The effectiveness of daily SMS reminders in pharmaceutical care of older adults on improving patients’ adherence to antihypertensive medication (SPPA): study protocol for a randomized controlled trial

Abstract Background Despite a variety of efficient and cost-effective antihypertensive medication, hypertension remains a serious health and economic burden. High consumption of cardiovascular drugs in the Slovak Republic does result neither in better hypertension control nor in significant decrease...

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Main Authors: Zuzana Haramiova, Michal Stasko, Martin Hulin, Tomas Tesar, Magdalena Kuzelova, Donald M. Morisky
Format: Article
Language:English
Published: BMC 2017-07-01
Series:Trials
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13063-017-2063-8
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author Zuzana Haramiova
Michal Stasko
Martin Hulin
Tomas Tesar
Magdalena Kuzelova
Donald M. Morisky
author_facet Zuzana Haramiova
Michal Stasko
Martin Hulin
Tomas Tesar
Magdalena Kuzelova
Donald M. Morisky
author_sort Zuzana Haramiova
collection DOAJ
description Abstract Background Despite a variety of efficient and cost-effective antihypertensive medication, hypertension remains a serious health and economic burden. High consumption of cardiovascular drugs in the Slovak Republic does result neither in better hypertension control nor in significant decrease in cardiovascular mortality. At the same time, Slovakia has alarmingly low patients’ adherence to medication intake. Studies have shown the efficiency of short messaging service (SMS) reminders to improve patients’ adherence and health outcomes at low costs. Since SMS is popular among Slovaks, this approach may be feasible also in Slovakia. The primary objective is to assess if daily SMS reminders of antihypertensive medication intake provided by pharmacists in addition to the standard pharmaceutical care increase the proportion of adherent older hypertensive ambulatory patients. Methods The SPPA trial is a pragmatic randomized parallel group (1:1) trial in 300 older hypertensive patients carried out in community pharmacies in Slovakia. Trial pharmacies will be selected from all main regions of Slovakia. Trial intervention comprises daily personalized SMS reminders of medication intake embedded into usual pharmaceutical practice. The primary outcome is a combined adherence endpoint consisting of subjective self-reported medication adherence via the eight-item Morisky Medication Adherence Scale (MMAS-8) and objective pill count rate. Secondary outcomes include: change in the MMAS-8; comparison of adherence rates using pill count; change in systolic blood pressure; and patient satisfaction. Also, direct treatment costs will be evaluated and a cost-effectiveness analysis will be carried out. Discussion The SPPA trial engages community pharmacists and mobile health (mHealth) technologies via evidence-based pharmaceutical care to efficiently and cost-effectively addresses current main healthcare challenges: high prevalence of hypertension; overconsumption of cardiovascular medicines; low adherence to medication treatment; and resulting uncontrolled blood pressure. The results may identify new possibilities and capacities in healthcare with low additional costs and high value to patients. Trial registration ClinicalTrials.gov, NCT03105687 . Registered on 07 March 2017.
