Education using SMS increases efficacy of treatment of hypertensive patients

Abstract

Background Poor patients’ compliance in the treatment of hypertension is one of the common causes of inadequate blood pressure control. The aim of the study was to assess the effectiveness of short messages service (SMS) for mobile phones for providing reminder notes as well educational information on the hypertension control.
Material and methods 2055 hypertensive patients, at least 2 weeks before inclusion in to the study were treated with angiotensin II receptor blockers (once daily as mono- or polytherapy). Patients were randomized (1:1) into two groups differing frequency of text messages (SMS) sent (once or twice weekly). Each SMS contained two modules: 1) a remainder about medication, 2) the information about life style modification, necessity of self blood pressure (BP) control, patients’ compliance and persistence in pharmacotherapy. Blood pressure, control of hypertension and improvement of patients’ compliance were assessed at 1, 3 and 6 months of intervention. Analysis per protocol was performed among 1015 of patients.
Results In two intervention groups, the BP reduction at 6-months of follow-up was similar for systolic and diastolic BP, respectively 17 ± 16 (p < 0.001) and 10 ± 11 mm Hg (p < 0.001). Percentages of patients who took all antihypertensive medications increased from 51% to 93% and from 49% to 93% in patients have received respectively: 1 or 2 SMS messages weekly. Rate of BP control (BP < 140/90 mm Hg or < 135/85 mm Hg in diabetic patients) increased from 36% to 67% in both groups. At the end of the follow-up 11% of subjects from group 1 SMS/week and 10% of subjects from group 2 SMS/week declared smoking cessation; 57% and 58% - increased physical activity; 56% and 55% - salt reduction, and 56% and 59% - fat reduction in diet.
Conclusions Weekly-intervention using SMS, improved antihypertensive therapy during six-month-follow-up, significantly decreased patients’ non-compliance and doubled effectiveness of blood pressure control. No other effects with more frequent SMS-intervention were observed.