Key Elements and Theoretical Foundations for the Design and Delivery of Text Messages to Boost Medication Adherence in Patients With Diabetes, Hypertension, and Hyperlipidemia: Scoping Review

BackgroundMedication nonadherence in cardiometabolic syndrome negatively impacts patients’ quality of life, health care systems, and economic stability. Despite extensive research, no universally recognized strategy has been established to improve adherence. SMS text messagin...

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Main Authors: Yu-Meng Yang, Tzu Wang, Hsun-Yu Chan, Yen-Ming Huang
Format: Article
Language:English
Published: JMIR Publications 2025-07-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2025/1/e71982
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author Yu-Meng Yang
Tzu Wang
Hsun-Yu Chan
Yen-Ming Huang
author_facet Yu-Meng Yang
Tzu Wang
Hsun-Yu Chan
Yen-Ming Huang
author_sort Yu-Meng Yang
collection DOAJ
description BackgroundMedication nonadherence in cardiometabolic syndrome negatively impacts patients’ quality of life, health care systems, and economic stability. Despite extensive research, no universally recognized strategy has been established to improve adherence. SMS text messaging has emerged as a widely accessible and cost-effective intervention, particularly when the intervention is structured using behavioral theories. ObjectiveThis study aimed to review existing literature and identify key factors in the design of SMS text messaging interventions for improving medication adherence among patients with diabetes, hypertension, or hyperlipidemia. MethodsWe conducted a scoping review following the SPIDER (sample, phenomenon of interest, design, evaluation, research type) framework and guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. Relevant literature on SMS text messaging interventions was searched in the PubMed and Scopus databases from inception to October 2024. The search terms included “diabetes,” “hypertension,” “hyperlipidemia,” “message,” “text,” “text message,” “app,” “application,” “digital,” “device,” “mobile,” “medical adherence,” and “medication adherence,” combined using logical operators “OR” and “AND.” Full-text articles were analyzed for study design, author, country, year of publication, disease focus, behavioral theory, and the constructs or domains of text messages. ResultsA total of 52 studies investigating SMS text messaging interventions to enhance medication adherence were identified. The targeted conditions included diabetes (26/52, 50%), hypertension (16/52, 31%), and various other chronic diseases (10/52, 19%). More than half of the studies (33/52, 64%) incorporated behavioral theories or techniques in their intervention design, using 19 distinct behavioral models. The most frequently used frameworks were the behavior change technique taxonomy (16/52, 31%) and the capability, opportunity, motivation, and behavior model (6/52, 12%). In addition, 33 (64%) studies implemented tailored messaging strategies, with the most common approach being content customization based on individual patient information (21/52, 40%), followed by personalized timing and frequency of messages (14/52, 27%), to enhance interventions’ adaptability and relevance to users’ needs. ConclusionsThis review highlights critical factors influencing the design of SMS text messaging interventions for medication adherence in the management of diabetes, hypertension, and hyperlipidemia. The findings underscore the importance of integrating behavioral theories and tailoring strategies to optimize patient engagement and intervention effectiveness. Further research is needed to evaluate the impact of different tailoring approaches and translate these insights into practical interventions.
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spelling doaj-art-54c32bdb7a444bfa9dd5705fe89509702025-08-20T03:13:27ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-07-0127e7198210.2196/71982Key Elements and Theoretical Foundations for the Design and Delivery of Text Messages to Boost Medication Adherence in Patients With Diabetes, Hypertension, and Hyperlipidemia: Scoping ReviewYu-Meng Yanghttps://orcid.org/0009-0003-9894-7023Tzu Wanghttps://orcid.org/0009-0003-5121-7699Hsun-Yu Chanhttps://orcid.org/0000-0001-5236-1009Yen-Ming Huanghttps://orcid.org/0000-0001-8673-2269 BackgroundMedication nonadherence in cardiometabolic syndrome negatively impacts patients’ quality of life, health care systems, and economic stability. Despite extensive research, no universally recognized strategy has been established to improve adherence. SMS text messaging has emerged as a widely accessible and cost-effective intervention, particularly when the intervention is structured using behavioral theories. ObjectiveThis study aimed to review existing literature and identify key factors in the design of SMS text messaging interventions for improving medication adherence among patients with diabetes, hypertension, or hyperlipidemia. MethodsWe conducted a scoping review following the SPIDER (sample, phenomenon of interest, design, evaluation, research type) framework and guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. Relevant literature on SMS text messaging interventions was searched in the PubMed and Scopus databases from inception to October 2024. The search terms included “diabetes,” “hypertension,” “hyperlipidemia,” “message,” “text,” “text message,” “app,” “application,” “digital,” “device,” “mobile,” “medical adherence,” and “medication adherence,” combined using logical operators “OR” and “AND.” Full-text articles were analyzed for study design, author, country, year of publication, disease focus, behavioral theory, and the constructs or domains of text messages. ResultsA total of 52 studies investigating SMS text messaging interventions to enhance medication adherence were identified. The targeted conditions included diabetes (26/52, 50%), hypertension (16/52, 31%), and various other chronic diseases (10/52, 19%). More than half of the studies (33/52, 64%) incorporated behavioral theories or techniques in their intervention design, using 19 distinct behavioral models. The most frequently used frameworks were the behavior change technique taxonomy (16/52, 31%) and the capability, opportunity, motivation, and behavior model (6/52, 12%). In addition, 33 (64%) studies implemented tailored messaging strategies, with the most common approach being content customization based on individual patient information (21/52, 40%), followed by personalized timing and frequency of messages (14/52, 27%), to enhance interventions’ adaptability and relevance to users’ needs. ConclusionsThis review highlights critical factors influencing the design of SMS text messaging interventions for medication adherence in the management of diabetes, hypertension, and hyperlipidemia. The findings underscore the importance of integrating behavioral theories and tailoring strategies to optimize patient engagement and intervention effectiveness. Further research is needed to evaluate the impact of different tailoring approaches and translate these insights into practical interventions.https://www.jmir.org/2025/1/e71982
spellingShingle Yu-Meng Yang
Tzu Wang
Hsun-Yu Chan
Yen-Ming Huang
Key Elements and Theoretical Foundations for the Design and Delivery of Text Messages to Boost Medication Adherence in Patients With Diabetes, Hypertension, and Hyperlipidemia: Scoping Review
Journal of Medical Internet Research
title Key Elements and Theoretical Foundations for the Design and Delivery of Text Messages to Boost Medication Adherence in Patients With Diabetes, Hypertension, and Hyperlipidemia: Scoping Review
title_full Key Elements and Theoretical Foundations for the Design and Delivery of Text Messages to Boost Medication Adherence in Patients With Diabetes, Hypertension, and Hyperlipidemia: Scoping Review
title_fullStr Key Elements and Theoretical Foundations for the Design and Delivery of Text Messages to Boost Medication Adherence in Patients With Diabetes, Hypertension, and Hyperlipidemia: Scoping Review
title_full_unstemmed Key Elements and Theoretical Foundations for the Design and Delivery of Text Messages to Boost Medication Adherence in Patients With Diabetes, Hypertension, and Hyperlipidemia: Scoping Review
title_short Key Elements and Theoretical Foundations for the Design and Delivery of Text Messages to Boost Medication Adherence in Patients With Diabetes, Hypertension, and Hyperlipidemia: Scoping Review
title_sort key elements and theoretical foundations for the design and delivery of text messages to boost medication adherence in patients with diabetes hypertension and hyperlipidemia scoping review
url https://www.jmir.org/2025/1/e71982
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