A Pilot Study of a Text Messaging Intervention to Modify Illness and Medication Beliefs Among Patients Diagnosed with Inflammatory Bowel Disease

Abstract

Intentional and unintentional medication non-adherence is a particular challenge for patients with inflammatory bowel disease (IBD). Non-adherence can affect patients’ quality of life, which can result in unfavorable treatment outcomes, more hospitalizations, and higher healthcare-related costs. The purpose of this study was to assess whether a tailored text message intervention designed to modify illness and medication adherence beliefs in patients with IBD would increase treatment compliance and change patients’ illness perceptions and medication concerns. This pilot study utilized a pre-test-post-test non-randomized design. A sample of 32 IBD patients was recruited within the UK. Participants’ medication beliefs and illness perception scores determined the set of tailored daily text messages, which were sent to patients over duration of 12 weeks. Medication adherence increased post-intervention, as “forgetting to take medication” decreased while “never” forgetting to take medication increased over time. A significant increase in treatment control and coherence and a decreased level of concern surrounding their condition was evident. Participants’ level of concern towards their medications changed during the 12 weeks, with a baseline mean concern score of 3.08 (.57) in comparison to the 12 weeks mean concern score of 2.89 (.59), which is statistically different, t (31) = 2.16, p < .038, r = .36 (medium effect). Sixty-six percent of participants from the baseline were aware of the necessity of their medication: “without my medication I would become ill.” The results have direct implications for improving medication adherence and changing illness and medication beliefs. This study validated the benefits of text messages and highlighted the importance of addressing these beliefs in order to understand the reasons for non-adherence fully.