Table 1. Descriptive statistics of patient demographics and personal information
Variable
control group
N=435 %
Medication adherence history
Have you ever NOT adhered to medication prescriptions?
Seldom
383
88.1
Often
52
12.0
Delayed doses
No
86
19.8
Yes
349
80.2
Missed doses
No
Yes
Socioeconomic status
Gender
Male
Female
Age（years）
20~34
35~49
50~64
≧65
Education level
≧Elementary
Junior High School
High School
College
University
Graduate school or above
Occupation
Unemployed
Military
Civil servant
Teacher
Student
Housekeeper
Self-employed
Medicine
Retired
Freelancer
Services
Worker
A.F.F.H.
Other
245
190
56.3
43.7
intervention group
N=763
%
p-value
0.828
675
88
88.5
11.5
117
646
15.3
84.7
411
352
53.9
46.13
0.574
211
224
48.5
51.5
383
380
50.2
49.8
0.085
96
135
146
58
22.1
31.0
33.6
13.3
162
227
229
145
21.2
29.8
30.0
19.0
<.001
27
6.2
34
4.5
52
89
91
135
41
12.0
20.2
20.9
31.0
9.4
65
275
151
179
59
8.5
36.0
19.8
23.5
7.7
0.026
26
1
45
33
6.0
0.2
10.3
7.6
22
3
57
49
2.9
0.4
7.5
6.4
29
60
67
10
33
16
57
47
3
8
6.7
13.8
15.4
2.3
7.6
3.7
13.1
10.8
0.7
1.8
38
103
116
46
78
37
103
95
2
14
5.0
13.1
15.2
6.0
10.2
4.9
13.5
12.5
0.3
1.8
Table 1. Descriptive statistics of patient demographics and personal information (cont’)
Variable
Control group
N=435
Average monthly household income
≦30,000 NTD
30,001-60,000 NTD
60,001-90,000 NTD
90,001-120,000 NTD
120,001-150,000 NTD
≧15,0001 NTD
Missing data
Marital status
Single
Married
Divorced/Separated
Widowed
intervention group
%
N=763
p-value
%
0.025
94
110
93
34
28
71
5
21.6
25.3
21.4
7.8
6.4
16.3
1.2
122
193
152
80
82
125
9
16.0
25.3
19.9
10.5
10.8
16.4
1.2
<.001
108
24.8
178
23.3
259
48
20
59.5
11.0
4.6
409
156
19
53.6
20.5
2.5
0
0.0
1
0.1
Missing data
Living status
Live with spouse only
Live with children only
Live with spouse and children
Live alone
Other
59
81
138
42
115
13.6
18.6
31.7
9.7
26.4
114
162
225
71
191
14.9
21.2
29.5
9.3
25.0
Medical history
Heart disease
Hypertension
Dialysis
Stroke
Peptic ulcer
Thyroid disease
Chronic kidney disease
Hyperlipidemia
Diabetes
79
120
2
51
39
42
9
16
88
18.2
27.6
0.5
11.7
9.0
9.7
2.1
3.7
20.2
142
197
11
45
73
36
13
32
141
18.6
25.8
1.4
5.9
9.6
4.7
1.7
4.2
18.5
0.847
0.505
0.115
0.121
0.731
<.001
0.651
0.662
0.459
3
9
7
4
20
19
8
14
3
105
0.7
2.1
1.6
0.9
4.6
4.4
1.8
3.2
0.7
24.1
8
15
8
2
42
17
3
11
12
190
1.1
2.0
1.1
0.3
5.5
2.2
0.4
1.4
1.6
24.9
0.531
0.903
0.401
<.001
0.496
0.037
0.012
0.039
0.186
0.768
Gynecology disease
Asthma/ Emphysema
Urinary disease
Cancer
Chronic liver disease
Gout
Pneumonia
Mental or psychiatric disease
Immunity disease
Others
0.735
NTD: New Taiwan dollar; A.F.F.H: agricultural, forestry, fishery or husbandry
Table 2. Comparing the results before and after the SMS intervention
Variable
Before SMS
intervention
N
%
After SMS
intervention
N
Improvement
%
P-value
%
<.001 a
Delayed doses
(Total)
Intervention
group
646
84.7c
137
18.0c
78.8
20~34 y/o
146
90.1
32
19.8
78.1
35~49 y/o
181
79.7
52
22.9
71.3
50~64 y/o
196
85.6
35
15.2
82.2
123
84.8
18
12.4
85.4
349
80.2c
187
43.0c
46.4
20~34 y/o
83
86.5
58
60.4
30.1
35~49 y/o
105
77.8
62
45.9
41.0
50~64 y/o
≧65 y/o
113
77.4
54
37.0
52.2
48
82.8
13
22.4
72.9
≧65 y/o
Delayed doses
(Total)
Control group
<.001b
<.001b
<.001a
Missed doses
(Total)
Intervention
group
352
46.1c
35
4.6c
90.1
20~34 y/o
90
55.6
9
5.6
90.0
35~49 y/o
97
42.7
9
4.0
90.7
101
44.1
10
4.4
90.0
64
44.1
7
4.8
89.1
190
43.7c
74
17.0c
61.1
20~34 y/o
52
54.2
28
29.2
46.2
35~49 y/o
62
45.9
14
10.4
77.4
50~64 y/o
≧65 y/o
