In the Journals

Text message reminders improved malaria treatment adherence

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November 3, 2014

Text message reminders improved patient adherence to malaria treatment regimens, according to recently published data.

Julia R.G. Raifman, MS, of Harvard School of Public Health, and colleagues enrolled participants (n=1,140) in Tamale, Ghana, who recently had received malaria treatment into a text messaging program. Treatment group participants either were sent periodic messages reminding them to take medication or the same message with an additional statement about completing the treatment. Self-reported completion of the artemisinin-based combination therapy regimen was the primary endpoint.

“When patients don’t complete their full medication regimen, diseases can develop resistance to treatment,” Raifman said in a press release. “With infectious diseases like malaria, drug-resistant diseases can spread to others.

“Even in the United States, studies show that about half of people don’t adhere to their medications. We’ve already begun to see resistance to artemisinin in Southeast Asia. It would be catastrophic if that became widespread and there was no effective treatment for the most deadly form of malaria.”

Treatment was completed by 61.5% of the control group, 66.4% of the simple text reminder group and 64.1% of the text group with the added informational message. A significant increase in adherence was seen in the simple text group (adjusted OR=1.45; 95% CI, 1.03-2.04), but not the group that received additional information (aOR=0.77; 95% CI, 0.5-1.2). The simple text reminder had the greatest impact among children, women, participants whose household heads had no education, those who received their treatment from private hospitals and those taking artesunate-amodiaquine. While receiving the informational text increased adherence among participants who obtained their treatment from pharmacies, it had the opposite effect among groups that benefited from the simple texts.

“The results of this study suggest that receiving a simple text message reminder can increase adherence to antimalarial treatment,” the investigators wrote. “Further research is needed to develop the most effective text message reminder content and frequency.”

Disclosure: The researchers report no relevant financial disclosures.

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