Reminder Methods Research Articles

Adherence to antiretroviral treatment in HIV-positive patients in the Cameroon context: promoting the use of medication reminder methods.

Antiretroviral treatment (ART) scale-up in sub-Saharan Africa has made it possible to investigate the maintenance of adherence to HIV medications. We describe here adherence to ART and identify its correlates in the Cameroonian context. Prospective cohort study in 9 rural district hospitals. A mixed logistic regression model was used to identify factors associated with adherence to ART in 401 patients with data prospectively collected on adherence. Although 73% of patients were adherent after the first month on ART, this proportion decreased to 61% after 24 months. After adjustment for known factors of adherence to ART (such as knowledge, motivation and side-effects), patients who reported willingness to start ART before initiation, those who were satisfied with information provided by their physicians, and those who implemented reminder methods for ART intake {eg, using an alarm clock, mobile phone, or watch [odds ratio (95% confidence interval)] = 2.45 (1.58 to 3.79), but also the help of a relative to remind them or other methods} were more likely to be adherent to ART. Besides highlighting some correlates already known to have an impact on adherence to ART, our findings also underline the need to reinforce the counseling component of follow-up through innovative methods. Accordingly, training and implementation research should encourage the use of medication reminder methods, such as mobile phones, to assure adherence over time and improve long-term response to ART.

A systematic review of the effect of retention methods in population-based cohort studies

BackgroundLongitudinal studies are of aetiological and public health relevance but can be undermined by attrition. The aim of this paper was to identify effective retention strategies to increase participation in population-based cohort studies.MethodsSystematic review of the literature to identify prospective population-based cohort studies with health outcomes in which retention strategies had been evaluated.ResultsTwenty-eight studies published up to January 2011 were included. Eleven of which were randomized controlled trials of retention strategies (RCT). Fifty-seven percent of the studies were postal, 21% in-person, 14% telephone and 7% had mixed data collection methods. A total of 45 different retention strategies were used, categorised as 1) incentives, 2) reminder methods, repeat visits or repeat questionnaires, alternative modes of data collection or 3) other methods. Incentives were associated with an increase in retention rates, which improved with greater incentive value. Whether cash was the most effective incentive was not clear from studies that compared cash and gifts of similar value. The average increase in retention rate was 12% for reminder letters, 5% for reminder calls and 12% for repeat questionnaires. Ten studies used alternative data collection methods, mainly as a last resort. All postal studies offered telephone interviews to non-responders, which increased retention rates by 3%. Studies that used face-to-face interviews increased their retention rates by 24% by offering alternative locations and modes of data collection.ConclusionsIncentives boosted retention rates in prospective cohort studies. Other methods appeared to have a beneficial effect but there was a general lack of a systematic approach to their evaluation.

Medication Adherence in Successful Kidney Transplant Recipients

To explore the medication-taking behavior of successful kidney transplant recipients and determine what behaviors were common among this group. Open-ended interviews were conducted by telephone with 19 individuals who had successfully maintained a transplanted kidney for 25 years or more. Data were coded by using a grounded theory approach to explore patterns of phenomena, common descriptions, and relationships. Four themes emerged as participants described the behaviors they developed to adhere successfully to the immunosuppressive medication required for maintaining their transplanted kidneys. The themes were reminder methods, obtaining medications, maintaining routines, and problem-solving strategies. Kidney transplant recipients identified the importance of developing and maintaining medication-taking skills and routines on medication adherence. Problem-solving abilities were also valuable during times of disruption of normal routines. Interventions focusing on medication-taking skills, habit formation, and resources for problem solving may improve immunosuppressive medication adherence and clinical outcomes in kidney transplant recipients.

Use of SMS text messaging to improve outpatient attendance

To evaluate the effect of appointment reminders sent as short message service (SMS) text messages to patients' mobile telephones on attendance at outpatient clinics. Cohort study with historical control. Royal Children's Hospital, Melbourne, Victoria. Patients who gave a mobile telephone contact number and were scheduled to attend any of five outpatient clinics (dermatology, gastroenterology, general medicine, paediatric dentistry and plastic surgery) in September (trial group) or August (control group), 2004. Failure to attend (FTA) rate compared between the group sent a reminder and those who were not. 2151 patients were scheduled to attend a clinic in September; 1382 of these (64.2%) gave a mobile telephone contact number and were sent an SMS reminder (trial group). Corresponding numbers in the control group were 2276 scheduled to attend and 1482 (65.1%) who gave a mobile telephone number. The FTA rate for individual clinics was 12%-16% for the trial group, and 19%-39% for the control group. Overall FTA rate was significantly lower in the trial group than in the control group (14.2% v 23.4%; P < 0.001). The observed reduction in failure to attend rate was in line with that found using traditional reminder methods. The ease with which large numbers of messages can be customised and sent by SMS text messaging, along with its availability and comparatively low cost, suggest it may be a suitable means of improving patient attendance.