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spelling doaj.art-d23a62b5403b41fbbeac21be50d33f2c2022-12-21T18:53:37ZengBMCTrials1745-62152017-07-0118111510.1186/s13063-017-2063-8The effectiveness of daily SMS reminders in pharmaceutical care of older adults on improving patients’ adherence to antihypertensive medication (SPPA): study protocol for a randomized controlled trialZuzana Haramiova0Michal Stasko1Martin Hulin2Tomas Tesar3Magdalena Kuzelova4Donald M. Morisky5Department of Organization and Management of Pharmacy, Faculty of Pharmacy, Comenius University in BratislavaDepartment of Organization and Management of Pharmacy, Faculty of Pharmacy, Comenius University in BratislavaResearch Institute for Child Psychology and PathopsychologyDepartment of Organization and Management of Pharmacy, Faculty of Pharmacy, Comenius University in BratislavaDepartment of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in BratislavaDepartment of Community Health Sciences, UCLA Fielding School of Public HealthAbstract Background Despite a variety of efficient and cost-effective antihypertensive medication, hypertension remains a serious health and economic burden. High consumption of cardiovascular drugs in the Slovak Republic does result neither in better hypertension control nor in significant decrease in cardiovascular mortality. At the same time, Slovakia has alarmingly low patients’ adherence to medication intake. Studies have shown the efficiency of short messaging service (SMS) reminders to improve patients’ adherence and health outcomes at low costs. Since SMS is popular among Slovaks, this approach may be feasible also in Slovakia. The primary objective is to assess if daily SMS reminders of antihypertensive medication intake provided by pharmacists in addition to the standard pharmaceutical care increase the proportion of adherent older hypertensive ambulatory patients. Methods The SPPA trial is a pragmatic randomized parallel group (1:1) trial in 300 older hypertensive patients carried out in community pharmacies in Slovakia. Trial pharmacies will be selected from all main regions of Slovakia. Trial intervention comprises daily personalized SMS reminders of medication intake embedded into usual pharmaceutical practice. The primary outcome is a combined adherence endpoint consisting of subjective self-reported medication adherence via the eight-item Morisky Medication Adherence Scale (MMAS-8) and objective pill count rate. Secondary outcomes include: change in the MMAS-8; comparison of adherence rates using pill count; change in systolic blood pressure; and patient satisfaction. Also, direct treatment costs will be evaluated and a cost-effectiveness analysis will be carried out. Discussion The SPPA trial engages community pharmacists and mobile health (mHealth) technologies via evidence-based pharmaceutical care to efficiently and cost-effectively addresses current main healthcare challenges: high prevalence of hypertension; overconsumption of cardiovascular medicines; low adherence to medication treatment; and resulting uncontrolled blood pressure. The results may identify new possibilities and capacities in healthcare with low additional costs and high value to patients. Trial registration ClinicalTrials.gov, NCT03105687 . Registered on 07 March 2017.http://link.springer.com/article/10.1186/s13063-017-2063-8mHealthSMS remindersAdherenceAntihypertensive drugsPharmacistsCost-effectiveness
spellingShingle Zuzana Haramiova
Michal Stasko
Martin Hulin
Tomas Tesar
Magdalena Kuzelova
Donald M. Morisky
The effectiveness of daily SMS reminders in pharmaceutical care of older adults on improving patients’ adherence to antihypertensive medication (SPPA): study protocol for a randomized controlled trial
Trials
mHealth
SMS reminders
Adherence
Antihypertensive drugs
Pharmacists
Cost-effectiveness
title The effectiveness of daily SMS reminders in pharmaceutical care of older adults on improving patients’ adherence to antihypertensive medication (SPPA): study protocol for a randomized controlled trial
title_full The effectiveness of daily SMS reminders in pharmaceutical care of older adults on improving patients’ adherence to antihypertensive medication (SPPA): study protocol for a randomized controlled trial
title_fullStr The effectiveness of daily SMS reminders in pharmaceutical care of older adults on improving patients’ adherence to antihypertensive medication (SPPA): study protocol for a randomized controlled trial
title_full_unstemmed The effectiveness of daily SMS reminders in pharmaceutical care of older adults on improving patients’ adherence to antihypertensive medication (SPPA): study protocol for a randomized controlled trial
title_short The effectiveness of daily SMS reminders in pharmaceutical care of older adults on improving patients’ adherence to antihypertensive medication (SPPA): study protocol for a randomized controlled trial
title_sort effectiveness of daily sms reminders in pharmaceutical care of older adults on improving patients adherence to antihypertensive medication sppa study protocol for a randomized controlled trial
topic mHealth
SMS reminders
Adherence
Antihypertensive drugs
Pharmacists
Cost-effectiveness
url http://link.springer.com/article/10.1186/s13063-017-2063-8
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