The Effectiveness of Short Term Mobile Phone Text Reminders in Improving Compliance among Hypertensive Patients
- Jung Ah Lee1, Woo Sang Kim1, Moon Jung Bae1, Young-Sik Kim1,, Han Jin Oh2, Sang Yeoup Lee3, Chul-Min Kim4, Dong Hyeok Shin5, Seong-Ho Han6, Kyung-Hwan Cho7
- Received March 18, 2014 Accepted March 28, 2014
- ABSTRACT
-
- Background
- For the effective management of hypertension, drug adherence and life style modification are important. We investigated the effects of mobile phone text‐message reminders on compliance and life style modification in patients with hypertension.
- Methods
- The study was performed at family medicine outpatient clinics at 15 hospitals in South Korea from July 2008 to June 2010. Study subjects included 1,449 patients who were all prescribed candesartan cilexetil. Patients were randomly divided into two groups‐ mobile phone text‐message reminder group and control group. In the reminder group, contents of text messages were recommendations for antihypertensive adherence, exercise, low salt diet, and reduction of weight and alcohol. In the control group, the date of next visit was sent at 10 week. Mobile phone text-messages were sent at 2, 4, 6, 8 and 10 weeks by the coordinating center. Thereafter, they were followed up for 12 weeks. Chi-square test was performed to compare compliance and performance indexes of the two groups.
- Results
- The reminder group had 719 (49.6%) patients vs. 730 (50.4%) patients in the control group. Attendance rate were 92.8% for the reminder group and 94.7% for the control group (P=0.14). 94.7% of the reminder group and 94.0% of the control group took their medication regularly (P=0.59). The target blood pressure was attained in 75.8% of the reminder group and 75.4% of the control group (P=0.87). Similarly, rates of weight loss, decreased alcohol use, increased physical activity and a low salt diet showed no significant differences between the two groups.
- Conclusions
- In our study, mobile phone text reminders did not show to have any significant positive effect on the management of hypertension.
Table 1–1.
Baseline characteristics of the subjectsa
| Variables | Text message reminder (n=719) | Control (n=730) | Pb |
|---|---|---|---|
| Sex | |||
| Man | 309 (43.0) | 296 (40.4) | 0.350 |
| Woman | 410 (57.0) | 434 (59.4) | |
| Age, y | 59.7±10.7 | 58.7±10.3 | 0.100 |
| <50 | 135 (18.8) | 127 (17.4) | 0.100 |
| 50–59 | 213 (29.6) | 256 (35.1) | |
| 60–69 | 241 (33.5) | 240 (32.9) | |
| ≥70 | 130 (18.1) | 107 (14.6) | |
| Monthly income, million Korean Won | |||
| <200 | 170 (25.8) | 141 (21.4) | 0.170 |
| 200–399 | 204 (30.9) | 219 (33.2) | |
| ≥400 | 286 (43.3) | 299 (45.4) | |
| Education, y | |||
| <12 12 | 188 (27.5) 263 (38.4) | 183 (26.2) 276 (39.5) | 0.850 |
| >12 | 233 (34.1) | 239 (34.3) | |
| Marital status | |||
| Married | 585 (84.1) | 612 (86.2) | 0.260 |
| Not married | 111 (15.9) | 98 (13.8) | |
| Smoking | |||
| None-smoker | 473 (66.4) | 463 (64.3) | 0.310 |
| Ex-smoker | 145 (20.4) | 170 (23.6) | |
| Smoker | 94 (13.2) | 87 (12.1) | |
| Alcohol use | |||
| None-drinker | 438 (62.5) | 454 (63.9) | 0.570 |
| Drinker | 263 (37.5) | 256 (36.1) | |
| Degree of physical activity | |||
| Inactive | 280 (40.1) | 312 (43.8) | 0.240 |
| Minimally active | 269 (38.5) | 270 (37.9) | |
| Health enhancing (vigorous) | 149 (21.4) | 130 (18.3) | |
| Body mass index, kg/m2 | 25.5±3.4 | 25.3±5.5 | 0.420 |
| Blood pressure, mmHg | |||
| <140 and <90 | 294 (42.9) | 305 (43.9) | 0.720 |
| ≥140 or ≥90 | 391 (57.1) | 390 (56.1) | |
| Habit of salt intake | |||
| Normal intake | 398 (55.7) | 405 (56.3) | 0.850 |
| High intake | 316 (44.3) | 315 (43.7) | |
Table 1–2.
Baseline characteristics of the subjectsa
| Variables | Text message reminder (n=719) | Control (n=730) | Pb |
|---|---|---|---|
| Family history of disease | |||
| Hypertension | 330 (47.7) | 326 (46.4) | 0.620 |
| Diabetes mellitus | 150 (21.7) | 149 (21.2) | 0.840 |
| Stroke | 128 (18.5) | 139 (19.8) | 0.540 |
| Heart disease | 79 (11.4) | 90 (12.8) | 0.430 |
| Comorbidity | 398 (58.2) | 385 (55.6) | 0.320 |
| Diabetes mellitus | 155 (22.7) | 138 (20.0) | 0.220 |
| Hyperlipidemia | 335 (49.2) | 323 (47.0) | 0.410 |
| Heart disease | 14 (2.1) | 11 (1.6) | 0.530 |
| Cerebrovascular disease | 13 (1.9) | 12 (1.7) | 0.820 |
| History of having taken antihypertensive agents | |||
| Yes | 480 (68.0) | 474 (65.5) | 0.300 |
| No | 226 (32.0) | 250 (34.5) | |
| Concurrently prescribed medication | 496 (72.3) | 499 (72.2) | 0.970 |
| Antihypertensive agents taking with candesartan cilexetil | 264 (38.5) | 253 (36.7) | 0.470 |
| Antidiabetic agents | 143 (20.9) | 127 (18.4) | 0.250 |
| Serum lipid lowering agents | 338 (49.3) | 310 (44.9) | 0.100 |
| Antiplatelet agents | 161 (23.5) | 177 (25.7) | 0.360 |
| Other cardiovascular medications | 10 (1.5) | 5 (0.7) | 0.190 |
Table 2.
Comparison of compliance and performance index between mobile phone text-message reminder group and control groupa
| Variables | Text message reminder (n=719) | Control (n=730) | Pb |
|---|---|---|---|
| Attendance | |||
| Yes | 605 (92.8) | 631 (94.7) | 0.140 |
| No | 47 (7.2) | 35 (5.3) | |
| Drug adherence | |||
| ≥80% | 612 (94.7) | 616 (94.0) | 0.590 |
| <80% | 34 (5.3) | 39 (6.0) | |
| Controlled blood pressurec | |||
| Yes | 500 (75.8) | 508 (75.4) | 0.870 |
| No | 160 (24.2) | 166 (24.6) | |
| Weight lossd | |||
| Yes | 40 (6.6) | 43 (6.9) | 0.800 |
| No | 568 (93.4) | 576 (93.1) | |
| Reduced alcohol usee | |||
| Yes | 68 (11.1) | 68 (11.0) | 0.940 |
| No | 542 (88.9) | 550 (89.0) | |
| Increased regular exercisee | |||
| Yes | 123 (18.8) | 117 (17.5) | 0.550 |
| No | 531 (81.2) | 550 (82.5) | |
| Reduced dietary sodium intakee | |||
| Yes | 219 (33.4) | 205 (30.8) | 0.300 |
| No | 430 (65.7) | 459 (68.9) |
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