Joseph Kvedar: The pros and cons of texting to boost med adherence

doc texting

Texting is a prime tool for potentially boosting medication adherence, but not an end-all solution, according to Partners HealthCare's Joseph Kvedar, who says that mobile health apps also can be effective, under the right circumstances.

Kvedar, who serves as vice president of connected health at Boston-based Partners, says in post to his cHealth Blog that both text messaging and apps are ripe for adoption, given increasing financial incentives to drive adherence and potential for big losses in failed treatment scenarios. Such tools also can be used easily via EMR systems, and what's more, boast a low-cost factor, he explains.

However, Kvedar says, there are some challenges to using both, such as regulatory requirements and patient engagement hurdles. As an example, he cites a 30 percent drop off in patients opting in for text messages and fatigue by users in paying attention to messaging.

“Mobile apps overcome most of these problems,” he writes, but are not a panacea.

He recommends text messaging for one-time, simple patient interactions, such as alerts for annual screenings, as well as short-term communication on more intense issues such as rehab needs.

Apps, Kvedar says, are a better fit for more complex treatment and long-term patient engagement.

“There are a few examples that come immediately to mind, including programs that use sensors or collect patient-reported outcome measures, highly dynamic medical conditions that require just-in-time care, or programs targeting sensitive conditions such as HIV or STIs. ... There is also a place for mobile apps in medication adherence, in cases when poor adherence is the result of factors other than forgetfulness," he says.

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