scholarly journals Assessing the acceptability of a text messaging service and smartphone app to support patient adherence to medications prescribed for high blood pressure: a pilot study.

2020 ◽  
Author(s):  
Aikaterini Kassavou ◽  
Charlotte A Court ◽  
Jagmohan Chauhan ◽  
James Brimicombe ◽  
Debbi Bhattacharya ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Text Messaging ◽  
Patient Adherence ◽  
Text Message ◽  
Drop Out ◽  
Smartphone App ◽  
Delivery Mode ◽  
Log Files ◽  
Intervention Content

Abstract Aims and objectives. This paper describes the pilot study of a highly tailored text message and smartphone app intervention to increase adherence to anti-hypertensive medication in primary care. The aim of this study was to evaluate the acceptability of the intervention and obtain patients views about the intervention content, the delivery mode, and the mechanisms by which the intervention supported medication adherence. Methods. Patients diagnosed with hypertension were invited to the study via general practice text message invitation and recruited face to face by the researcher team. Participants tested the text message intervention for 28 or the text message followed by the app for 56 days. Participants completed baseline and follow up questionnaires and took part in a weekly or end of intervention telephone interviews. Digital log files captured patients’ usage of the intervention. Participant transcripts were analysed using thematic analysis. Descriptive statistics were used to summarize data from questionnaires and log files. A mixed methods analysis generated data to respond to the research questions. Results. 79 patients expressed their interest to participate in this study and 23 of these patients were recruited to take part. With one drop-out, 22 participants tested the text message delivery mode (with 20 being interviewed) and four requested to switch to the app (with 3 being interviewed). All participants used and engaged with the text message and app notifications, and most participants found the intervention content and delivery mode acceptable. They also self-reported that the intervention supported them to take their medications as prescribed. Conclusion. This study provides evidence that the digital intervention is acceptable by hypertensive patients recruited in primary care, thus it should be tested for its effectiveness using rigorous research methods. ISRCTN12805654 https://doi.org/10.1186/ISRCTN12805654

scholarly journals Assessing the acceptability of a text messaging service and smartphone app to support patient adherence to medications prescribed for high blood pressure: a pilot study.

2020 ◽  
Author(s):  
Aikaterini Kassavou ◽  
Charlotte A Court ◽  
Jagmohan Chauhan ◽  
James Brimicombe ◽  
Debbi Bhattacharya ◽  
...  
Keyword(s):  
Primary Care ◽  
Text Messaging ◽  
Text Message ◽  
Text Messages ◽  
Controlled Study ◽  
Future Research ◽  
Smartphone App ◽  
Delivery Mode ◽  
Log Files ◽  
Intervention Content

Abstract Aims and objectives. This paper describes a pilot non-randomised controlled study of a highly tailored 56-days text message and smartphone app prototype intervention to increase adherence to anti-hypertensive medication in primary care. The aim of this study was to evaluate the acceptability of the intervention and obtain patients views about the intervention content, delivery mode, and the mechanisms by which the intervention supported medication adherence. Methods. Patients diagnosed with hypertension were invited to the study via general practice text messages and were recruited face to face by the researcher team. Participants were asked to test the text message intervention for 28 consecutive days and switch to the smartphone app for 28 more days. Participants completed baseline and follow up questionnaires and took part in semi-structured telephone interviews. Digital log files captured patients’ usage of the intervention. Participant transcripts were analysed using thematic analysis. Descriptive statistics were used to summarize data from questionnaires and log files. A mixed methods analysis generated data to respond to the research questions. Results. 79 patients expressed interest to participate in this study, of whom 23 (64% male, 82% above 60 years old) were recruited to take part. With one drop-out, 22 participants tested the text message delivery mode (with 20 being interviewed) and four of them (17%) switched to the app (with 3 being interviewed). All participants engaged and interacted with the text message and app notifications, and most participants found the intervention content and delivery mode acceptable. They also self-reported that the interactive elements of the intervention motivated them to take their medications as prescribed. Conclusion. This study provides evidence that the digital intervention is acceptable by hypertensive patients recruited in primary care. Future research could usefully investigate its feasibility and effectiveness using rigorous research methods.

