Trial Outcomes & Findings for SMS Reminder to Assess Adherence (NCT NCT01308476)

NCT ID: NCT01308476

Last Updated: 2013-01-18

Results Overview

Adherence was defined as percentage of documented applications of Spiriva HandiHaler as compared to the regularly planned seven applications during the week before questioning the patients. Patients in the SMS reminder group and in the control group were asked via SMS how often they had used Spiriva HandiHaler during the last week and were requested to call the IVR system to provide their response. Baseline was defined as week 4.

Recruitment status

COMPLETED

Target enrollment

95 participants

Primary outcome timeframe

Baseline, Week 8, Week 12, Week 16, Week 20 and Week 24

Results posted on

2013-01-18

Participant Flow

Patients who participated in this study had to have access to a mobile phone since a SMS (short message service) / IVR (interactive voice response) system was used to remind to medication intake and to evaluate the adherence to Spiriva HandiHaler.

Non-interventional controlled pilot study with two parallel groups.

Participant milestones

Participant milestones
Measure
SMS Reminder Group
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Control Group
Control group with same medication but not receiving reminder SMS.
Overall Study
STARTED
48
47
Overall Study
COMPLETED
45
45
Overall Study
NOT COMPLETED
3
2

Reasons for withdrawal

Reasons for withdrawal
Measure
SMS Reminder Group
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Control Group
Control group with same medication but not receiving reminder SMS.
Overall Study
Lost to Follow-up
2
2
Overall Study
Other
1
0

Baseline Characteristics

SMS Reminder to Assess Adherence

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
SMS Reminder Group
n=48 Participants
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Control Group
n=47 Participants
Control group with same medication but not receiving reminder SMS.
Total
n=95 Participants
Total of all reporting groups
Age Continuous
62.6 Years
STANDARD_DEVIATION 7.3 • n=39 Participants
63.2 Years
STANDARD_DEVIATION 8.1 • n=41 Participants
62.9 Years
STANDARD_DEVIATION 7.7 • n=35 Participants
Sex: Female, Male
Female
15 Participants
n=39 Participants
17 Participants
n=41 Participants
32 Participants
n=35 Participants
Sex: Female, Male
Male
33 Participants
n=39 Participants
30 Participants
n=41 Participants
63 Participants
n=35 Participants

PRIMARY outcome

Timeframe: Baseline, Week 8, Week 12, Week 16, Week 20 and Week 24

Population: Full Analysis Set (FAS) is defined as all treated patients who additionally met the study diagnosis (Chronic Obstructive Pulmonary Disease (COPD) requiring long-acting anticholinergics) and who had evaluable data in at least one effectiveness endpoint. Only subjects who responded to the SMS/ IVR system were considered in this analysis.

Adherence was defined as percentage of documented applications of Spiriva HandiHaler as compared to the regularly planned seven applications during the week before questioning the patients. Patients in the SMS reminder group and in the control group were asked via SMS how often they had used Spiriva HandiHaler during the last week and were requested to call the IVR system to provide their response. Baseline was defined as week 4.

Outcome measures

Outcome measures
Measure
Control Group
n=26 Participants
Control group with same medication but not receiving reminder SMS.
SMS Reminder Group
n=28 Participants
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Adherence to Spiriva HandiHaler Over Time
Baseline
96.2 Percentage of applications
Standard Deviation 12.5
99.0 Percentage of applications
Standard Deviation 5.4
Adherence to Spiriva HandiHaler Over Time
Week 12 (N=20, 30)
98.6 Percentage of applications
Standard Deviation 7.8
100.0 Percentage of applications
Standard Deviation 0.0
Adherence to Spiriva HandiHaler Over Time
Week 16 (N=25, 29)
96.1 Percentage of applications
Standard Deviation 14.2
100.0 Percentage of applications
Standard Deviation 0.0
Adherence to Spiriva HandiHaler Over Time
Week 20 (N=27, 29)
95.1 Percentage of applications
Standard Deviation 18.8
100.0 Percentage of applications
Standard Deviation 0.0
Adherence to Spiriva HandiHaler Over Time
Week 24 (N=26, 30)
95.7 Percentage of applications
Standard Deviation 18.4
99.5 Percentage of applications
Standard Deviation 2.8
Adherence to Spiriva HandiHaler Over Time
Week 8 (N=28, 29)
99.5 Percentage of applications
Standard Deviation 2.7
99.5 Percentage of applications
Standard Deviation 2.7

SECONDARY outcome

Timeframe: Week 8, Week 12, Week 16, Week 20 and Week 24

Population: FAS. Only subjects who responded to the SMS/ IVR system were considered in this analysis.

