title: Randomised trial of text messaging on adherence to cardiovascular preventive treatment (INTERACT trial).
abstract: BACKGROUND
  About one third of patients prescribed blood pressure or lipid-lowering drugs for the prevention of coronary heart disease and stroke do not take their medication as prescribed. We conducted a randomized trial to evaluate text messaging as a means of improving adherence to cardiovascular disease preventive treatment.
  
  
  METHODS
  303 patients taking blood pressure and/or lipid-lowering medications were randomly assigned to being sent text messages (Text group, 151) or not being sent them (No text group, 152). Texts were sent daily for 2 weeks, alternate days for 2 weeks and weekly thereafter for 22 weeks (6 months overall), using an automated computer programme. Patients were asked to respond on whether they had taken their medication, whether the text reminded them to do so if they had forgotten, and if they had not taken their medication to determine if there was a reason for not doing so. At 6 months, use of medication was assessed.
  
  
  RESULTS
  Two patients were lost to follow-up, providing data on 301 for analysis. In the No text group 38/151 (25%) took less than 80% of the prescribed regimen (ie. stopped medication completely or took it on fewer than 22 of the last 28 days of follow-up) compared to 14/150 patients (9%) in the Text group - an improvement in adherence affecting 16 per 100 patients (95% CI 7 to 24), p<0.001. The texts reminded 98/151 patients (65%) to take medication on at least one occasion and lead to 20/151 (13%) who stopped taking medication because of concern over efficacy or side-effects, resuming treatment.
  
  
  CONCLUSIONS
  In patients taking blood pressure or lipid-lowering treatment for the prevention of cardiovascular disease, text messaging improved medication adherence compared with no text messaging.
  
  
  BACKGROUND
  Controlled-Trials.com ISRCTN74757601.
authors.affiliation: Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, United Kingdom.
authors.forename: David S
authors.initials: DS
authors.lastname: Wald
authors.affiliation: Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, United Kingdom.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Bestwick
authors.affiliation: Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, United Kingdom.
authors.forename: Lewis
authors.initials: L
authors.lastname: Raiman
authors.affiliation: Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, United Kingdom.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Brendell
authors.affiliation: Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, United Kingdom.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wald
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000523:psychology; D002319:Cardiovascular System / Q000187:drug effects; D040421:Cell Phone; D005260:Female; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D060145:Text Messaging