Two-way SMS Reminders for Medication Adherence and Quality of Life in Adults with Type 2 Diabetes: A Randomized Controlled Trial

Non-adherence to a medication regime often has a negative impact on patient outcomes. With a relatively low cost, many countries are using short messaging services to reduce non-adherence rates. In Thailand, research using a short messaging service reminder for people to take their medications is understudied. This multi-center randomized controlled trial, 2-arm, parallel-group research aimed to determine the effects of 2-way SMS reminders on the medication adherence and quality of life of adults with type 2 diabetes mellitus. Data were collected from 63 participants with diabetes in a treatment group (33) and a control group (30). The sample consisted of adults aged 18 and older who were diagnosed with diabetes living in a northeast province of Thailand. All participants received standard care, but those in the treatment group also received a tailored 2-way short message service as a mobile health (mHealth) treatment for four months. Medication adherence was measured by the level of hemoglobin A1c. Quality of life was measured using the Thai version of a Quality-of-Life Questionnaire developed by the World Health Organization and the Diabetes-39 Questionnaire. Data were analyzed using descriptive statistics. One-way repeated measures ANOVA was used to compare hemoglobin A1c levels and quality of life mean scores across three-time points (0, 2, and 4 months). The results revealed that at the completion of the study, the participants in the treatment group had significantly lower hemoglobin A1c than those in the control group and significantly better health-related quality of life, demonstrating that the 2-way SMS reminder service improved their health outcomes. Thus, it is recommended that nurses should employ mHealth, such as 2-way SMS reminder solutions tailored to patients' daily routines. A future investigation comparing the cost-effectiveness and patient outcomes of different mHealth technologies is suggested.