scholarly journals Assessing the acceptability of a text messaging service and smartphone app to support patient adherence to medications prescribed for high blood pressure: a pilot study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Aikaterini Kassavou ◽  
Charlotte Emily A’Court ◽  
Jagmohan Chauhan ◽  
James David Brimicombe ◽  
Debi Bhattacharya ◽  
...  
Keyword(s):  
Primary Care ◽  
Text Messaging ◽  
Patient Adherence ◽  
Text Messages ◽  
Controlled Study ◽  
Future Research ◽  
Smartphone App ◽  
Delivery Mode ◽  
Log Files ◽  
Intervention Content

Abstract Aims and objectives This paper describes a pilot non-randomised controlled study of a highly tailored 56-day text messaging and smartphone app prototype intervention to increase adherence to anti-hypertensive medication in primary care. The aim of this study was to evaluate the acceptability of the intervention and obtain patients’ views about the intervention content, the delivery mode, and the mechanisms by which the intervention supported medication adherence. Methods Patients diagnosed with hypertension were invited and recruited to the study via general practice text messages and attended a face to face meeting with a member of the researcher team. Participants were asked to test the text messaging intervention for 28 consecutive days and switch to the smartphone app for 28 more days. Participants completed baseline and follow-up questionnaires and took part in semi-structured telephone interviews. Digital log files captured patients’ engagement with the intervention. Participant transcripts were analysed using thematic analysis. Descriptive statistics were used to summarise data from questionnaires and log files. A mixed methods analysis generated data to respond to the research questions. Results Seventy-nine patients expressed interest to participate in this study, of whom 23 (64% male, 82% above 60 years old) were registered to take part. With one drop-out, 22 participants tested the text messaging delivery mode (with 20 being interviewed) and four of them (17%) switched to the app (with 3 being interviewed). All participants engaged and interacted with the text messages and app notifications, and all participants found the intervention content and delivery mode acceptable. They also self-reported that the interactive elements of the intervention motivated them to take their medications as prescribed. Conclusion This study provides evidence that the digital intervention is acceptable by hypertensive patients recruited in primary care. Future research could usefully investigate its feasibility and effectiveness using rigorous research methods. Trial registration ISRCTN12805654

scholarly journals Assessing the acceptability of a text messaging service and smartphone app to support patient adherence to medications prescribed for high blood pressure: a pilot study.

2020 ◽  
Author(s):  
Aikaterini Kassavou ◽  
Charlotte A Court ◽  
Jagmohan Chauhan ◽  
James Brimicombe ◽  
Debbi Bhattacharya ◽  
...  
Keyword(s):  
Primary Care ◽  
Text Messaging ◽  
Text Message ◽  
Text Messages ◽  
Controlled Study ◽  
Future Research ◽  
Smartphone App ◽  
Delivery Mode ◽  
Log Files ◽  
Intervention Content

Abstract Aims and objectives. This paper describes the a pilot non-randomised controlled study of a highly tailored 56-days text message and smartphone app prototype intervention to increase adherence to anti-hypertensive medication in primary care. The aim of this study was to evaluate the acceptability of the intervention and obtain patients views about the intervention content, the delivery mode, and the mechanisms by which the intervention supported medication adherence. Methods. Patients diagnosed with hypertension were invited to the study via general practice text messages invitation and were recruited face to face by the researcher team. Participants were asked to tested the text message intervention for 28 consecutive days and switch to or the text message followed by the smartphone app for 56 28 more days. Participants completed baseline and follow up questionnaires and took part in a semi-structured weekly or end of intervention telephone interviews. Digital log files captured patients’ usage of the intervention. Participant transcripts were analysed using thematic analysis. Descriptive statistics were used to summarize data from questionnaires and log files. A mixed methods analysis generated data to respond to the research questions. Results. 79 patients expressed their interest to participate in this study, of whom and 23 (64% male, 82% above 60 years old) of these patients were recruited to take part. With one drop-out, 22 participants tested the text message delivery mode (with 20 being interviewed) and four of them (17%) requested to switched to the app (with 3 being interviewed). All participants used and engaged and interacted with the text message and app notifications, and most participants found the intervention content and delivery mode acceptable. They also self-reported that the interactive elements of the intervention supported motivated them to take their medications as prescribed. Conclusion. This study provides evidence that the digital intervention is acceptable by hypertensive patients recruited in primary care. Future research could usefully, thus it should investigatebe its tested for its feasibility and effectiveness using rigorous research methods.

