RCT: Text message-based program boosts adherence to appointments, medication

By Jonah Comstock

sense healthAn interactive text-message based care management system was able to create a 40 percent improvement in appointment adherence and modest improvement in medication and care plan adherence, according to new data from New York City-based Sense Health's randomized control trial with Montefiore Medical Center.

Sense Health uses pre-scripted but customizable text messaging to help overloaded Medicaid care managers work with a large number of patients, while still making those patients feel they’re getting individual attention. The company also sends out educational and motivational content as well as specific appointment and medication reminders and check-in messages to solicit patient feedback.

The pilot was conducted at Montefiore through their University Behavioral Associates group, and was supported by a $100,000 Pilot Health Tech NYC Grant. Over two months, Sense Health's system was tested on 67 patients and 15 care managers. 

"We wanted to see if there was actually improvement in people attending appointments and taking medication more, or were they more confident [in their health management] and knowledgeable [about their health]?” CEO Stan Berkow told MobiHealthNews in March. “And a lot of these things key into ‘are we enabling their activation as a patient?’ Because that’s been a metric that’s been really tightly linked to reducing costs in the long run. The other side to the trial was on the provider side, understanding does integrating a system like ours into the workflow of a care manager ultimately make their providing of services easier to their clients or does it become more of a burden?”

The study found that between the control and experiment groups, self-reported patient adherence to appointments increased by 40 percent, while adherence to  medications increased by 12 percent and adherence to care plan goals increased by just 7 percent. They also tracked what the company called in a statement "the key health determinants that dictate how effectively someone manages their own health," namely knowledge, motivation, and ability. The patients that used Sense Health's technology were 21 percent more motivated, 26 percent more confident, and 22 percent more knowledgeable about the lifestyle changes recommended for their health, than the patients in the control group, who received more traditional care management.

"Prior to helping people take their medications more consistently or attend their appointments more frequently, it's critical to ensure they feel sufficiently motivated, knowledgeable and confident to actually take all of the necessary actions to improve their health," Dr. Fred Muench, a Columbia University physician and a Sense Health advisor, said in a statement. "Technologies like Sense Health that combine tailored health interventions with the support and accountability of care managers take us one step closer to impacting the complex behavioral side of encouraging people to better manage their health."

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