Medication adherence rates are significantly improved when a mobile phone text message intervention is used to support adherence in patients on long-term therapy for chronic diseases, a study published online first in the journal JAMA Internal Medicine has shown.1

Patients with chronic diseases must maintain adherence to therapies over the long term; however, traditional interventions are complex and not widely effective resulting in poor adherence. A meta-analysis of randomized clinical trials was conducted to determine if mobile telephone text messaging could improve medication adherence in patients with chronic diseases.

The researchers identified 16 randomized clinical trials that evaluated a text message intervention in medication adherence from MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL databases. Two authors of this study extracted information on study characteristics, text message characteristics, and outcome measures.

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Text message characteristics assessed in the 16 trials included personalization (5 trials), 2-way communication (8 trials), and a daily text message frequency (8 trials). Median intervention duration was 12 weeks, and self-report was the most commonly used method for assessing medication adherence. The pooled analysis included 2742 patients: median age 39 years and 50.3% (1380) were female.

Text messaging significantly improved medication adherence regardless of study characteristics (intervention duration or type of disease) or text message characteristics. This improvement translates to an absolute increase of 17.8% (from 50% to 67.8%) in adherence rates.

Although these results are promising, the authors caution that the trials had limitations, including short duration and reliance on self-reported medication adherence measures.

“Future studies need to determine the features of text message interventions that improve success, as well as appropriate patient populations, sustained effects, and influences on clinical outcomes,” the authors report.


1. Thakkar J, Kurup R, Laba TL, et al. Mobile telephone text messaging for medication adherence in chronic disease: a meta-analysis [published online ahead of print February 1, 2016]. JAMA Intern Med. doi:10.1001/jamainternmed.2015.7667.