Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Medication Adherence in Chronic Disease

Is mobile telephone text messaging the answer?

Publish date:: February 16, 2016

The use of mobile phone text messaging increases adherence to long-term therapies in chronic disease, according to a meta-analysis of 16 randomized clinical trials and 2,742 patients where mobile telephone text messaging interventions were evaluated over 12 weeks. Researchers found:

• Medication adherence rates improved from 50% to 67.8%, or an absolute increase of 17.8%.

• The effect was not sensitive to study characteristics or text message characteristics.

• The findings remained robust to change in inclusion criteria based on study quality (OR=1.67).

Citation: Thakkar J, Kurup R, Laba TL, et al. Mobile telephone text messaging for medication adherence in chronic disease: a meta-analysis. [Published online ahead of print February 1, 2016]. JAMA Intern Med. doi:10.1001/jamainternmed.2015.7667.

Commentary: Poor adherence to medications is a critical issue in chronic disease management. Numerous studies show that individuals often do not take their medicines as prescribed.^1,2 Adherence rates for medications for chronic disease show that patients on the average take only about 50% of prescribed doses. The causes for suboptimal adherence are numerous and include cost of medications, patient-physician communication, patient education, motivation, and simple forgetfulness. When patients do not take their medications correctly there can be severe consequences, including increased hospitalizations.³ Text messaging appears to be an effective and promising method to enhance patient adherence in taking medications. —Neil Skolnik, MD

1. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005;353:487-97. doi: 10.1056/NEJMra050100.

2. Cutler D, Everett W. Thinking outside the pillbox — medication adherence as a priority for health care reform. N Engl J Med 2010;362:1553-55. doi: 10.1056/NEJMp1002305.

3. Sokol MC, McGuigan KA, Verbrugge RR, et al. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care 2005;43:521e30.

This Week's Must Reads

Osteoporosis prevalence in PsA similar to general population,

Oral steroids plus PPIs increase osteoporotic fracture risk in RA patients,

Denosumab favored over alendronate for BMD protection in glucocorticoid-induced osteoporosis,

Treatment sequence with romosozumab influences osteoporosis outcomes,

Must Reads in Vaccines

Vaccination for Prevention of Herpes Zoster, Ann Intern Med; ePub 2019 Feb 19; Prosser, et al

ACIP Updates Adult Immunization Schedule, Ann Intern Med; 2019 Feb 5; Kim, Hunter, et al

Influenza Vaccination Safety During Hospitalization, Mayo Clin Proc; ePub 2019 Jan 8; Tartof, et al

Acellular Pertussis Vaccine Is Safe & Effective, JAMA Pediatr; 2018 Nov; Wood, Nolan, et al

Influenza and Pertussis Vaccination in Pregnancy, Vaccine; ePub 2018 Nov 3; Wilcox, Bottrell, et al