Text Message Communication with Patients

In a single-blind randomized, patients with hypertension in South Africa were divided into three different groups of care. The first group continued the usual way with routine doctor’s appointments. The second group was involved in an information only daily text messaging system and finally, the last group was involved in an interactive text messaging system. The goal of the study was to see how increased interaction with the patient could impact systolic blood pressure over the span of twelve months. The hopes of increased interaction through the text messaging system were that they would increase the adherence and that cognitive thought about their disease state daily would ensure better decision making in their lifestyle choices. The study concluded that there was a greater decrease in the systolic blood pressure of those individuals whom received daily text messages and then only a slight decrease in the individuals with the interactive text messaging.

In the medical world today, it is crucial to be able to keep up with the technology when interacting with patients. Being able to reach patients efficiently, as according to the study, is necessary in maintaining patient adherence. Additionally, being able to be readily available to patients will enable the patient to get questions easily answered and clear up any confusion with medications or therapy regiments. Keeping up with the technology and creating new ways to reach patients is important to maintain the contact with patients throughout the term of a year in between doctor’s visits.

Bobrow, K, Farmer, AJ, et al. Mobile Phone Text Messages to Support Treatment Adherence in Adults with High Blood Pressure (StAR): A Single-Blind Randomized Trial. Circulation Journal. (published 14 January 2016)


Borrow, K, Farmer, AJ, et al. Mobile Phone Text Messaging to Support Treatment Adherence in Adults with High Blood Pressure. Circulation AHA. Published online January 14, 2016.

Adherence to preventative HIV infection therapies

Several studies have shown that actions to prevent HIV infection prior to exposure reduce HIV infection in men who have sex with men and transgender women by 44%. These preventative actions include tenofovir disoproxil fumarate and emtricitabine oral drug therapies. This study assessed adherence to these therapies, sexual behaviors, and STI and HIV infection in men who have sex with men and transgender women in STI clinics in San Francisco, Miami, and Washington, D.C. They tested the blood concentration of the drugs, number of sex partners, instances of unsafe sex, and HIV infection. At follow-up visits, 80% of participants had levels of the drug that would be sufficient to protect them from infection. African American populations and those in Miami were less likely to have sufficient blood concentration. Populations with stable housing and those who had more than two unsafe sex partners within the last three months were more likely to have sufficient blood concentration. The study concluded that the more a participant acts on risky behaviors, the more likely they are to be adherent to the preventative therapies.

I was pleasantly surprised by the results of the study. I was expecting the people who have risky behaviors to be less inclined to prevent infection simply because they were participating in the risky behaviors. It bodes well in regards to the HIV epidemic that these people are working to prevent infection, though in a perfect world, all people participating in these behaviors would be adherent to preventative therapies.


JAMA Intern Med. 2016;176(1):75-84.