Text messaging may be effective for treatment adherence, study finds

Daily text-message reminders appear to increase patient adherence to recommendations from physicians, at least when it comes to sunscreen use, according to a report in the Archives of Dermatology.

April W. Armstrong, MD, of the University of California–Davis Health System, Sacramento, and colleagues assessed effectiveness of receiving daily text-message reminders to wear sunscreen over a six-week period. Seventy patients aged at least 18 years participated in the study and were asked to apply sunscreen daily. Half were randomly assigned to receive text-message reminders, and the other half did not receive any reminders. The text messages consisted of two components: a message detailing daily local weather information, and a message reminding users to apply sunscreen. Adherence was assessed through electronic adherence monitors adapted to participants’ sunscreen tubes, which would send electronic messages to a central station every time the cap of a tube was removed.

“At the end of the 42-day (six-week) study period, the control group had a mean adherence of 12.6 days of sunscreen application, which corresponded to a 30 percent daily adherence rate. In comparison, the group that received daily reminder messages had a mean adherence of 23.6 days and a daily adherence rate of 56.1 percent,” the investigators wrote. Twenty-four (69 percent) of the participants in the reminder group reported that they would continue to use the text-message reminders after the study, and 31 (89 percent) said they would recommend the reminder system to others. No significant demographic factors predicted adherence.

“The short-term results of our study suggest that cellular telephone text-message reminders are a low-cost, scalable, and effective method of bridging this knowledge-action gap,” the researchers concluded. “Introduction of a program that incorporates text-message reminders to a large population may be an innovative preventive health measure against the development of skin cancer.”