Text Messages May Improve Adherence in Diabetes

Changing patient habits, especially dietary habits, is a routine struggle for many people diagnosed with type 2 diabetes.

A recent census conducted by the International Diabetes Foundation estimates that 451 million people are living with diabetes around the world. That number is predicted to increase by 54% by 2045. Furthermore, nearly 50% of people with type 2 diabetes do not meet target treatment values.

A study published in the Journal of Pharmacy and BioAllied Sciences earlier this year explores how pharmacists and direct-messaging services could improve medication adherence and resulting clinical outcomes.

The researchers recruited 330 patients from a secondary care referral hospital and divided them into 2 groups. All participants were on glucose-lowering oral and/or injectable drugs. One group received counseling from a pharmacist about pharmacologic and nonpharmacologic management strategies, as well as daily text messages about medication adherence and exercise. The other group received the usual care given by a physician.

The study lasted 6 months.

Medication adherence improved over both the first and second visits in the test group. This difference was measured by counting the pills remaining when the patient presented for follow up. The researchers do not explain how they measured adherence to injectable medications.

Study participants appreciated text-message alerts/reminders—these communications (unlike other types of communication, such as verbal reminders provided over the phone) reduce interference in the patient’s daily life.

The test group’s mean HbA1C was reduced more than the control group’s HbA1C. This measure provides evidence that the patients in the test group ingested less excess sugar than others, suggesting a benefit of pharmacist counseling and reminder messages in patient behavior.

The intervention group’s blood pressure and bad cholesterol levels were markedly reduced. Significant changes in these levels cannot be accomplished by medication alone—behavior is also a factor. Changing patient habits, especially dietary habits, is a routine struggle for many people diagnosed with type 2 diabetes.

The researchers concluded that pharmacist-directed patient counseling combined with text-message alerts improves medication adherence and patient glycemic control.

As we continue in an age where information is abundant and easy to access, providing patient counseling to address what may seem like basic questions is essential to prevent the spread of misinformation. As technology advances, opportunities to integrate tech and medicine continue to arise and can prove beneficial to patients and to caregivers.


Goruntla N, Mallela V, Nayakanti D. Impact of pharmacist-directed counseling and message reminder services on medication adherence and clinical outcomes in type 2 diabetes mellitus. J Pharm Bioallied Sci. 2019;11(1):69-76.

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