Influencing medication taking behaviors using automated two-way digital communication: A narrative synthesis systematic review informed by the Behavior Change Wheel

Gemma Donovan; Nicola Hall; Jonathan Ling; Felicity Smith; Scott Wilkes

doi:10.1111/bjhp.12580

Influencing medication taking behaviors using automated two-way digital communication: A narrative synthesis systematic review informed by the Behavior Change Wheel

Br J Health Psychol. 2022 Sep;27(3):861-890. doi: 10.1111/bjhp.12580. Epub 2022 Jan 26.

Authors

Gemma Donovan¹, Nicola Hall², Jonathan Ling³, Felicity Smith⁴, Scott Wilkes⁵

Affiliations

¹ Faculty of Health Sciences and Wellbeing, School of Pharmacy and Pharmaceutical Sciences, University of Sunderland, UK.
² Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, UK.
³ Faculty of Health Sciences and Wellbeing, University of Sunderland, UK.
⁴ UCL School of Pharmacy, UK.
⁵ Faculty of Health Sciences and Wellbeing, School of Medicine, University of Sunderland, UK.

Abstract

Purpose: Around half of prescribed medications for long-term conditions are not taken as directed. Automated two-way digital communication, such as text messaging and interactive voice response technology, could deliver interventions to improve medication adherence, and subsequently health. However, exploration of how such interventions may improve medication adherence is limited. This review aimed to explore how automated two-way digital communication can improve medication taking with or without using non-digital intervention components, such as phone calls with healthcare professionals.

Methods: A theory-informed narrative synthesis systematic review. Several databases were searched including CINAHL, Embase, Medline, and Web of Science using key words relating to 'medication adherence' and digital communication technologies. The Behavior Change Technique (BCT) coding using the BCT Taxonomy V1 and the Behavior Change Wheel were used to identify BCTs delivered within the included interventions.

Results: A total of 3,018 records were screened with 43 study reports included in the review. Four medication-taking behaviors: taking medication, obtaining medication, self-testing, and asking for support were identified as targets for behavior change within the included interventions. Most BCTs within the digital communication component aimed to increase motivation for medication adherence, with non-digital intervention components included to address other medication taking barriers, such as physical and psychological capability.

Conclusion: Automated two-way digital communication can detect barriers to medication adherence by monitoring performance of the taking medication behavior. Monitoring outcomes from taking medication may increase reflective motivation to take medicines. Addressing physical opportunity to taking medication by facilitating the behavior obtaining medication may also increase adherence.

Keywords: behaviour change; chronic illness; mobile health; treatment compliance.

Publication types

Review
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Behavior Therapy / methods
Communication
Humans
Medication Adherence
Telephone
Text Messaging*