Text message reminders improve inhaler adherence in asthma, COPD

Key takeaways:

• Text messages addressing barriers to preventer inhaler use came from general practitioner practices.
• Patients with asthma receiving text messages vs. only usual care had more improvement in symptom control.

Adults with asthma and/or COPD who received 23 text messages about preventer inhaler use over 26 weeks had improved inhaler adherence, according to a poster presented at the European Respiratory Society International Congress.

“This clinical trial illustrates that a simple and low-cost text message intervention can meaningfully impact medication adherence in patients with asthma and/or COPD, and even improve symptom control,” John Luke Twelves, MD, medical director at Lindus Health, and colleagues wrote on the poster.

In a randomized controlled trial, Twelves and colleagues evaluated 5,873 adults with asthma and/or COPD in England with a prescription for a preventer inhaler to determine the impact of 23 text message reminders about inhaler use plus usual care vs. usual care alone on self-reported inhaler adherence at 26 weeks.

Text messages came from the general practitioner practice of each patient and addressed forgetting, doubts about needing regular treatment from a preventer inhaler, lack of understanding about preventer inhaler role and lack of understanding on correct inhaler usage, according to the poster.

Researchers used the Medication Adherence Report Scale (MARS-5) questionnaire to assess adherence at three points (baseline, week 13 and week 26), with better adherence signaled by higher scores.

Of the total cohort, 2,929 patients (n = 2,299 with asthma; n = 630 with COPD) received text messages plus usual care, whereas the remaining 2,944 patients (n = 2,272 with asthma; n = 672 with COPD) received usual care alone.

Among those with asthma, patients receiving text message reminders plus usual care vs. usual care alone had a significantly greater mean MARS-5 score at week 26 (4.47 vs. 4.31; P < .001), and this was also true among those with COPD (4.59 vs. 4.49; P = .04).

Additionally, patients receiving text messages in the asthma group had more improvement in symptom control at week 26 vs. patients receiving usual care per the Asthma Control Test (mean score, 20.66 vs. 20.16; P < .001).

In contrast, COPD Assessment Test scores at week 26 did not significantly differ between those with COPD in the text message group and in the usual care group.

“Further research to build on [these] data should be considered to look at longer follow-up periods, medicines usage tracking technology and the use of hospital and primary care data to track actual health care and medicines utilization over a longer period of time, as supplemental data to ePro data sources,” Twelves and colleagues wrote on the poster.