventions using electronic reminders in improving patients' adherence to chronic medication.

Methods: A comprehensive literature search was conducted in PubMed, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials. Electronic searches were supplemented by manual searching of reference lists and reviews. Two reviewers independently screened all citations. Full text was obtained from selected citations and screened for final inclusion. The methodological quality of studies was assessed.

Results: Thirteen studies met the inclusion criteria. Four studies evaluated short message service (SMS) reminders, seven audiovisual reminders from electronic reminder devices (ERD), and two pager messages. Best evidence synthesis revealed evidence for the effectiveness of electronic reminders, provided by eight (four high, four low quality) studies showing significant effects on patients' adherence, seven of which measured short-term effects (follow-up period <6 months). Improved adherence was found in all but one study using SMS reminders, four studies using ERD and one pager intervention. In addition, one high quality study using an ERD found subgroup effects.

Conclusion: This review provides evidence for the short-term effectiveness of electronic reminders, especially SMS reminders. However, long-term effects remain unclear.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Audiovisual Aids
  • Automation
  • Cell Phone
  • Humans
  • Medication Adherence*
  • Reminder Systems*
  • Telemedicine
  • Text Messaging*