The feasibility of text reminders to improve medication adherence in adolescents with asthma

J Am Med Inform Assoc. 2016 May;23(3):449-55. doi: 10.1093/jamia/ocv158. Epub 2015 Dec 11.


Objective: Personal health applications have the potential to help patients with chronic disease by improving medication adherence, self-efficacy, and quality of life. The goal of this study was to assess the impact of MyMediHealth (MMH) - a website and a short messaging service (SMS)-based reminder system - on medication adherence and perceived self-efficacy in adolescents with asthma.

Methods: We conducted a block-randomized controlled study in academic pediatric outpatient settings. There were 98 adolescents enrolled. Subjects who were randomized to use MMH were asked to create a medication schedule and receive SMS reminders at designated medication administration times for 3 weeks. Control subjects received action lists as a part of their usual care. Primary outcome measures included MMH usage patterns and self-reports of system usability, medication adherence, asthma control, self-efficacy, and quality of life.

Results: Eighty-nine subjects completed the study, of whom 46 were randomized to the intervention arm. Compared to controls, we found improvements in self-reported medication adherence (P = .011), quality of life (P = .037), and self-efficacy (P = .016). Subjects reported high satisfaction with MMH; however, the level of system usage varied widely, with lower use among African American patients.

Conclusions: MMH was associated with improved medication adherence, perceived quality of life, and self-efficacy.Trial Registration This project was registered under identifier NCT01730235.

Keywords: adherence; adolescent; asthma; biomedical informatics; clinical trial; mHealth; mobile technology; personal health records.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Asthma / drug therapy*
  • Feasibility Studies
  • Female
  • Humans
  • Intention to Treat Analysis
  • Internet
  • Male
  • Medication Adherence*
  • Mobile Applications
  • Quality of Life
  • Reminder Systems*
  • Self Care
  • Text Messaging*

Associated data