Presentation Abstract

Session: AOS.200.01YN-Katharine A. Lembright Award/Lecture and Martha N. Hill New Investigator Award Finalists
Presentation: 15249 - A Text Messaging Intervention Improves Medication Adherence for Patients With Coronary Heart Disease: A Randomized Controlled Trial
Pres Time: Sunday, Nov 17, 2013, 4:30 PM - 4:45 PM
Location: Room D162
Pres. Time: Sunday, Nov 17, 2013, 4:30 PM - 4:45 PM
Specialty: +205. Prevention, Education, and Disease Management
Keywords: Adherence; Coronary heart disease; Health promotion; Antiplatelet drugs; Statins
Authors: Linda G Park, San Francisco VA Medical Ctr, San Francisco, CA; Jill Howie-Esquivel, Univ of California, San Francisco, San Francisco, CA; Misook Chung, Univ of Kentucky, Lexington, KY; Kathleen Dracup, Univ of California, San Francisco, San Francisco, CA
Abstract: Introduction: More than half of individuals with chronic diseases do not take medications as prescribed. Pharmacologic treatment for secondary prevention of coronary heart disease (CHD) is critical to prevent adverse clinical outcomes. The primary aim of this randomized controlled trial was to compare adherence to antiplatelet and statin therapy among patients after myocardial infarction and/or coronary stent procedure who: 1) received text messages (TM) for medication reminders and health education (TM Reminders + TM Education), 2) received TM for health education (TM Education Alone), and 3) did not receive TM (No TM). We hypothesized that the two intervention groups would have better adherence as compared to the No TM group.
Methods: A mobile health intervention was designed to deliver customized TM for 30 days to patients who were recruited from a hospital setting. We assessed medication adherence by electronic monitoring devices [Medication Event Monitoring System (MEMS)], two-way TM response rates, and self-reported adherence (Morisky Medication Adherence Scale). Data from the MEMS were analyzed by One-Way ANOVA and Welch tests, two-way TM response rates by t-tests, and self-reported adherence by Repeated Measures ANOVA.
Results: Among 90 patients (76% male, mean age 59.2 years), MEMS revealed a significant difference in adherence among groups for antiplatelets only (p < .05). Specifically, the TM Reminders + TM Education group had a higher percentage of correct doses taken (88.0 ± 14.0 vs. 72.4 ± 27.6; p = .016) and a higher percentage of prescribed doses taken on schedule compared to the No TM group (86.2 ± 15.4 vs. 69.0 ± 29.2; p = .01). In addition, the TM Education Alone group had a higher percentage number of doses taken compared to the No TM group (95.8 ± 9.5 vs. 79.1 ± 27.7; p = .01). Two-way TM response rates were higher for antiplatelets than statins (90.2 ± 9 vs. 83.4 ±15.8; p = .01). Self-reported adherence improved for all groups over time, but did not differ among groups.
Conclusions: TM increased adherence to antiplatelet therapy demonstrated by MEMS and TM responses. This text messaging intervention shows promise in promoting medication adherence in patients with CHD; however, more research is needed to explore the full potential of mobile health.
Disclosures:  L.G. Park: None. J. Howie-Esquivel: None. M. Chung: None. K. Dracup: None.

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