What Text Reminders Do for Medication Adherence

A review of six studies on SMS text messaging for malaria management across Africa found promising results, including one by Zurovac and colleagues in which text reminders to healthcare workers in a rural Kenyan clinic substantially improved compliance with treatment guidelines, an improvement that persisted after the intervention ended. The technology was simple and low cost, which is why the approach transfers to other settings. Spruce offers scheduled messages and automations so practices can check in with patients about appointments and medications without adding work for staff.

This article is part of a series dedicated to thinking big about technology in healthcare and how it can be used to drive improved communication and better health outcomes.

Spotlight: Communication for Medication Adherence

In the words of Dr. Rob Lamberts, “healthcare is communication.” But what exactly does that mean? One piece of evidence that good healthcare depends on good communication comes from recent studies of patient reminders, which have been shown to increase adherence to healthy behaviors. In the past, these reminders would have been difficult for healthcare teams to manage, but new technologies like texting and automation have now made possible a new era of efficiency and efficacy. 

Research has shown that improved communication has the ability to improve health outcomes, especially in rural and developing regions. A recent review article, for instance, found promising results in six separate studies of SMS text messaging for managing malaria in different regions of Africa where communication has historically been a barrier to treatment.¹

In one of the reviewed studies, Zurovac et al. found that text message reminders sent to healthcare workers in a rural Kenyan clinic substantially improved provider compliance with malaria treatment guidelines. The researchers also observed that this improvement persisted beyond the end of the intervention. These are notable results, as guideline compliance is critical both to improving individual treatment outcomes and reducing population-level drug resistance. It is also compelling that these positive findings depended only on simple and low-cost technology, as this implies that the results may be generalizable and potentially impactful for millions of people.

While the success of the Zurovac study is one great example of communication technology improving healthcare, it increasingly seems that the possible applications for innovations like text-message reminders may actually be limitless. For example, many elderly Americans now rely on basic SMS reminders to help them take their medications correctly, and there is a growing demand for even more sophisticated and precise reminders (sneak peak — this will be covered more in depth in next month’s blog).²

Given the clear benefit of technology-enabled “reminder” communications, we’ve also made sure to build features in Spruce that allow healthcare teams to check in with their patients and help them stay on top of everything, from upcoming appointments to important medications. We also built automation around these check-ins so that busy providers don’t have to remember every detail or send every message by hand. The evidence is strong that reminders empower patients to get the care that they need for better outcomes, and we take that seriously. After all, as Dr. Lamberts puts it, healthcare is communication.

Technology has drastically changed the way that healthcare is delivered, because it has changed the way that we communicate with each other. We are inundated with healthcare information in every aspect of our lives. And while this can be overwhelming, there are so many ways that technology and rapid communication can empower us to optimize our health and wellbeing through better access to information.

The fields of healthcare technology and digital health are huge and rapidly growing, forming the basis of ongoing research and innovation. This is where our new blog series comes in: health tech & communication. Here, we’ll focus specifically on the role of technology in healthcare communication as a way to highlight some of the revolutionary change that has transpired in the new digital age. We’ll be featuring some innovative advances and research findings that highlight how diverse groups of people benefit from better healthcare communication.

On Deck

Over the next few months, we’ll dive into these topics and more:

• How Caretakers Utilize Technology for Elderly Care
• What is Telemedicine?
• Online Behavioral Healthcare for Substance Abuse
• The Patient-Provider Relationship as Facilitated by Technology
• Second Opinion Services for Improved Remote Care

Frequently Asked Questions

Do text message reminders improve medication adherence?

The evidence supports it. Studies of patient reminders show increased adherence to healthy behaviors, and elderly patients in the United States commonly rely on basic SMS reminders to take medications correctly.

What did the Kenya malaria study find?

Zurovac and colleagues found that text message reminders sent to healthcare workers in a rural Kenyan clinic substantially improved provider compliance with malaria treatment guidelines, and that the improvement persisted beyond the end of the intervention.

Why does low-cost technology matter in these results?

Because it provides greater accessibility across patients and healthcare professionals. The positive findings depended only on simple, inexpensive messaging, which means the approach can be reproduced widely rather than only where sophisticated systems exist.

How does Spruce support reminder workflows?

Spruce offers scheduled messages and saved messages (templates), plus automations around them, so a care team can check in with patients about upcoming appointments and important medications without sending each message by hand.

References

1. Zurovac, Dejan et al. “Mobile phone text messaging: tool for malaria control in Africa.” PLoS medicine vol. 9,2 (2012): e1001176. doi:10.1371/journal.pmed.1001176
2. United States, Congress, Executive Office of the President of the United States, and Task Force on Research and Development For Technology to Support Aging Adults Committee On Technology. “Emerging Technologies To Support An Aging Population.” Emerging Technologies To Support An Aging Population, The White House, 2019, pp. 1–40.