Electronic technology can improve patient adherence to chronic medications

Electronic reminders, without personal contact between the healthcare provider and patient, can improve patient adherence to chronic medications, at least in the short term, according to a recently published review.

Neelesh Bhandari, MD“Indian physicians and health consumers are both optimistic of using mHealth to bring down costs and increase access to healthcare services.”
-Neelesh Bhandari, MD, author of the Indian blog Digital Health

“Reminders can be especially used to modify the[s2If !is_user_logged_in()]…

[/s2If][s2If is_user_logged_in()] behaviour of… patients who are willing to take their medication but who forget it or are inaccurate,” wrote the authors of the review, from The Netherlands. They said the reminders also improve compliance among patients who deliberately don’t take their prescribed medication.

Key Point: Electronic reminders are effective for at least up to 6 months in getting patients with diseases that require chronic medication to adhere to their medication regimens.

Reminders can be automated, requiring no additional intervention from healthcare providers, so that patients receive them at the appropriate time.

Neelesh Bhandari, MD, who runs the Indian blog Digital Medicine, said that with many surveys and experts predicting widespread use of mHealth (mobile health–the use of mobile phones, tablets, and other technology in the delivery of medical care) in India, these types of studies are a welcome addition to the understanding of the technology’s scope and limitations. “A teledensity of almost 80% can be put to good use for improving healthcare services in the country,” Bhandari said. “Indian physicians and health consumers are both optimistic of using mHealth to bring down costs and increase access to healthcare services” (see http://bit.ly/mhealthIndia).

The authors of the recently published review identified 13 studies from a comprehensive literature search that evaluated the effect of either short message service (SMS) reminders sent to a mobile phone, audiovisual reminders from electronic reminder devices (ERD), and pager messages on adherence in various patient populations.

Five of the studies involved electronic reminders for patients prescribed antiretroviral therapy, 3 involved patients with hypertension, 2 enrolled patients with asthma, 2 studied patients with glaucoma, and 1 focused on women using oral contraceptives.

Eight of the studies demonstrated significant effects on patients’ adherence, and 7 of those 8 studies measured short-term effects up to 6 months. (Overall, only 3 of the 13 studies measured adherence beyond 6 months.)

Improved adherence was found in all but 1 study using SMS reminders, in 4 studies using ERD, and 1 intervention using a pager. Only 1 of the 3 studies that monitored patients for more than 6 months reported a significant impact on adherence rates.

Source: Vervloet M, Linn AJ, van Weert JCM, et al. The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature. J Am Med Inform Assoc. April 25, 2012 [epublication ahead of print].

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