scholarly journals Assessing the acceptability of a text messaging service and smartphone app to support patient adherence to medications prescribed for high blood pressure: a pilot study.

2020 ◽  
Author(s):  
Aikaterini Kassavou ◽  
Charlotte A Court ◽  
Jagmohan Chauhan ◽  
James Brimicombe ◽  
Debbi Bhattacharya ◽  
...  
Keyword(s):  
Primary Care ◽  
Text Messaging ◽  
Text Message ◽  
Text Messages ◽  
Controlled Study ◽  
Future Research ◽  
Smartphone App ◽  
Delivery Mode ◽  
Log Files ◽  
Intervention Content

Abstract Aims and objectives. This paper describes a pilot non-randomised controlled study of a highly tailored 56-days text message and smartphone app prototype intervention to increase adherence to anti-hypertensive medication in primary care. The aim of this study was to evaluate the acceptability of the intervention and obtain patients views about the intervention content, delivery mode, and the mechanisms by which the intervention supported medication adherence. Methods. Patients diagnosed with hypertension were invited to the study via general practice text messages and were recruited face to face by the researcher team. Participants were asked to test the text message intervention for 28 consecutive days and switch to the smartphone app for 28 more days. Participants completed baseline and follow up questionnaires and took part in semi-structured telephone interviews. Digital log files captured patients’ usage of the intervention. Participant transcripts were analysed using thematic analysis. Descriptive statistics were used to summarize data from questionnaires and log files. A mixed methods analysis generated data to respond to the research questions. Results. 79 patients expressed interest to participate in this study, of whom 23 (64% male, 82% above 60 years old) were recruited to take part. With one drop-out, 22 participants tested the text message delivery mode (with 20 being interviewed) and four of them (17%) switched to the app (with 3 being interviewed). All participants engaged and interacted with the text message and app notifications, and most participants found the intervention content and delivery mode acceptable. They also self-reported that the interactive elements of the intervention motivated them to take their medications as prescribed. Conclusion. This study provides evidence that the digital intervention is acceptable by hypertensive patients recruited in primary care. Future research could usefully investigate its feasibility and effectiveness using rigorous research methods.

scholarly journals Correction to: Assessing the acceptability of a text messaging service and smartphone app to support patient adherence to medications prescribed for high blood pressure: a pilot study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Aikaterini Kassavou ◽  
Charlotte Emily A’Court ◽  
Jagmohan Chauhan ◽  
James David Brimicombe ◽  
Debi Bhattacharya ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pilot Study ◽  
High Blood Pressure ◽  
Text Messaging ◽  
Patient Adherence ◽  
Smartphone App

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals A Mobile Health Intervention for Adolescents Exposed to Secondhand Smoke: Pilot Feasibility and Efficacy Study

10.2196/18583 ◽  
2020 ◽  
Vol 4 (8) ◽  
pp. e18583
Author(s):  
Natalie Nardone ◽  
Jeremy Giberson ◽  
Judith J Prochaska ◽  
Shonul Jain ◽  
Neal L Benowitz
Keyword(s):  
Pilot Study ◽  
Mobile Health ◽  
Secondhand Smoke ◽  
Text Messaging ◽  
Text Message ◽  
Preliminary Evidence ◽  
Text Messages ◽  
Urinary Cotinine ◽  
Mhealth Intervention ◽  
Shs Exposure

