Study Shows SMS Text-Reminders Enhance Medication Adherence for CHF Patients

A recent study published in PLOS Digital Health highlights a promising strategy that could transform medication adherence for patients with congestive heart failure (CHF). The research underscores the potential of SMS-based digital nudges to tackle persistent issues such as prescription abandonment and high readmission rates, which challenge both pharmacists and healthcare systems.

Medication Non-Adherence in CHF: A Pervasive Issue

CHF patients frequently face non-adherence issues, with a staggering 40-60% failing to adhere to medication schedules. This non-adherence contributes significantly to high 30-day readmission rates. Tackling this issue is crucial for improving patient outcomes and reducing healthcare costs.

The Study: Innovative Use of SMS Technology

Conducted at a rural hospital in the United States, the study involved 1,276 CHF inpatients and explored the impact of personalized SMS messages sent five minutes after an e-prescription. These messages provided patients with the ability to confirm where their prescriptions were sent, view educational content about their medications, access cost-saving coupons, and set up medication pick-up reminders.

Key Findings

The study found that patients who interacted with the SMS messages, defined as clicking at least one link, had 19% higher odds of filling their prescriptions. Notably, the effect was most pronounced among patients who were readmitted, who had a 52% higher likelihood of filling their prescriptions when they engaged with the SMS. Additionally, SMS interaction was linked to a 6% reduction in 30-day readmission odds. A remarkable 90% of the patients clicked on the SMS links, though fewer than 8% opted out of the intervention.

Importance for Pharmacists

This study provides valuable insights for pharmacists, especially concerning cost barriers. For instance, patients showed higher abandonment rates for more expensive medications like Entresto compared to ACE inhibitors. The inclusion of coupons in the SMS messages likely played a significant role in improving fill rates by alleviating financial burdens.

The findings emphasize that the highest-risk patients reap the greatest benefits from these digital nudges, highlighting a critical opportunity for targeted interventions. However, the study's observational design and reliance on smartphones are notable limitations, as they present potential biases.

Practical Implications

For pharmacy practice, these findings advocate for the integration of digital engagement strategies in transitions of care and discharge counseling. Proactive digital interventions can enhance medication adherence and potentially reduce readmission rates, ultimately improving patient care.

Despite the study’s observational nature, the evidence suggests a need for further randomized controlled trials to confirm these findings definitively. However, the practical implications for today's pharmacy landscape are clear: digital nudges offer a scalable and effective solution for improving medication adherence among CHF patients.

Source

• Long, B., Davis, B., McPheters, R., Burton, S., Hamoud, N., Garmat, D., Catalfomo, S., Li, F., Zhou, Y., Zhuang, Y. L., Banas, C. A., & Blakeslee, W. W. (2025). Interaction with SMS text-reminders correlate with improved medication adherence and readmission rates for congestive heart failure patients: A retrospective cohort study. PLOS Digital Health, 4(12), e0001157. https://doi.org/10.1371/journal.pdig.0001157