Interaction with SMS Text-Reminders Correlate with Improved Medication Adherence and Readmission Rates for Congestive Heart Failure Patients - A Retrospective Cohort Study

Q: How were SMS text-reminders evaluated in the study?

The study compared CHF patients who did and did not interact with SMS nudges using a retrospective cohort design, then matched patients with prescription fill records after hospitalization.

Q: What effect did interacting with SMS nudges have on prescription filling?

Patients who interacted with SMS nudges had 19% higher odds of filling prescriptions overall.

Q: Did interacting with SMS nudges affect hospital readmissions?

Yes. Interacting patients had 6% lower odds of being readmitted to the hospital than non-interacting patients.

Sep 28, 2026

Uploaded by mieayamfan

Short message service text reminders (SMS nudges) aimed to help vulnerable patients remember to fill prescriptions are increasingly used, yet their impact on prescription fill and hospital readmission outcomes remains difficult to quantify. A retrospective cohort study included congestive heart failure (CHF) patients presenting to the emergency department with a primary CHF diagnosis. Patients who interacted with SMS nudges showed 19% higher odds of filling prescriptions overall and 6% lower odds of readmission versus non-interacting patients. Interactive SMS nudges delivered via a novel tool may improve prescription fill rates across multiple CHF groups and reduce readmissions.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Abstract

Study design and population

Key outcomes: prescription fills and readmissions

Interpretation and implications

OPEN ACCESS Citation: Long B, Davis B, McPheters R, Burton S, Hamoud N, Garmat D, et al. (2025) Interaction with SMS text-reminders correlate with improved medication adherence andreadmission rates for congestive heart failure patients: A retrospective cohort study. PLOS Digit Health 4(12): e0001157. [https://doi](https://doi). org/10.1371/journal.pdig.0001157 Editor: Simon Reif, ZEW-Leibniz Centre for European Economic Research: ZEW-LeibnizZentrum fur Europaische Wirtschaftsforschung GmbH Mannheim, GERMANY Received: January 20, 2025 Accepted: December 8, 2025 Published: December 31, 2025 Copyright: © 2025 Long et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data availability statement: The data underlying this study contain Protected Health Information (PHI) and cannot be RESEARCH ARTICLE Interaction with SMS text-reminders correlate with improved medication adherence andreadmission rates for congestive heart failure patients: A retrospective cohort study Ben Long1☯, Brian Davis1☯, Rebekah McPheters1☯, Steven Burton1☯, Nabeel Hamoud2‡, Dan Garmat2‡, Suzanne Catalfomo2‡, Fei Li2‡, Ying Zhou2‡, Yan L. Zhuang2‡, Colin A. Banas2‡, Weston W. Blakeslee2‡* 1 Department of Internal Medicine, Magnolia Regional Health Center, Corinth, Mississippi, United States of America, 2 Department of Applied Clinical Research, DrFirst, Rockville, Maryland, United States of America ☯ These authors contributed equally to this work. ‡ These authors contributed equally to this work. * [wblakeslee@drfirst.com](wblakeslee@drfirst.com) Abstract Short message service text reminders (SMS nudges) aimed to help vulnerable patient populations remember to fill their prescriptions are becoming more common but accurately measuring their effects on improving prescription fill and readmission rates remains challenging. Patients who presented to the emergency department (ED) with a primary diagnosis of congestive heart failure (CHF) were included in the study. We conducted a retrospective cohort study of CHF patients who did and did not interact with SMS nudges, then matched patients who were prescribed medications at any point in their hospital visit with records of subsequent prescription fills. Patients that interacted with SMS nudges had 19% higher odds of filling prescriptions overall (1 .19 OR (95% CI: 1.15 – 1.24), p < 0.001) and 6% lower odds of being readmitted to the hospital (0 .94 (95% CI: 0.9 – 0.99), p = 0.009) than patients who did not interact with SMS nudges. Interactive SMS nudges via a novel tool may improve prescription fill rates across multiple groups of CHF patients, and contribute to a reduction in readmissions. Author summary When patients leave the hospital with new prescriptions, many never fill them. A problem that can lead to worsening symptoms and costly hospital readmissions. We wanted to investigate if personalized text message reminders could help patients remember to pick up their medications after being hospitalized for heart failure. We studied over 1,200 heart failure patients at a rural hospital who received PLOS Digital Health | [https://doi.org/10.1371/journal.pdig.0001157](https://doi.org/10.1371/journal.pdig.0001157) December 31, 2025 1 / 14 shared publicly for ethical and legal reasons. A Business Associates Agreement (BAA) is in place between the two collaborating organizations for the protection and exchange of PHI to comply with HIPAA and NIST standards. Making these data publicly available enables the chance to compromise patient privacy. In our analysis, linking readmission data, electronic prescribing data, medication history data, and text message engagement data to unique patients were essential for the accuracy of our findings. A reader of our study may make a reasonable request to

FAQs

How were SMS text-reminders evaluated in the study?

The study compared CHF patients who did and did not interact with SMS nudges using a retrospective cohort design, then matched patients with prescription fill records after hospitalization.

What effect did interacting with SMS nudges have on prescription filling?

Patients who interacted with SMS nudges had 19% higher odds of filling prescriptions overall.

Did interacting with SMS nudges affect hospital readmissions?

Yes. Interacting patients had 6% lower odds of being readmitted to the hospital than non-interacting patients.

Sep 28, 2026

Uploaded by mieayamfan