Mobile phone based reminders for improving medication adherence in patients with common mental health disorders and determining the prescription pattern cost and adverse effects A randomized controlled trial

Abstract

newline Background: Medication non-adherence is a significant challenge in the management of mental health disorders. Mobile phone reminders have been shown to improve medication adherence in these disorders, but research on their effectiveness for common mental health disorders in India is limited. Objectives: The study aimed to assess the effect of mobile phone short message service or pre-recorded voice calls on treatment persistence and adherence in patients with common mental health disorders and to identify the reasons for non-adherence. It also determined the drug prescribing patterns, analysed the cost in the management of common mental health disorders over six months, determined the incidence of adverse drug reactions and assessed their causality, severity, predictability, and preventability. Methods: This open-label rater-blinded, randomized controlled trial involved 216 participants diagnosed with a common mental health disorder. They were randomized into three groups: a control and two intervention groups. The control group received treatment as usual during the entire six months of the study, and the intervention group received either an SMS or voice call medication reminder along with treatment as usual. Reminders for follow-up visits were sent five days prior to their appointment. Persistence was measured using the refill sequence method, and adherence was assessed using the Medication Adherence Rating Scale and secondary database analysis. Reasons for non-adherence were identified using the Medication Adherence Reasons Scale. Drug prescribing patterns, direct and indirect costs, and adverse drug reactions were also analysed. The sample was analysed using the Intention-to-Treat method. newlineResults: Mobile phone-based interventions did not improve persistence or adherence in patients with common mental health disorders. Even though adherence showed improvement using MARS at some time points, it was not consistent. Reasons for non-adherence were difficulty in reaching the medication provider, bel