BACKGROUND
Adherence to medication regimens is critical to effectively manage chronic diseases, prevent their complications, and reduce costs. Text messaging interventions, are a potentially cost-effective way to support chronic disease management in developing nations, owing to the increasing availability of mobile phones.
OBJECTIVE
To systematically review and meta-analyze scientific literature on the effectiveness of text message-interventions that support medication adherence in adults with chronic diseases in developing nations.
METHODS
Systematic searches were conducted in CINAHL, MEDLINE, PsycINFO, PubMed, Scopus, and Web of Science databases for randomized controlled trials (RCTs) for the period of January 2000-October 2023. Publications that met eligibility criteria were subsequently evaluated for risk of bias, and qualitatively and quantitatively analyzed.
RESULTS
Systematic searches identified 19 RCTs that evaluated the effectiveness of text-messaging interventions in adults with chronic cardio-metabolic (78.9%), respiratory (10.5%), renal (5.3%), and neurological (5.3%) disorders. Meta-analysis results for medication adherence, quantified as a questionnaire-based and numeric outcome (n= 9), demonstrated statistically significant standardized mean difference (SMD) between groups at post intervention, favoring text message interventions (SMD= 0.84, P=.0001, 95% CI= 0.45, 1.24, I2= 93.0%). Meta-analysis results for medication adherence, evaluated as a dichotomous criteria-based outcome (n= 8), indicated an overall 1.73 times greater likelihood of medication adherence in text message interventions groups compared to comparison conditions, expressed in odds ratios (OR= 1.73, P=.0002, 95% CI= 1.30, 2.31, I2= 48.0%).
CONCLUSIONS
Despite differences in methodological quality, medication adherence evaluation, and heterogeneity in effect sizes, text messaging interventions appear to beneficially influence medication adherence in developing nations.