Interact Trial

Overview

INTERACT is a randomised controlled clinical trial assessing the effectiveness of programmed text message reminders on adherence to cardiovascular disease preventive medication.

• 50% of randomised patients will receive a Text Message Programme of periodic medication reminders plus standard care (interventional group)
• 50% of randomised patients will receive standard care alone (control group)

Trial Sponsor: Queen Mary University of London

Co-ordinating Centre: Wolfson Institute of Preventive Mediicine, Barts and the London School of Medicine

Background

Coronary heart disease (CHD) is the world’s leading cause of death. Approximately one third of all deaths in England and Wales are due to CHD.

Combination Drug Therapy and Cardiovascular Disease [PDF 269KB]

Combination drug therapy with blood pressure and serum cholesterol lowering drugs is effective in reducing the risk of first cardiovascular disease events; about ¾ of all heart attacks and strokes could be prevented with complete adherence to treatment. [PDF 269KB]

Non adherence to Medication

Non-adherence to medications is however common for patients with cardiovascular diseases and greatly reduces the preventive effect. An estimated 50% of patients do not take their tablets as prescribed.

N I C E

The National Institute for Health and Clinical Excellence has called for interventions to improve the extent to which patients remain on effective preventive medications.

Mobile Telephone Technology

Mobile telephone technology is a possible method of improving medication adherence. More than 90% of people now own a mobile phone.

Ofcom, 2013.

Design

• A randomised parallel group trial design, involving the enrolment of about 300 patients from General Practices in London.
• Patients prescribed either cholesterol lowering or blood pressure lowering medications (or both), are randomly assigned to two groups, about 150 receiving periodic Text Message Reminders and about 150 are not. Patients are followed up at their GP practice at 6 and 18 months.

Primary endpoints:

1. Continuation rate: The proportion of patients in each trial arm remaining on prescribed cholesterol or blood pressure lowering treatment.
2. Number of days in the last month of the study that patients missed taking their medication.

Secondary endpoints:

1. Serum cholesterol and blood pressure levels, in each arm at the end of follow up.

Software

Text Messaging Programme Software

Inputs

Text Scheduling takes three simple steps:

Step 1: Register the patient by entering their name and mobile phone number

Fig 1: Enter patient demographic details and mobile phone number

Step 2: Assign the patient to a text message group (allocated by time of their medication reminder's)

Fig 2: Patient groups are listed by times. Select a timed group or create a new one to assign the patient to a particular group.

Step 3: Assign the patient to a text message group (allocated by time of their medication reminder's)

Fig 3: Once the registered patient is selected, their schedule can be created in the ‘Text Message Method’ section.

Adherence Report

The software application generates an adherence report for each patient based on the responses received over the previous quarter (time period can be customised). The chart below gives an example of a moderately adherent patient.

Staff

• David Wald
• Shahena Butt