Adherence was defined as percentage of documented applications of Spiriva HandiHaler as compared to the regularly planned seven applications during the week before questioning the patients. Patients in the SMS reminder group and in the control group were asked via SMS how often they had used Spiriva HandiHaler during the last week and were requested to call the IVR system to provide their response. Baseline was defined as week 4.

Outcome measures

Outcome measures
Measure
Control Group
n=23 Participants
Control group with same medication but not receiving reminder SMS.
SMS Reminder Group
n=23 Participants
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Change From Baseline in Adherence to Spiriva HandiHaler Over Time
Week 8
3.7 Percent change
Standard Deviation 12.3
0.6 Percent change
Standard Deviation 3.0
Change From Baseline in Adherence to Spiriva HandiHaler Over Time
Week 12 (N=15, 23)
2.5 Percent change
Standard Deviation 16.5
0.0 Percent change
Standard Deviation 0.0
Change From Baseline in Adherence to Spiriva HandiHaler Over Time
Week 24 (N=21, 23)
-1.2 Percent change
Standard Deviation 9.5
0.0 Percent change
Standard Deviation 0.0
Change From Baseline in Adherence to Spiriva HandiHaler Over Time
Week 16 (N=20, 20)
0.7 Percent change
Standard Deviation 22.0
0.0 Percent change
Standard Deviation 0.0
Change From Baseline in Adherence to Spiriva HandiHaler Over Time
Week 20 (N=20, 21)
-1.4 Percent change
Standard Deviation 11.0
0.0 Percent change
Standard Deviation 0.0

SECONDARY outcome

Timeframe: 24 weeks

Population: FAS

Adherence was dichotomised into yes and no at the end of study depending on whether the percentage of adherence was at least 80 percent or less than 80 percent, respectively. Patients who did not respond to the SMS/ IVR system to provide information about the actual number of inhalations were considered with 0 percent adherence.

Outcome measures

Outcome measures
Measure
Control Group
n=45 Participants
Control group with same medication but not receiving reminder SMS.
SMS Reminder Group
n=47 Participants
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Response Rate Regarding Adherence
no (not adherent)
35.6 Percentage of participants
44.7 Percentage of participants
Response Rate Regarding Adherence
yes (adherent)
64.4 Percentage of participants
55.3 Percentage of participants

SECONDARY outcome

Timeframe: 24 weeks

Population: FAS

Compliance was defined as the percentage of patients answers to the IVR system as compared to the number of SMS automatically sent to the patients by the SMS/ IVR system asking for the number of Spiriva HandiHaler applications.

Outcome measures

Outcome measures
Measure
Control Group
n=45 Participants
Control group with same medication but not receiving reminder SMS.
SMS Reminder Group
n=47 Participants
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Patients Compliance With SMS System
64.1 Percentage of participants answers
Standard Deviation 38.3
55.0 Percentage of participants answers
Standard Deviation 39.8

SECONDARY outcome

Timeframe: Visit 2 (12 weeks) and visit 3 (24 weeks)

Population: FAS for SMS reminder group only

Only patients in the SMS reminder group were asked to assess the usefulness of the SMS system by the categories very helpful, helpful and not helpful.

Outcome measures

Outcome measures
Measure
Control Group
Control group with same medication but not receiving reminder SMS.
SMS Reminder Group
n=47 Participants
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Patients Assessment of Usefulness of the SMS System
Not helpful (week 12)
23.4 Percentage of participants
Patients Assessment of Usefulness of the SMS System
Missing (week 12)
2.1 Percentage of participants
Patients Assessment of Usefulness of the SMS System
Very helpful (week 24), N=45
8.9 Percentage of participants
Patients Assessment of Usefulness of the SMS System
Helpful (week 24), N=45
53.3 Percentage of participants
Patients Assessment of Usefulness of the SMS System
Very helpful (week 12)
12.8 Percentage of participants
Patients Assessment of Usefulness of the SMS System
Helpful (week 12)
61.7 Percentage of participants
Patients Assessment of Usefulness of the SMS System
Not helpful (week 24), N=45
33.3 Percentage of participants
Patients Assessment of Usefulness of the SMS System
Missing (week 24), N=45
4.4 Percentage of participants

SECONDARY outcome

Timeframe: Visit 2 (12 weeks) and visit 3 (24 weeks)

Population: FAS for SMS reminder group only

Only physicians of patients in the SMS reminder group were asked to assess the usefulness of the SMS system by the categories very helpful, helpful and not helpful.

