Increasing compliance toward home exercise in chiropractic patients using SMS texting: A pilot study

Objective

In addition to manipulation, and in line with evidence, many manual therapists include prescribed home exercise for patients with musculoskeletal problems; however, compliance to these exercises can be low and patients potentially miss the added benefit these interventions can provide. Increasing patient compliance is, therefore, important and previous attempts have been met with varying success. The emergence of mobile technology may offer efficient methods whereby the practitioner can stay in contact with the patient and impact compliance positively. We therefore investigated the use of SMS messages in increasing compliance in chiropractic patients who were given exercise advice.

Design

This was a prospective pilot clinical trial.

Subjects

New patients consenting to the study with musculoskeletal problems amenable to chiropractic treatment, who were given exercise advice as part of their care and who possessed a mobile phone.

Methods

Thirty-two patients attending chiropractic clinics in Germany were assigned pseudo randomly into two groups, one that received SMS messages and one that did not. Three messages were sent each week over a 4 week period. A follow up questionnaire ascertained self reported compliance to the exercises given.

Results

Patients in the SMS group were 6 times more likely [OR = 6.3 (95% CI (2.2–17.9)] to complete the exercises given than those who did not receive an SMS. In addition, only the SMS group reported significant increases in self reported compliance in comparison to previous episodes where exercise was also given. Annoyance scores indicated that patients receiving SMS texts did not find them onerous.

Conclusions

This pilot study indicates that SMS messaging to patients increases self reported compliance. This is in line with other areas of compliance research and warrants further development.