Background Secondhand smoke (SHS) exposure in children and adolescents has adverse health effects. For adolescents of lower socioeconomic status (SES), exposure is widespread, evidenced in the measurement of urinary cotinine, a major metabolite of nicotine. Direct intervention with exposed children has been proposed as a novel method, yet there is minimal evidence of its efficacy. Combining this approach with a mobile health (mHealth) intervention may be more time and cost-effective and feasible for adolescent populations. Objective In this pilot study, we assessed the feasibility and preliminary evidence of efficacy of a 30-day text message–based mHealth intervention targeted at reducing SHS exposure in adolescent populations of low SES. Methods For the study, 14 nonsmoking and nonvaping participants between the ages of 12-21 years exposed to SHS were enrolled. The intervention consisted of a daily text message sent to the participants over the course of a month. Text message types included facts and information about SHS, behavioral methods for SHS avoidance, or true-or-false questions. Participants were asked to respond to each message within 24 hours as confirmation of receipt. Feasibility outcomes included completion of the 30-day intervention, receiving and responding to text messages, and feedback on the messages. Efficacy outcomes included a reduction in urinary cotinine, accuracy of true-or-false responses, and participants’ perceptions of effectiveness. Results Of the 14 participants that were enrolled, 13 completed the intervention. Though not required, all participants had their own cell phones with unlimited text messaging plans. Of the total number of text messages sent to the 13 completers, 91% (372/407) of them received on-time responses. Participant feedback was generally positive, with most requesting more informational and true-or-false questions. In terms of efficacy, 54% (6/11) of participants reduced their cotinine levels (however, change for the group overall was not statistically significant (P=.33) and 45% (5/11) of participants increased their cotinine levels. Of the total number of true-or-false questions sent across all completers, 77% (56/73) were answered correctly. Participants’ ratings of message effectiveness averaged 85 on a scale of 100. Conclusions In this pilot study, the intervention was feasible as the majority of participants had access to a cell phone, completed the study, and engaged by responding to the messages. The efficacy of the study requires further replication, as only half of the participants reduced their cotinine levels. However, participants answered the majority of true-or-false questions accurately and reported that the messages were helpful.

scholarly journals Development and piloting of a highly tailored text and voice messaging intervention to support adherence to antihypertensive medications within the primary care setting (Preprint)

2017 ◽  
Author(s):  
Aikaterini Kassavou ◽  
Vikki Houghton ◽  
Simon Edwards ◽  
James Brimicombe ◽  
Stephen Sutton
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Service Providers ◽  
Delivery Mode ◽  
Care Providers ◽  
Intervention Content ◽  
Systematic Development ◽  
Voice Message ◽  
Meta Analyses

