Time to Reconsider Texting? Using Daily Text-Message Reminders to Improve Adherence With Oral Contraceptives

We just spotted one of those television ads  to discourage texting … in this case, when driving a car. It was a sobering ad as the narration was performed by the parent of a young woman who did not surive the  outcome of her multiple actions. Now a respected journal points is currently running an article that presents an example of a text reminder’s lack of effectiveness.  We don’t subscribe to the Obstetrics & Gynecology Journal, but the abstract from this randomized controlled trial succinctly states results and conclusions:

Abstract from Obstetrics & Gynecology Journal

OBJECTIVE: To estimate whether women receiving daily text-message reminders have increased oral contraceptive pill adherence compared with women not receiving reminders.

METHODS: This randomized controlled trial estimated whether there was an effect of daily text-message reminders on oral contraceptive pill adherence of new oral contraceptive pill users. Pill-taking was tracked for 3 months by an electronic monitoring device with wireless data collection. During the study period, participants assigned the intervention received a daily reminder text message. Eighty-two women were assigned randomly to detect a 1.6±2.0 pill difference (90% power, 5% α, 15% dropout).

RESULTS: Participants were 79% white, non-Hispanic, 99% high school graduates, and 99% nulliparous [SeniorWomen.com’s Editor’s note:  A woman who has never given birth.] with a mean age of 22 years. Most reported condom use with past coital activity, and more than half reported prior emergency contraception use. The mean number of missed pills per cycle did not differ significantly between the groups: 4.9±3.0 for the text-message group and 4.6±3.5 for the control group (P=.60). The number of missed pills per cycle increased over the course of the study, but this pattern did not increase differentially between the groups. Adherence recorded by the electronic monitoring device indicated much poorer adherence than that recorded by patient diaries. Despite poor pill-taking, there were no pregnancies.

CONCLUSION: Daily text-message reminders did not improve oral contraceptive pill adherence. Although the lack of benefit may be attributed to the frequent use of alternative reminder systems in the control group, the rate of missed pills when measured objectively was still very high in both groups.

A correction: “The findings and conclusions in this article are those of the authors and do not necessarily represent the views of Planned Parenthood Federation of America, Inc.”

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