Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Central Clinical School, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia.
Sydney Health Economics Collaborative, Sydney Local Health District, Camperdown, New South Wales, Australia.
Obesity (Silver Spring). 2020 Oct;28(10):1889-1901. doi: 10.1002/oby.22930. Epub 2020 Sep 9.
Adherence to weight-loss medication is suboptimal, leading to poor health outcomes. Short message service (SMS) can potentially improve adherence.
A total of 3,994 participants with overweight or obesity in Australia receiving Saxenda® (liraglutide 3.0 mg) were enrolled from September 1, 2017, to February 28, 2018, through doctors, pharmacists, or websites and were randomly assigned to receive none, three, or five SMS per week. Participants were additionally offered a face-to-face consultation with a diabetes educator or a call from a dietitian. Medication adherence was measured as whether the total scripts claimed were at least as many as the total claims expected by March 31, 2018, and was modeled adjusting for age, sex, baseline BMI, residential region, enrolment channel, the total number of SMS, and additional patient support.
Participants receiving five SMS (OR, 6.25; 95% CI: 4.28-9.12) had greater adherence than those receiving three SMS (OR, 3.67; 95% CI: 2.67-5.03) or zero SMS per week. The effectiveness of SMS on adherence decreased as participants received more SMS over time. Moreover, the odds of adhering to liraglutide were higher for participants enrolled with pharmacists compared with those enrolled with doctors (OR, 2.28; 95% CI: 1.82-2.86) and for participants who received a face-to-face consultation (OR, 3.10; 95% CI: 1.82-5.29) or a call (OR, 1.31; 95% CI: 1.02-1.68) compared with those who received no extra support.
Integration of SMS into routine clinical practice should consider not only the frequency and content of reminders but also additional patient support to achieve higher and more sustained adherence to medication and health behavior changes.
减肥药物的依从性不理想，导致健康状况不佳。短信服务（SMS）有可能提高依从性。
2017 年 9 月 1 日至 2018 年 2 月 28 日，共有 3994 名超重或肥胖的澳大利亚参与者通过医生、药剂师或网站登记参加了 Saxenda®（利拉鲁肽 3.0mg）研究，并被随机分配每周接受零条、三条或五条短信。参与者还可选择与糖尿病教育者进行面对面咨询或与营养师进行电话咨询。药物依从性的测量方法是，根据截至 2018 年 3 月 31 日的总处方数是否至少与预期的总处方数相符进行评估，并通过调整年龄、性别、基线 BMI、居住地区、登记渠道、SMS 总数和额外的患者支持等因素进行建模。
与每周接受三条短信相比，每周接受五条短信的参与者（比值比[OR]，6.25；95%置信区间[CI]：4.28-9.12）的依从性更高；与每周接受零条短信相比，每周接受三条短信的参与者（OR，3.67；95%CI：2.67-5.03）的依从性更高。随着参与者接受短信的时间增加，SMS 对依从性的影响逐渐减弱。此外，与医生登记相比，与药剂师登记的参与者（OR，2.28；95%CI：1.82-2.86）和接受面对面咨询（OR，3.10；95%CI：1.82-5.29）或电话咨询（OR，1.31；95%CI：1.02-1.68）的参与者的利拉鲁肽依从率更高。
将 SMS 纳入常规临床实践时，不仅应考虑提醒的频率和内容，还应考虑额外的患者支持，以实现更高和更持续的药物依从性和健康行为改变。
