Groups that promote digital health focus on the pervasiveness of mobile phones. Most people have at least a flip phone if not a smartphone. So companies that can develop a way to use text message interventions to tackle the challenge of helping patients with chronic conditions stick to their care plan or stop smoking or trigger a behavior change to better manage health have garnered a lot of interest. A new study in the Annual Review of Public Health points out where this technology has been most effective and where more study is needed.
MobiHealthNews first highlighted the findings on its website.
It covered 89 relevant individual studies within 15 reviews published between 2009-2014. The studies included 10-5,800 participants.
Using SMS for self management of diabetes also garnered favorable results. The majority were interactive and personalized.
“All of the 16 individual TMI studies we identified that focused specifically on diabetes, controlling for duplicates that appeared in multiple reviews, reported statistically significant effects on health outcomes and/or health behaviors.”
Smoking cessation was one of the most successful uses of SMS interventions in the health promotion category followed by physical activity. It was less effective for weight loss and primary care appointments. SMS strategies that personalized the messages for each patient and reduced the number of message participants received tended to have greater intervention efficacy, the report said.
Text message interventions also proved effective for HIV care, specifically medication adherence for antiretroviral therapies. A review of eight studies with a total of 1,551 participants, found that these interventions significantly improved average adherence outcomes, the study said.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
The report also highlighted areas that scientists want to investigate further. Those included research on the use of behavior change theories for TMIs, such as theories that can address qualities of SMS delivery and address specific health behaviors. They’d also like to explore potential risks and unintended consequences associated with TMIs.
Like all so many studies, however, the answer to the question of why the interventions worked so well for diabetes and smoking cessation, for example, were evasive. Still, the cost of reaching patients through text messaging is relatively low, and can be easy to scale as long as the interventions aren’t complex, the study noted. Also, text messages have a high rate of being opened, which makes it an effective way to reach most patients. They’re also easily personalized and tailored to specific conditions. At a time when pharmaceutical companies, payers and providers are demonstrating an interest in technologies that can help improve adherence and reduce hospitalization costs, this analysis draws some useful insights on digital health’s merits.