BACKGROUND Tailored automated text and voice message interventions are effective ways to increase adherence to medications. OBJECTIVE This paper describes the systematic development and piloting of a highly tailored text and voice message intervention to increase adherence to medications within primary care. METHODS Following the MRC guidance this paper describes: a) the systematic development of the theoretical framework and tailored intervention content, based on review of theories and meta-analyses of effectiveness (n=2 meta-analyses with meta-regression); b) the systematic development of the intervention delivery mode, intervention content and implementation procedures, based on consultations with telecommunication experts (n=6 experts, including industry, academics, and university service providers), face-to-face interviews using think aloud protocols (n=19 patients and n=5 health care providers), experiential focus groups (n=12 patients), stakeholders’ consultations (n=7 stakeholders, including commissioners, health care providers, and patients), systematic reviews (n=2 reviews), and PPI input (n=100 PPI members); and c) the piloting of the intervention, based on a one-month pre-post study (n=17 patients). The mixed methods analysis combined findings from the parallel studies complementarily. The target population that informed the intervention were adults above 40 years old, with a primary diagnosis of hypertension, taking multiple medications, presumed to be non-adherent to their medications, and attending primary care settings within different areas of deprivation in the East of England. RESULTS Intervention development suggested the target behaviour of the intervention to be the tablets taken at a regular time of the day. It also suggested the delivery of both INA and NINA messages and their interchange during a prescription-based month, but INA messages to be less frequent than NINA messages. It also suggested that participants could be more receptive to intervention content when they initiate medication taking or they change prescription plan. Intervention piloting suggested that the intervention is acceptable and feasible. It also suggested high intervention engagement with, and fidelity of, the intervention content, which included Behaviour Change Techniques (BCTs). The final version of the intervention aims to increase adherence to daily prescribed oral medications, is delivered using text and voice messages, and includes a combination of nine BCTs (e.g., implementation intentions, information about health consequences), is highly tailored to patients’ beliefs (e.g., beliefs about medications, self-efficacy, social norms, perceived regimens complexity), and prescription plan. During the intervention, patients can select between two BCTs to maintain medication taking (e.g., habit formation or self-monitoring). CONCLUSIONS This paper describes a theory and evidence based intervention that aims to support adherence to high blood pressure medications, as an adjunct to primary care consultations, and it is currently evaluated in a randomised controlled trial. CLINICALTRIAL ISRCTN10668149 DOI 10.1186/ISRCTN10668149.

scholarly journals Text Message Medication Adherence Reminders Automated and Delivered at Scale Across Two Institutions: Testing the Nudge System: Pilot Study

2021 ◽  
Author(s):  
Phat Luong ◽  
Thomas J. Glorioso ◽  
Gary K. Grunwald ◽  
Pamela Peterson ◽  
Larry A. Allen ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Pilot Study ◽  
Phase I ◽  
Phase Ii ◽  
Text Messaging ◽  
Care Delivery ◽  
Text Message ◽  
Text Messages ◽  
Medication Refill ◽  
The Impact

Background: Medication refill behavior in patients with cardiovascular diseases is suboptimal. Brief behavioral interventions called Nudges may impact medication refill behavior and can be delivered at scale to patients using text messaging. Methods: Patients who were prescribed and filled at least one medication for hypertension, hyperlipidemia, diabetes, atrial fibrillation, and coronary artery disease were identified for the pilot study. Patients eligible for the pilot (N=400) were enrolled with an opportunity to opt out. In phase I of the pilot, we tested text message delivery to 60 patients. In phase II, we tested intervention feasibility by identifying those with refill gap of ≥7 days and randomized them to intervention or control arms. Patients were texted Nudges and assessed whether they refilled their medications. Results: Of 400 patients sent study invitations, 56 (14%) opted out. In phase I, we successfully delivered text messages to 58 of 60 patients and captured patient responses via text. In phase II, 207 of 286 (72.4%) patients had a medication gap ≥7 days for one or more cardiovascular medications and were randomized to intervention or control. Enrolled patients averaged 61.7 years old, were primarily male (69.1%) and White (72.5%) with hypertension being the most prevalent qualifying condition (78.7%). There was a trend towards intervention patients being more likely to refill at least 1 gapping medication (30.6% versus 18.0%; P =0.12) and all gapping medications (17.8% versus 10.0%; P =0.27). Conclusions: It is possible to set up automated processes within health care delivery systems to identify patients with gaps in medication adherence and send Nudges to facilitate medication refills. Text message Nudges could potentially be a feasible and effective method to facilitate medication refills. A large multi-site randomized trial to determine the impact of text-based Nudges on overall CVD morbidity and mortality is now underway to explore this further. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03973931.