Strategies for increasing influenza vaccination rates among a high-risk cardiovascular population

Epidemics of influenza result in approximately 114,000 hospitalizations per year, as well as 10,000 to 40,000 deaths per year. Patients with cardiovascular disease risk factors are at increased risk for developing influenza, and at a higher risk for hospitalizations, complications, or death secondary to influenza virus. Ninety percent of deaths due to influenza occur in older adults, the majority of which have cardiovascular disease. Vaccination against influenza is the most effective means for reducing the effect of the influenza virus. Increasing vaccination rates in high-risk cardiovascular populations is essential. The purpose of this study is to evaluate the effectiveness of different strategies for increasing vaccination rates, specifically telephone versus mail reminder methods. Patients seen at the University of Mississippi Medical Center Hypertension Clinic, who have multiple cardiovascular disease risk factors, were randomized to one of three groups: telephone reminder, mail reminder, or control. A total of 1546 patients were randomized. Of the total number of patients recommended for vaccination, 515 received telephone reminders, 515 received mail reminders, and 516 served as controls. Patients in both the telephone and mail reminder groups received the same educational information regarding influenza vaccination. Rates of vaccination are compared among the three groups. Many patients do not realize influenza may lead to death, while others believe vaccination is ineffective or unnecessary. Other patients simply forget to be revaccinated annually. Incorporating educational patient information into reminder strategies should raise patient awareness and diminish these barriers to vaccination. Through these efforts, overall vaccination rates will be improved, ultimately resulting in reduced complications and death.

Pharmaceutical Care for Patients with Chronic Conditions

ObjectiveTo assess factors associated with participation in pharmaceutical care and the benefits of participation—in terms of amount of information about medications, administration of medications, and awareness of side effects. DesignQuasi-experimental design, with a control group. Medication Survey, administered 6 months after pharmaceutical care intervention to participants, refusers, and controls. Logistic regression analyses. SettingThree staff clinic pharmacies and three contract clinic pharmacies affiliated with a health maintenance organization (HMO). Patients and Other ParticipantsPatients with chronic health conditions (asthma, chronic obstructive pulmonary disease, or heart disease) enrolled at six intervention sites, identified through the HMO's electronic pharmacy database. Control sample with the same chronic health conditions, without access to pharmaceutical care (n = 210 participants, 162 refusers, and 368 controls; overall adjusted response rate = 72%). InterventionPharmaceutical care, in the form of a comprehensive drug therapy management program. Main Outcome MeasuresPredictors of participation, amount of information about medications, use of reminder methods, and awareness of side effects. ResultsThe following variables were significantly associated with the probability of participating in pharmaceutical care (P < .05): number of medications, employment, income, health status, education, and living situation. Participants were more likely than controls to say they received “a lot of information” from their pharmacist about all aspects of medications (odds ratio [OR], 1.75 to 2.68). Participants were more likely to report leaving their medication container in a visible place and using two or more reminder methods (OR, 1.87 to 1.48). There were no significant differences in the probability of missing doses. Participants were more likely to report experiencing “symptoms or problems” associated with prescription medications (OR, 1.81). ConclusionPharmaceutical care appears to increase the information given to patients about medications, promote more effective self-administration of medications by encouraging patients to use systematic reminders, and increase awareness of medication side effects.

Computer reminders and alerts

With busy users relying increasingly on computers to provide reminders and alerts, the enabling technology is rapidly gaining importance. Surprisingly, many issues have not yet been thoroughly explored. The state of the art is characterized by after-the-fact application patches, plug-ins and custom-designed reminder methods. This hodgepodge of approaches is likely to change. Recent trends indicate that hundreds of millions of dollars of personal information management (PIM) programs have been sold, mainly because of their reminding abilities. Billions of dollars in savings per year and increased quality of work are projected as more reminder and alerting programs are deployed. Agents that perform reminding and alerting tasks represent one of the fastest growing areas of the World Wide Web and other digital repositories.