52
35.6
30
20.6
42.3
24
41.4
2
3.5
91.7
50~64 y/o
≧65 y/o
Missed doses
(Total)
Control group
<.001b
<.001 b
a: used chi-square test to examine the difference between groups; b: Used the McNemar's test to examine
the difference between the pre-test and post-test data within the group. c: intervention group % = n/763;
control group %＝n/435
Table 3. Weighted logistic regression of SMS on decreasing delayed doses
Variable
OR
After SMS intervention
No（reference）
3.2 **
Yes
95% CI
2.7
P-value
3.7 <.001
Socioeconomic status
Gender
Male（reference）
Female
0.9
0.7
1.1 0.197
Age （years）
Variable
Average monthly household income
≦30,000 NTD（reference）
30,001-60,000 NTD
0.8 *
95% CI
0.6
P-value
1.0
0.043
60,001-90,000 NTD
90,001-120,000 NTD
120,001-150,000 NTD
1.6 **
0.8
0.7
1.2
0.6
0.5
2.1
1.2
1.0
0.001
0.254
0.062
≧150,001 NTD
2.1 **
1.5
3.0
<.001
1.7 **
0.7
1.2
0.5
2.4
1.1
0.005
0.143
0.7
0.4
1.2
0.231
2.7 **
1.8
4.1
<.001
0.7 **
0.5
0.9
0.006
0.7 *
0.4
1.0
0.049
1.3
0.9
1.9
0.149
Heart disease
0.7 **
0.5
0.9
0.001
Hypertension
0.7 **
0.6
0.9
0.001
Marital status
20~34 （reference）
35~49
0.6 **
50~64
0.9
0.4
0.6
0.8 0.001
1.2 0.419
Sigle（reference）
Married
Divorced/Separated
≧65
0.6
1.5 0.955
Widowed
1.0
Education level
Living status
Elementary or less （reference）
Junior High
1.1
0.7
School
Live with spouse only（reference）
1.7 0.641
Live with children only
High School
2.1 **
1.4
3.2 <.001
College
1.3
0.8
1.9 0.288
Live with spouse and
children
Live alone
0.9
0.6
1.5 0.782
Other
0.6
0.4
1.1 0.076
University
Graduate school
or above
Occupation
OR
Unemployed（reference）
Medical history
Military
1.4
0.4
5.3 0.582
Dialysis
0.6
0.3
1.3
0.217
Civil servant
0.9
0.5
1.4 0.579
Stroke
0.5 **
0.4
0.7
<.001
Teacher
2.1 *
1.2
3.6 0.011
Peptic ulcer
1.8 **
1.2
2.5
0.002
Student
Housekeeper
Self-employed
Medicine
Retired
Freelancer
Services
Worker
A.F.F.H.
Other
1.0
0.6 *
0.9
1.8
0.7
0.7
1.2
0.7
2.7
1.1
0.6
0.4
0.6
1.0
0.4
0.4
0.8
0.4
0.8
0.5
1.7
0.9
1.4
3.5
1.1
1.2
1.8
1.1
9.7
2.1
0.938
0.023
0.611
0.064
0.145
0.234
0.418
0.078
0.127
0.881
Thyroid disease
0.6 **
0.4
0.8 0.001
Chronic kidney disease
0.7
0.4
1.3 0.285
Hyperlipidemia
1.0
0.7
1.5 0.876
Diabetes
1.0
0.8
1.3 0.930
Gynecology disease
0.9
0.4
1.8 0.672
Asthma/ Emphysema
0.8
0.4
1.3 0.328
Urinary disease
1.0
0.5
2.0 0.992
Cancer
3.9 *
1.0 14.8 0.046
Chronic liver disease
1.3
0.9
2.1 0.199
Gout
1.3
0.8
2.1 0.357
Pneumonia
2.5
0.9
7.0 0.090
Mental or psychiatric
1.0
0.6
1.6 0.884
disease
Immunity disease
3.9 **
1.67
9.0 0.002
Others
0.7 **
0.52
0.8 <.001
N=1198. Dependent variable: 1 indicates with complete improvement; 0 indicates without complete improvement. Medical history
reference group is the participants without this disease; A.F.F.H: agricultural, forestry, fishery or husbandry. * p<0.05; ** p<0.01
Table 4. Weighted logistic regression of SMS on decreasing missed doses
Variable
OR
95% CI P-value
After SMS intervention
No（reference）
Yes
2.2 ** 1.9 2.6 <.001
Socioeconomic status
Gender
Male（reference）
Female
2.1 ** 1.8 2.6 <.001
Age （years）
20~34（reference）
35~49
0.7 *
0.5 1.0 0.024
50~64
0.7 *
0.5 0.9 0.014
≧65
0.6 ** 0.4 0.9 0.009
Education level
Elementary or less （reference）
Junior High School
1.3
0.8 2.0 0.244
High School
0.7
College
0.7
University
0.7
Graduate school or
0.6 *
above
Occupation
Unemployed（reference）
Military
0.1 **
Civil servant
0.4 **
Teacher
0.4 **
Student
0.5 **
Housekeeper
0.7
Self-employed
0.7
Medicine
0.7
Retired
0.7
Freelancer
0.9
Services
0.9
Worker
1.3
A.F.F.H.