Implementation of a text message intervention to promote behavioural change and weight loss among overweight and obese Brazilian primary care patients

2018 ◽  
Vol 25 (8) ◽  
pp. 476-483 ◽  
Author(s):  
Lorenn L Gusmão ◽  
Antonio L Ribeiro ◽  
Maíra Viana Rego Souza-Silva ◽  
Paulo R Gomes ◽  
Alline M Beleigoli ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Pilot Study ◽  
Behavioural Change ◽  
Text Message ◽  
Text Messages ◽  
Wilcoxon Test ◽  
Message Delivery ◽  
Belo Horizonte ◽  
Text Message Intervention

Introduction Mobile-technology-based interventions are promising strategies for promoting behavioural change in obese patients. The aims of this study were to evaluate the feasibility of implementing a text message intervention, and to assess the effects of the intervention on body mass index (BMI) and self-reported behavioural change. Methods TELEFIT was a three-phase feasibility study comprising the following stages: (a) the development of text messages; (b) testing; and (c) a quasi-experimental pilot study in which patients who were engaged in obesity/overweight educational groups in public primary care centres in Belo Horizonte, Brazil, were recruited. A bank of text messages was drafted and reviewed by an expert panel, text message delivery software was developed and tested, and a pilot study assessed patients before and after receiving the intervention using validated questionnaires and body measures. The data were analysed using the Wilcoxon test. Results A total of 46 patients completed the follow-up; 93.5% were women and the median age was 42 years (interquartile range (IQR) 34–52 years). At four months, participants had a significant reduction in BMI (median 31.3 (IQR 28.2–34.6) vs. 29.9 (IQR 27.2–34.6) kg/m2, p < 0.001), systolic (median 125 (IQR 120–132) vs. 120 (IQR 110–130) mmHg, p = 0.013) and diastolic blood pressure (median 80 (IQR 70–100) vs. 80 (IQR 70–80) mmHg, p = 0.006), when compared to baseline. All patients reported to be satisfied and willing to continue receiving the intervention, and 93.3% felt that the intervention helped them change their behaviours. Discussion This study has shown that a text message intervention to promote behavioural change and weight loss was feasible and effective in a short-term period. Participants were satisfied and willing to continue receiving the SMS messages.

scholarly journals Combining Real-Time Ratings With Qualitative Interviews to Develop a Smoking Cessation Text Messaging Program for Primary Care Patients (Preprint)

2018 ◽  
Author(s):  
Gina Kruse ◽  
Elyse R Park ◽  
Naysha N Shahid ◽  
Lorien Abroms ◽  
Jessica E Haberer ◽  
...  
Keyword(s):  
Primary Care ◽  
Real Time ◽  
Text Messaging ◽  
Qualitative Interviews ◽  
Text Message ◽  
Intervention Development ◽  
Text Messages ◽  
Behavioral Skills ◽  
Message Service ◽  
Primary Care Patients

BACKGROUND Text messaging (short message service, SMS) interventions show promise as a way to help cigarette smokers quit. Few studies have examined the effectiveness of text messaging (SMS) programs targeting smokers associated with primary care or hospital settings. OBJECTIVE This study aimed to develop a text messaging (SMS) program targeting primary care smokers. METHODS Adult smokers in primary care were recruited from February 2017 to April 2017. We sent patients 10 to 11 draft text messages (SMS) over 2 days and asked them to rate each message in real time. Patients were interviewed daily by telephone to discuss ratings, message preferences, and previous experiences with nicotine replacement therapy (NRT). Content analysis of interviews was directed by a step-wise text messaging (SMS) intervention development process and the Information-Motivation-Behavioral Skills model of medication adherence. RESULTS We sent 149 text messages (SMS) to 15 patients. They replied with ratings for 93% (139/149) of the messages: 134 (96%, 134/139) were rated as clear or useful and 5 (4%, 5/139) as unclear or not useful. Patients’ preferences included the addition of graphics, electronic cigarette (e-cigarette) content, and use of first names. Regarding NRT, patients identified informational gaps around safety and effectiveness, preferred positively framed motivational messages, and needed behavioral skills to dose and dispose of NRT. CONCLUSIONS Patients recommended text message (SMS) personalization, inclusion of e-cigarette information and graphics, and identified barriers to NRT use. Combining real-time ratings with telephone interviews is a feasible method for incorporating primary care patients’ preferences into a behavioral text messaging (SMS) program.

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