Making it Easier for Patients to Help Themselves

Text messages could hasten tuberculosis drug compliance
Original source: The Lancet Volume 373, Issue 9657
Authors: Eliza Barclay
Publication date: 3 January 2009
DOI (digital document ID): 10.1016/S0140-6736(08)61938-8
Requires subscription? No
Publicly-available abstract: No

Synopsis:
The use of SMS (Short Message System) technology is examined as an option for improving patient compliance in terms of taking pills for the treatment of tuberculosis. Techniques examined include text messages to cellphones with follow-ups if the patients do not respond to the messages, pill bottles with SIM cards that alert a central server when the bottle has been opened (ostensibly for the patient to take the medication), asking patients to speed-dial a special cellphone number after taking their medication, or asking patients to text back a code from a post-medication urine test. The use of financial and other incentives to follow the regimen is also discussed.

Reliability:
The compliance techniques are currently being investigated. The letter does not address the possibility of false compliance (response to the message without taking the medication; opening the pill bottle without removing a pill; speed-dialing the appropriate phone number without taking the medication).

Practical Applications:
While these techniques are being investigated for the management of tuberculosis patients in Africa, there are many people in industrialized nations who don't take their medications because they forget, or because they have not correctly processed a change in their medication regimens, or because they have so many medications that it is difficult to keep track of which one to take when. This is particularly, but not exclusively, true of elderly patients. There are also patients who don't correctly take their medications for economic reasons.

People with Type 2 diabetes, who are often on several medications in addition to those for glycemic control, fall into this category. In addition, many of us don't test as often as we should, or log our blood glucose readings reliably.

Some insurance companies and hospitals offer a reminder service where they phone these groups of patients to remind them to take their medications. The SMS techniques discussed in this letter may be useful either as adjuncts to the phone-reminder services, or as a new service where none currently exists.

This synopsis was based on the complete article.