One-way versus two-way text messaging on improving medication adherence: meta-analysis of randomized trials

Am J Med. 2015 Oct;128(10):1139.e1-5. doi: 10.1016/j.amjmed.2015.05.035. Epub 2015 Jun 16.

Abstract

Background: Mobile telephone text messaging is a simple potential solution to the failure to take medications as directed. There is uncertainty over the effectiveness of 1-way text messaging (sending text message reminders only) compared with 2-way text messaging (sending reminders and receiving replies confirming whether medication has been taken) as a means of improving medication adherence.

Methods: A meta-analysis of 8 randomized trials (1994 patients) that tested the effectiveness of text messaging on medication adherence was performed. The trials were divided into 2 groups: trials using 1-way text messaging versus no text messaging and trials using 2-way text messaging versus no text messaging. The summary estimates of the effect of the 2 methods of text messaging (1-way or 2-way) were compared.

Results: The summary relative risk estimate was 1.04 (95% confidence interval, 0.97-1.11) for 1-way text messaging and 1.23 (95% confidence interval, 1.13-1.35) for 2-way text messaging. The difference in effect between the 2 methods was statistically significant (P = .007).

Conclusions: Two-way text messaging is associated with substantially improved medication adherence compared with 1-way text messaging. This has important implications in the provision of mobile-based messaging in the management of patients taking medication for the prevention of chronic disease.

Keywords: Adherence; Medication; Text message.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Humans
  • Medication Adherence*
  • Models, Statistical
  • Outcome and Process Assessment, Health Care
  • Randomized Controlled Trials as Topic
  • Reminder Systems*
  • Text Messaging*