Looking for an effective Digital Adherence Program? Use text messages

Human Care Systems / Dec 09, 2020

While often overlooked, text messages are the perfect channel to deliver effective digital support

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When thinking of a digital adherence program most people envision sending emails. But do they work? With open rates rapidly decreasing and the undesirability of 2-way email, most email programs serve up a "one-size-fits-all" content that has little or no impact.   

Contrary, text messages can add significant value to patients and patient adherence programs. And we are not just talking abut sending reminders, but providing a personalized SMS program delivering valued content is a powerful tool to drive behavioral change.   

At HCS we have seen the impact of SMS directly in our own programs; a SMS-only program supporting neurology patients showed that patients receiving support were 22% more likely to fill a 2nd prescription and 47% more likely to fill a 3rd prescription. The value of SMS has also been born out in studies - one meta-analysis found that text message interventions can improve adherence rates for chronic medications by 36% (Thakkar, 2016) and a recent study identified text messages as a proven effective technologies, but often overlooked as part of the mobile health (mHealth) toolbox.

Impact of SMS patient support program on neurology patients

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Below are some of the main reasons why text messaging is such a valuable tool:

  1. Everyone checks their phone

People have a close relationship with their phone across all age groups. Text messaging reaches consumers in a ubiquitous real-time exchange, contrasting the multistep active engagement required for apps and wearables. It continues to be the most widely adopted and least expensive mobile phone function. As an intervention modality, text messaging is useful for tailored interactive health communication; reaching and engaging a broad audience and delivering additional valued content - in studies on the efficacy of text messaging in digital adherence, the most frequently accessed web pages and Youtube videos are those linked directly to text messages.

  1. Bite-size content

Text messaging is effective because people learn most effectively when they receive information in small, relevant, timely pieces: a perfect fit with texting. With a 98% open rates, SMS based programs impact treatment initiation, adherence, and satisfaction. Furthermore, the simple design and ubiquitous use of text reduces the need for learning a new interface for digital adherence programs.

  1. Personalization

Messaging that is individually tailored comes across as personal in a way that email or dynamic websites are rarely able to achieve. In studies of patient support programs, the perception of personalized support is a key driver of program effectiveness. Programs can make use of natural language processing to drive that personalization by for example, asking patients what interests they have and adjusting the content based on their responses.

  1. Even hard to reach communities have phones

Text messaging interventions can appeal to, connect with, and achieve positive health outcomes for the most difficult-to-reach communities including those that do not connect with traditional health services. Due to the ease of tailoring text messaging interventions, programs can be delivered in multiple languages, locations, and cultural versions to ensure relevance and appropriateness for a wide range of populations. Screen Shot 2020-12-07 at 3.54.24 PM

While other technologies such as patient apps often suffer from poor long-term engagement, the digital divide within society, and low health and technology literacy of users, text messages are a proven technology that can provide highly effective support, particularly when combined with machine learning and chat bot functionality to maximize personalization. Furthermore, text message programs are low cost compared to case manager programs, can be set up quickly (in as little as 12 weeks) and can be set-up to support and complement existing patient services infrastructure and partners.

Developing an effective digital adherence program requires a tool that is simple, widely available, highly personal, and used frequently. SMS is the only channel that meets those requirements, which is why it should be front and center for any digital adherence program. 

To learn more about how text messaging can drive value for you and your brand, click here.


Jane C Willcox, Rosie Dobson, Robyn Whittaker. Old-Fashioned Technology in the Era of “Bling”: Is There a Future for Text Messaging in Health Care? Journal of Medicine Internet Research 2019 (Dec 20); 21(12):e16630

Thakkar J, Kurup R, Laba T, Santo K, Thiagalingam A, Rodgers A, et al. Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease: A Meta-analysis. JAMA Intern Med 2016 Mar 01;176(3):340-349


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