Abstract
Aims and objectivesThis 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.MethodsPatients 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.ResultsSeventy-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.ConclusionThis 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 registrationISRCTN12805654
Highlights
In England, over 12.5 million people are diagnosed with hypertension [1]
This study provides evidence that the digital intervention is acceptable by hypertensive patients recruited in primary care
The acceptability of a digital intervention, combining text messaging service with a smartphone app, to support medication adherence in patients with hypertension in the UK primary care, has not been evaluated. This pilot study proved that the digital intervention is acceptable among patients with hypertension, and it recommended that an interactive intervention to enable patients track health-related behaviours might be the way forward to provide personalised and highly tailored advice and support for adherence in primary care
Summary
In England, over 12.5 million people are diagnosed with hypertension (high blood pressure) [1]. A recent meta-analysis showed that 41% of people do not adhere adequately to antihypertensive medications, i.e. they take less than 80% of their prescribed tablets [4]. Questions to assess participants’ experiences using the digital intervention. Did the digital intervention help you to take your medications as prescribed?. What did you like most about the digital intervention? How often would you estimate you do not take your medications as prescribed? Did you find any faults in the text messaging service?. Do you have any suggestions for improvements regarding any features in the text messaging service?. How easy was it to reply to the Q&A style questions on the digital intervention?. In what way? If no, can you elaborate on the reasons? What did you like most about the digital intervention? Do you ever forget to take your medication or alter the dose? If yes, which medications? If yes, how often would you estimate you do not take your medications as prescribed? What might be the reasons for this? What did you find difficult about the digital intervention? How did you find the content of the reminder messages? Did you like the personalisation of the text messages? E.g. name.
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