title: Short- and long-term effects of real-time medication monitoring with short message service (SMS) reminders for missed doses on the refill adherence of people with Type 2 diabetes: evidence from a randomized controlled trial.
abstract: OBJECTIVE
  To investigate short- and long-term effects of real-time monitoring medication use combined with short message service (SMS) reminders for missed doses on refill adherence to oral anti-diabetic medication.
  
  
  METHODS
  A randomized controlled trial with two intervention groups and one control group involving 161 participants with Type 2 diabetes with suboptimal adherence. For 6 months, participants in the SMS group (n = 56) were monitored and received SMS reminders if they missed their medication. Participants in the non-SMS group (n = 48) were only monitored. The control group (n = 57) was not exposed to any intervention. Primary outcome measure was refill adherence to oral anti-diabetic medication. Multi-level regression analyses were performed to examine intervention effects on adherence between and within groups after 1 and 2 years of follow-up.
  
  
  RESULTS
  At baseline, mean refill adherence was comparable between the groups. After 1 year, adherence in the SMS group was significantly higher than in the control group (79.5% vs. 64.5%; P < 0.001) and showed a significant improvement from baseline (+16.3%; P < 0.001). Mean adherence in the non-SMS group reached 73.1% (+7.3%; P < 0.05), but did not differ from the control group (P = 0.06). After 2 years, the improved adherence in the SMS group persisted and remained significantly higher than in the control group (80.4% vs. 68.4%; P < .01), contrary to the non-SMS group whose adherence approached baseline level again (65.5%).
  
  
  CONCLUSIONS
  This study shows the long-term effectiveness of real-time medication monitoring combined with SMS reminders in improving refill adherence. This new reminder system can strengthen the self-management of people with diabetes.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht.
authors.forename: M
authors.initials: M
authors.lastname: Vervloet
authors.forename: L
authors.initials: L
authors.lastname: van Dijk
authors.forename: D H
authors.initials: DH
authors.lastname: de Bakker
authors.forename: P C
authors.initials: PC
authors.lastname: Souverein
authors.forename: J
authors.initials: J
authors.lastname: Santen-Reestman
authors.forename: B
authors.initials: B
authors.lastname: van Vlijmen
authors.forename: M C W
authors.initials: MC
authors.lastname: van Aarle
authors.forename: L S
authors.initials: LS
authors.lastname: van der Hoek
authors.forename: M L
authors.initials: ML
authors.lastname: Bouvy
mesh_terms: D000284:Administration, Oral; D040421:Cell Phone; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology*; D016903:Drug Monitoring; D055317:Evidence-Based Practice; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D009426:Netherlands; D017010:Reminder Systems / Q000639:trends; D012648:Self Care / Q000523:psychology*; D060145:Text Messaging / Q000639:trends; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human