NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Int J Med Inform. 2012 Sep;81(9):594-604. doi: 10.1016/j.ijmedinf.2012.05.005. Epub 2012 May 30.
Poor adherence to oral antidiabetics has a negative influence on glycaemic control in type 2 diabetes patients. Real Time Medication Monitoring (RTMM) combines real time monitoring of patients' medication use with SMS reminders sent only if patients forget their medication, aiming to improve adherence. This study aimed to investigate the effect of these SMS reminders on adherence to oral antidiabetics in patients using RTMM and investigate patients' experiences with RTMM.
Data were collected in a RCT involving 104 type 2 diabetes patients with suboptimal adherence to oral antidiabetics. Fifty-six patients were randomised to receive SMS reminders if they forgot their medication, 48 patients received no reminders. Primary outcome measure was adherence to oral antidiabetics registered with RTMM, measured as: (1) days without dosing; (2) missed doses; (3) doses taken within predefined standardized time windows. Patients' experiences were assessed with written questionnaires.
Over the six-month study period, patients receiving SMS reminders took significantly more doses within predefined time windows than patients receiving no reminders: 50% vs. 39% within a 1-h window (p=0.003) up to 81% vs. 70% within a 4-h window (p=0.007). Reminded patients tended to miss doses less frequently than patients not reminded (15% vs. 19%, p=0.065). Days without dosing were not significantly different between the groups. The majority of patients reported positive experiences with RTMM and SMS reminders.
RTMM with SMS reminders improves adherence of type 2 diabetes patients, especially the precision with which patients follow their prescribed regimen, and is well accepted by patients.
Netherlands Trial Register NTR1882.
2 型糖尿病患者口服降糖药依从性差会对血糖控制产生负面影响。实时药物监测（RTMM）将患者用药的实时监测与仅在患者忘记服药时发送的短信提醒相结合，旨在提高依从性。本研究旨在调查这些短信提醒对使用 RTMM 的 2 型糖尿病患者口服降糖药依从性的影响，并调查患者对 RTMM 的体验。
这项 RCT 纳入了 104 例口服降糖药依从性差的 2 型糖尿病患者，收集了数据。将 56 例患者随机分为如果忘记服药则接受短信提醒组，48 例患者为未接受提醒组。主要观察指标为 RTMM 记录的口服降糖药依从性，包括：（1）无剂量天数；（2）漏服剂量；（3）在预先设定的标准化时间窗口内服用的剂量。患者的体验通过书面问卷进行评估。
在六个月的研究期间，接受短信提醒的患者在预先设定的时间窗口内服用的剂量明显多于未接受提醒的患者：1 小时窗口内（50% vs. 39%，p=0.003），4 小时窗口内（81% vs. 70%，p=0.007）。与未接受提醒的患者相比，接受提醒的患者漏服的频率较低（15% vs. 19%，p=0.065）。两组患者无剂量天数无显著差异。大多数患者报告对 RTMM 和短信提醒有积极的体验。
RTMM 与短信提醒可提高 2 型糖尿病患者的依从性，尤其是提高患者遵循规定治疗方案的精确性，且患者接受度高。
荷兰临床试验注册 NTR1882。