Outcome measures

Outcome measures
Measure
Control Group
Control group with same medication but not receiving reminder SMS.
SMS Reminder Group
n=47 Participants
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Physicians Assessment of Usefulness of the SMS System
Helpful (week 24), N=45
80.0 Percentage of participants
Physicians Assessment of Usefulness of the SMS System
Not helpful (week 24), N=45
6.7 Percentage of participants
Physicians Assessment of Usefulness of the SMS System
Missing (week 24), N=45
2.2 Percentage of participants
Physicians Assessment of Usefulness of the SMS System
Very helpful (week 12)
6.4 Percentage of participants
Physicians Assessment of Usefulness of the SMS System
Helpful (week 12)
87.2 Percentage of participants
Physicians Assessment of Usefulness of the SMS System
Not helpful (week 12)
6.4 Percentage of participants
Physicians Assessment of Usefulness of the SMS System
Missing (week 12)
0.0 Percentage of participants
Physicians Assessment of Usefulness of the SMS System
Very helpful (week 24), N=45
11.1 Percentage of participants

SECONDARY outcome

Timeframe: Visit 2 (12 weeks) and visit 3 (24 weeks)

Population: FAS for SMS reminder group only

Only physicians of patients in the SMS reminder group were asked if they would recommend the SMS system (no, yes, don't know)

Outcome measures

Outcome measures
Measure
Control Group
Control group with same medication but not receiving reminder SMS.
SMS Reminder Group
n=47 Participants
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Physicians Recommendation of the SMS System
No (week 12)
8.5 Percentage of participants
Physicians Recommendation of the SMS System
Yes (week 12)
70.2 Percentage of participants
Physicians Recommendation of the SMS System
Don't know (week 12)
21.3 Percentage of participants
Physicians Recommendation of the SMS System
No (week 24), N=45
8.9 Percentage of participants
Physicians Recommendation of the SMS System
Yes (week 24), N=45
64.4 Percentage of participants
Physicians Recommendation of the SMS System
Don't know (week 24), N=45
26.7 Percentage of participants

SECONDARY outcome

Timeframe: Visit 2 (12 weeks) and visit 3 (24 weeks)

Population: FAS for SMS reminder group only

Only patients in the SMS group were asked to assess their satisfaction with the SMS system by assigning German school grades 1=very good, 2=good, 3=satisfactory, 4=sufficient, 5=deficient, 6=insufficient.

Outcome measures

Outcome measures
Measure
Control Group
Control group with same medication but not receiving reminder SMS.
SMS Reminder Group
n=47 Participants
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Patients Satisfaction With SMS System
Good (week 24), N=45
37.8 Percantage of participants
Patients Satisfaction With SMS System
Satisfactory (week 24), N=45
28.9 Percantage of participants
Patients Satisfaction With SMS System
Sufficient (week 24), N=45
11.1 Percantage of participants
Patients Satisfaction With SMS System
Very good (week 12)
23.4 Percantage of participants
Patients Satisfaction With SMS System
Good (week 12)
42.6 Percantage of participants
Patients Satisfaction With SMS System
Satisfactory (week 12)
21.3 Percantage of participants
Patients Satisfaction With SMS System
Sufficient (week 12)
6.4 Percantage of participants
Patients Satisfaction With SMS System
Deficient (week 12)
2.1 Percantage of participants
Patients Satisfaction With SMS System
Insufficient (week 12)
4.3 Percantage of participants
Patients Satisfaction With SMS System
Very good (week 24), N=45
15.6 Percantage of participants
Patients Satisfaction With SMS System
Deficient (week 24), N=45
4.4 Percantage of participants
Patients Satisfaction With SMS System
Insufficient (week 24), N=45
2.2 Percantage of participants

Adverse Events

SMS Reminder Group

Serious events: 2 serious events
Other events: 0 other events
Deaths: 0 deaths

Control Group

Serious events: 2 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
SMS Reminder Group
n=48 participants at risk
Patients receive a daily SMS to remind them to inhale Spiriva 18 mcg by using HandiHaler.
Control Group
n=47 participants at risk
Control group with same medication but not receiving reminder SMS.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Bronchial carcinoma
2.1%
1/48 • 24 weeks
0.00%
0/47 • 24 weeks
Nervous system disorders
Syncope
0.00%
0/48 • 24 weeks
2.1%
1/47 • 24 weeks
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
0.00%
0/48 • 24 weeks
2.1%
1/47 • 24 weeks
Respiratory, thoracic and mediastinal disorders
Nasal septum deviation
2.1%
1/48 • 24 weeks
0.00%
0/47 • 24 weeks

Other adverse events

Adverse event data not reported

Additional Information

Boehringer Ingelheim Call Center

Boehringer Ingelheim Pharmaceuticals

Phone: 1-800-243-0127

Results disclosure agreements

  • Principal investigator is a sponsor employee Any publication of the result of this trial must be consistent with the Boehringer Ingelheim publication policy. The rights of the investigator and of the sponsor with regard to publication of the results of this trial are described in the investigator contract.
  • Publication restrictions are in place

Restriction type: OTHER