2.3
Other
1.1
0.5
1.1
0.138
0.5
0.4
1.1
1.0
0.100
0.058
Variable
OR
95% CI P-value
Average monthly household income
≦30,000 NTD（reference）
30,001-60,000 NTD
1.2
1.0 1.5
0.099
60,001-90,000 NTD
1.5 **
1.1 1.9
0.006
90,001-120,000 NTD
1.1
0.8 1.5
0.668
120,001-150,000 NTD
2.2 **
1.5 3.2 <.001
≧150,001 NTD
4.8 **
3.4 6.8 <.001
Marital status
Single（reference）
Married
1.4
1.0 1.9
0.065
Divorced/Separated
0.4 **
0.3 0.6 <.001
Widowed
1.7
1.0 2.9
0.054
Living status
Live with spouse only（reference）
Medical history
0.7
0.5 1.1
0.093
Live with spouse and
1.4 *
1.1 1.8
0.013
children
Live alone
1.4
0.9 2.1
0.118
Other
0.6 **
0.4 0.8
0.004
0.4
1.0
0.034
Medical history
0.0
0.2
0.2
0.3
0.4
0.5
0.4
0.5
0.6
0.6
0.8
0.7
0.6
0.3
0.6
0.7
0.8
1.0
1.1
1.3
1.1
1.5
1.4
2.0
7.9
2.1
<.001
<.001
<.001
0.005
0.062
0.136
0.277
0.164
0.711
0.753
0.278
0.190
0.868
Heart disease
Hypertension
Dialysis
Stroke
Peptic ulcer
Thyroid disease
Chronic kidney disease
Hyperlipidemia
Diabetes
Gynecology disease
Asthma/ Emphysema
Urinary disease
Cancer
Chronic liver disease
Gout
Pneumonia
Mental or psychiatric
disease
Others
0.4 **
0.4 **
0.5
0.6 **
0.7 *
0.7 *
0.7
0.8
0.9
1.0
1.0
1.0
1.1
1.4
1.5
1.9
0.3
0.4
0.2
0.4
0.5
0.5
0.4
0.5
0.7
0.5
0.6
0.5
0.4
0.9
0.9
0.7
0.5
0.5
1.0
0.8
0.9
1.0
1.3
1.1
1.1
2.2
1.8
2.2
3.3
2.0
2.3
5.2
<.001
<.001
0.051
0.002
0.014
0.028
0.252
0.186
0.354
0.965
0.917
0.910
0.893
0.111
0.089
0.185
2.2 **
1.3
3.8
0.003
0.5 **
0.4
0.6
<.001
N=1,198; Dependent variable: 1 indicates with complete improvement; 0 indicates without complete improvement. Medical history
reference group is the participants without this disease. The patients with immunity disease had no decrease on missed doses; A.F.F.H:
agricultural, forestry, fishery or husbandry. * p<0.05; ** p<0.01
Table 5. Satisfaction with and demand for the SMS content
Weighted
Mean
SD
The SMS clearly describes the frequency of medication use.
3.8
0.7
The SMS clearly describes the method of medication use.
3.8
0.7
Frequency of SMSs received
3.1
1.0
Satisfaction with the precision of wording in the SMS
4.2
0.9
Satisfaction with the understandability of the content of the SMS
4.2
0.8
Satisfaction with medication use privacy in the SMS
4.2
0.9
Overall satisfaction with the SMS
4.3
0.7
Weighted
Mean
SD
Demand for SMS clearly displaying the frequency of medication
2.8
1.0
Demand for SMS clearly showing method of medication
2.5
0.9
Demand for SMS clearly displaying the medication dose
2.9
0.9
Frequency of SMSs received
2.7
0.9
Satisfaction with SMS content (N=763)
Demand for SMS content (N=763)
SMS: Short message service
A 5-point Likert scale, ranging from 1, not at all necessary/extremely unsatisfied, to 5, highly
necessary/extremely satisfied.
Table 6. Demand for SMS reminders
Variable
N=763
%
Variable
N=763
%
Preferring time to receive text messages
before medication taken
Helpfulness of the text message medication
reminder in improving the incidence of
delayed or missed doses
10 minutes
262
34.3
Very unhelpful
13
1.7
15 minutes
65
8.5
Unhelpful
41
5.4
30 minutes
337
44.2
Neutral
75
9.8
60 minutes
71
9.3
Helpful
401
52.6
others
28
3.7
Very helpful
233
30.5
Necessity of receiving text messages after
the time medication should be consumed
Benefits of text message medication reminders
for disease control
Yes
48
6.3
Very unhelpful
14
1.8
No
715
93.7
Unhelpful
55
7.2
Neutral
132
17.3
Helpful
373
48.9
Very helpful
189
24.8
Willingness to recommend the text
message service to family and friends
Yes
699
91.6
No
64
8.4