Mobile phone text messaging approximately doubles the odds of medication adherence. A [[meta analysis]] was conducted of 16 [[randomized control trial]]s to assess the effect of mobile phone text messaging on medication adherence in the setting chronic disease. Study concluded that this intervention improved adherence rates from 50% to 67.8% or an absolute increase of 17.8%.<ref name="pmid26831740">{{cite journal| author=Thakkar J, Kurup R, Laba TL, Santo K, Thiagalingam A, Rodgers A et al.| title=Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease: A Meta-analysis. | journal=JAMA Intern Med | year= 2016 | volume= | issue= | pages= | pmid=26831740 | doi=10.1001/jamainternmed.2015.7667 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26831740 }} </ref>
A smartphone app may improve adherence and total weight loss after 6 months when compared to a website monitoring group. <ref name="pmid3636323">{{cite journal| author=Rahal JJ, Simberkoff MS| title=Comparative bactericidal activity of penicillin-netilmicin and penicillin-gentamicin against enterococci. | journal=J Antimicrob Chemother | year= 1986 | volume= 17 | issue= 5 | pages= 585-91 | pmid=3636323 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3636323 }} </ref> In a pilot study done in the UK, a sample of 128 overweight individuals were randomized to receive a weight management intervention delivered by smartphone app, website, or paper diary. The smartphone app intervention, My Meal Mate (MMM), was developed by the research team using an evidence-based behavioral approach. <ref name="pmid3636323"/>
* Trial retention was 93% in the smartphone group, 55% in the website group, and 53% in the paper diary group at 6 months.
* Adherence means were 92 days in the smartphone group, 35 days in the website group, and 29 days in the paper diary group.
* Mean weight loss and BMI reduction, respectively, at 6 months were -4.6 kg and -1.6 kg/m2 in the smartphone group, -2.9 kg and -1.0 kg/m2 in the paper diary group, and -1.3 kg and -0.5 kg/m2 in the website group.
Regarding care of [[diabetes mellitus]]:
A meta-analysis and more recent trial have found that mobile health technology has a greater reduction in [[hemoglobin A1c]].<ref name="pmid27926892">{{cite journal| author=Hou C, Carter B, Hewitt J, Francisa T, Mayor S| title=Do Mobile Phone Applications Improve Glycemic Control (HbA1c) in the Self-management of Diabetes? A Systematic Review, Meta-analysis, and GRADE of 14 Randomized Trials. | journal=Diabetes Care | year= 2016 | volume= 39 | issue= 11 | pages= 2089-2095 | pmid=27926892 | doi=10.2337/dc16-0346 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27926892 }} </ref><ref name="pmid26645932">{{cite journal| author=Hsu WC, Lau KH, Huang R, Ghiloni S, Le H, Gilroy S et al.| title=Utilization of a Cloud-Based Diabetes Management Program for Insulin Initiation and Titration Enables Collaborative Decision Making Between Healthcare Providers and Patients. | journal=Diabetes Technol Ther | year= 2016 | volume= 18 | issue= 2 | pages= 59-67 | pmid=26645932 | doi=10.1089/dia.2015.0160 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26645932 }} </ref>
Regarding [[coronary artery disease]], a [[randomized controlled trial]] found reduction of risk factors associated with using mobile health.<ref name="pmid26393848">{{cite journal| author=Chow CK, Redfern J, Hillis GS, Thakkar J, Santo K, Hackett ML et al.| title=Effect of Lifestyle-Focused Text Messaging on Risk Factor Modification in Patients With Coronary Heart Disease: A Randomized Clinical Trial. | journal=JAMA | year= 2015 | volume= 314 | issue= 12 | pages= 1255-63 | pmid=26393848 | doi=10.1001/jama.2015.10945 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26393848 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26784497 Review in: Ann Intern Med. 2016 Jan 19;164(2):JC7] </ref>.
Regarding [[physical activity]], text messaging may give short term improvement.<ref>{{Cite journal| doi = 10.2196/jmir.6439| issn = 1438-8871| volume = 18| issue = 11| pages = –307| last1 = Agboola| first1 = Stephen| last2 = Jethwani| first2 = Kamal| last3 = Lopez| first3 = Lenny| last4 = Searl| first4 = Meghan| last5 = O’Keefe| first5 = Sandra| last6 = Kvedar| first6 = Joseph| title = Text to Move: A Randomized Controlled Trial of a Text-Messaging Program to Improve Physical Activity Behaviors in Patients With Type 2 Diabetes Mellitus| journal = Journal of Medical Internet Research| accessdate = 2016-11-18| date = 2016-11-18| url = http://www.jmir.org/2016/11/e307/}}</ref>
Patient engagement, also called patient activation or patient participation, is defined as "patient involvement in the decision-making process in matters pertaining to health."[1]
Measuring patient engagement
Patient activation can be measured with the "Patient Activation Measure".[2]
Readiness to change can be measured by the Readiness to Change Ruler[3][4] or by the University of Rhode Island Change Assessment (URICA) questionnaire[5] based on the Transtheoretical Model of Change. The URICA is 23 or 32 items and a 12 item "'Readiness to change" version[6] has been developed. The Ruler correlates with the full questionnaire[7][6] and predicts behavioral intentions[7].
How to increase patient engagement / participation
Encouraging the patient to participate in decisions may increase engagement and patient compliance.[8][2] Using stories to describe medical evidence may help communication.[9]
↑DiClemente CC, Hughes SO (1990). "Stages of change profiles in outpatient alcoholism treatment". J Subst Abuse. 2 (2): 217–35. PMID2136111.
↑ 6.06.1Rollnick S, Heather N, Gold R, Hall W (1992). "Development of a short 'readiness to change' questionnaire for use in brief, opportunistic interventions among excessive drinkers". Br J Addict. 87 (5): 743–54. PMID1591525.CS1 maint: Multiple names: authors list (link)
↑Bodenheimer T (2007). "A 63-year-old man with multiple cardiovascular risk factors and poor adherence to treatment plans". JAMA. 298 (17): 2048–55. doi:10.1001/jama.298.16.jrr70000. PMID17986698.
↑Steiner JF (2007). "Using stories to disseminate research: the attributes of representative stories". Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine. 22 (11): 1603–7. doi:10.1007/s11606-007-0335-9. PMID17763914.