The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature
- Marcia Vervloet1,
- Annemiek J Linn2,
- Julia C M van Weert2,
- Dinny H de Bakker1,3,
- Marcel L Bouvy4,
- Liset van Dijk1
- 1NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- 2Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
- 3Tranzo, Scientific Centre for Care and Welfare, Tilburg University, Tilburg, The Netherlands
- 4Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands
- Correspondence to Marcia Vervloet, NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands;
- Received 2 December 2011
- Accepted 13 March 2012
- Published Online First 25 April 2012
Background Many patients experience difficulties in adhering to long-term treatment. Although patients' reasons for not being adherent are diverse, one of the most commonly reported barriers is forgetfulness. Reminding patients to take their medication may provide a solution. Electronic reminders (automatically sent reminders without personal contact between the healthcare provider and patient) are now increasingly being used in the effort to improve adherence.
Objective To examine the effectiveness of interventions using electronic reminders in improving patients' adherence to chronic medication.
Methods A comprehensive literature search was conducted in PubMed, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials. Electronic searches were supplemented by manual searching of reference lists and reviews. Two reviewers independently screened all citations. Full text was obtained from selected citations and screened for final inclusion. The methodological quality of studies was assessed.
Results Thirteen studies met the inclusion criteria. Four studies evaluated short message service (SMS) reminders, seven audiovisual reminders from electronic reminder devices (ERD), and two pager messages. Best evidence synthesis revealed evidence for the effectiveness of electronic reminders, provided by eight (four high, four low quality) studies showing significant effects on patients' adherence, seven of which measured short-term effects (follow-up period <6 months). Improved adherence was found in all but one study using SMS reminders, four studies using ERD and one pager intervention. In addition, one high quality study using an ERD found subgroup effects.
Conclusion This review provides evidence for the short-term effectiveness of electronic reminders, especially SMS reminders. However, long-term effects remain unclear.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.