Text messaging program increases medication adherence in hypertension
CHICAGO — A text messaging program for patients with hypertension was associated with increased medication adherence and reduced systolic BP, researchers reported at the American Heart Association Scientific Sessions.
For the NIH-sponsored TEXT MY MEDS NOLA pilot study, researchers enrolled 36 patients with hypertension. Participants were given a wireless BP monitor that automatically tracked and recorded readings via Bluetooth to a cloud-based mobile app (Sphygmo) and received daily text messages about medication compliance from a software system (Mosio).
“There were no changes to pharmacotherapy and no doctor’s visits,” Cardiology Today Editorial Board Member Keith C. Ferdinand, MD, FACC, FAHA, FASPC, FNLA, professor of medicine in the John W. Deming department of medicine at Tulane University School of Medicine and co-principal investigator of the study, told Healio. “Doing that for 2 months lowered blood pressure and significantly increased adherence. Antihypertensive therapies are one of the greatest breakthroughs in medicine, especially the newer medicines, which are well tolerated and effective.”
Among the cohort, the mean age was 59 years, 64% were women, 89% were non-Hispanic Black and 74% had diabetes, Tina K. Reddy, MS, a medical student at Tulane University School of Medicine, said during a presentation.
“Approximately 55% of Black adults have hypertension, and higher rates of more severe high blood pressure and hypertension that develops earlier in life,” Reddy said during the presentation. “Social determinants of health, historical and systemic factors play a critical role in nonadherence and control, including poor patient-clinician communication, low socioeconomic status, lack of access to primary care and health care distrust based on historical discrimination. Our pilot study wanted to investigate whether simple text messaging could increase medication adherence.”
The Krousel-Wood Medication Adherence Scale score improved from 2.19 + 0.86 at baseline to 1.58 + 0.87 at 2 months (P = .0001), Reddy said during the presentation.
Systolic BP declined by a mean of 10.5 mm Hg at 2 months (P = .0027), but diastolic BP did not change (P = .1337), she said.
The average number of unhealthy days in the past 30 days as determined by the CDC health-related quality of life survey declined from 9.1 days at baseline to 6.8 days at the end of the study (difference, –2.3; P = .21), she said.
The researchers also compared results between participants who received social support in taking or refilling medications (n = 19) and those who did not (n = 14).
Both groups had declines in systolic BP during the study period, which was significant in the social support group (P = .0198) and a trend in the no support group (P = .0771), Reddy said, noting that the result for the no support group may have been significant if the sample size were larger.
“What TEXT MY MEDS NOLA showed was that if you can increase adherence, you can then lower blood pressure without increasing pharmacotherapy, because many times, patients may have effective medicines prescribed, but do not take them,” Ferdinand told Healio.
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Reddy TK, et al. Abstract 11679. Presented at: American Heart Association Scientific Sessions; Nov. 5-7, 2022; Chicago (hybrid meeting).
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