SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored.
BACKGROUND
Poor adherence to oral antidiabetics has a negative influence on glycaemic control in type 2 diabetes patients. Real Time Medication Monitoring (RTMM) combines real time monitoring of patients' medication use with SMS reminders sent only if patients forget their medication, aiming to improve adherence. This study aimed to investigate the effect of these SMS reminders on adherence to oral antidiabetics in patients using RTMM and investigate patients' experiences with RTMM.


METHODS
Data were collected in a RCT involving 104 type 2 diabetes patients with suboptimal adherence to oral antidiabetics. Fifty-six patients were randomised to receive SMS reminders if they forgot their medication, 48 patients received no reminders. Primary outcome measure was adherence to oral antidiabetics registered with RTMM, measured as: (1) days without dosing; (2) missed doses; (3) doses taken within predefined standardized time windows. Patients' experiences were assessed with written questionnaires.


RESULTS
Over the six-month study period, patients receiving SMS reminders took significantly more doses within predefined time windows than patients receiving no reminders: 50% vs. 39% within a 1-h window (p=0.003) up to 81% vs. 70% within a 4-h window (p=0.007). Reminded patients tended to miss doses less frequently than patients not reminded (15% vs. 19%, p=0.065). Days without dosing were not significantly different between the groups. The majority of patients reported positive experiences with RTMM and SMS reminders.


CONCLUSIONS
RTMM with SMS reminders improves adherence of type 2 diabetes patients, especially the precision with which patients follow their prescribed regimen, and is well accepted by patients.


BACKGROUND
Netherlands Trial Register NTR1882.
NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands. M.Vervloet@nivel.nl
M
M
Vervloet
L
L
van Dijk
J
J
Santen-Reestman
B
B
van Vlijmen
P
P
van Wingerden
M L
ML
Bouvy
D H
DH
de Bakker
D000284:Administration, Oral; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D016903:Drug Monitoring / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010349:Patient Compliance; D017010:Reminder Systems / Q000706:statistics & numerical data*; D060145:Text Messaging / Q000706:statistics & numerical data*
D007004:Hypoglycemic Agents