Technology Corner

Text Messaging in Pharmacy

Joshua Hollingsworth Auburn UniversityBrent Fox Auburn UniversityIf you are like us, you send and receive a great many text messages every day. You use your phone to text more than you do to talk. This is, in fact, the norm. Texting — also known as Short Message Service (SMS) — is the most widely used smartphone feature of all. Let’s look at the numbers. Ninety-seven percent of U.S. smartphone owners use text messaging. This further breaks down to 100% of 18–29-year-olds and 92% of those 50 and older sending and receiving texts on their smartphone. Texting, however, is not limited to smartphones. Older, “less intelligent” cell phones are just as capable of sending and receiving texts. And now that nearly all (95%) U.S. adults own a cell phone of some type, text messaging is a universal mechanism that can be used to reach out to and interact with your patients.

Nearly all U.S. adults now have the needed technology — a cell phone — to send and receive texts. Text messaging is simple and familiar. Not only is nearly everyone able to send and receive texts, most people text regularly and are therefore comfortable with the practice.

We like text messaging for many reasons. As just discussed, text messaging is ubiquitous. Nearly all U.S. adults now have the needed technology — a cell phone — to send and receive texts. Text messaging is simple and familiar. Not only is nearly everyone able to send and receive texts, most people text regularly and are therefore comfortable with the practice. Texts are timely. Unless they are charging them, most individuals rarely let their phones out of arm’s reach. This results in most individuals receiving a text immediately after it is sent, or shortly thereafter. Texts are minimally distracting. Text messaging is generally considered less distracting and less time-consuming than voice calling or voicemails. (An obvious caveat here is that no one should text while driving.) Lastly, text messaging offers a convenient form of automated communication. With the proper system in place, texts can be personalized and scheduled for delivery.

Okay, so communication via text has many attributes, but how can texting actually be used in pharmacy? After you have your automated text messaging service up and running, here are four pharmacy-specific uses of text messaging, in no particular order.

Refill Reminders And Requests

A pharmacy can schedule texts to be sent to patients a few days prior to when their prescription should run out. Patients can then respond to these messages in order to inform the pharmacy as to whether they actually need the refill or not. Patients can also use text messaging to submit a refill request that is unprompted by the pharmacy. A pharmacy can then continue the interaction by texting status updates.

Prescription Status Updates

A pharmacy can alert patients via automated text messaging as to the status of their prescription. For instance, the pharmacy can let patients know when their prescription is ready for pickup and how much it will cost. Alternatively, if the prescription has expired or has no remaining refills, then patients can be informed of this via text. If the filling of a prescription is delayed for some reason — due to being out of stock or on backorder, for example — then this can be relayed to patients by text. If a prescription is not covered by insurance, then this too can be relayed to patients by text. Texts can also be used to let patients know that their prescription has been picked up. This can be helpful when someone other than the patient picks up the prescription.

Upcoming Clinics And Events

Oftentimes, pharmacies hold events such as vaccine clinics, diabetes care clinics, and general health fairs. Patients can be made aware of these events via text messaging.

Dose Reminders

Medications do not work if they are not taken. Many patients, even if they have good intentions, often need reminding to ensure they take their medications as prescribed. This may be especially true when patients are first starting a continuous regimen, are prescribed a medication for only a short duration, or are on multiple medications. Scheduled text messages can be used to gently remind patients at the opportune time to take their medications. This approach has been shown to significantly improve medication adherence, at least in the short term.

Automated text messaging is now a convenient way to interact and engage with nearly all pharmacy patients in a timely fashion.

Of course there are a few important considerations we should point out. The most obvious is the potential for HIPAA violations, but text messages must also comply with the Telephone Consumer Protection Act (TCPA). Current guidelines are a bit unclear, but there are precautions you can take to maintain HIPAA and TCPA compliance. First and foremost, the service must allow patients to opt in, thereby giving their consent, after they have been fully informed. This should include a description of the program, expected message frequency and message content, any costs, any risks, how to get support/help, and any applicable terms and conditions. Patients must be allowed to opt in to each type of message individually. For instance, some patients may prefer to receive text messages concerning their prescriptions but not those concerning upcoming events. Sending unsolicited text messages for marketing purposes would be a violation of the TCPA. After signing up, patients must be able to easily opt out, if they so choose. This is usually addressed by having the patient text a special word (e.g., STOP) to your system. Another potential concern is simply alert fatigue. Be mindful of message number and frequency, or else patients are likely to ignore or disable the service.

Automated text messaging is now a convenient way to interact and engage with nearly all pharmacy patients in a timely fashion. We discussed using text messages for refill requests and prescription status updates, to make patients aware of upcoming events, and to send dose reminders, but we are sure there are other potential uses. What about adverse drug event reporting? Or checking/reporting efficacy with, say, antibiotics? What are some other potential uses? No matter how text messaging is used, precautions must be taken to ensure compliance with HIPAA and the TCPA. Check with your pharmacy management system vendor to see about getting your automated text message system up and running. We welcome your comments. CT

Joshua C. Hollingsworth, Pharm.D, Ph.D., is an assistant professor, Pharmacology and Biomedical Sciences, Edward Via College of Osteopathic Medicine, Auburn Campus, and Brent I. Fox, Pharm.D., Ph.D., is an associate professor in the Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University. The authors can be reached at jhollingsworth@auburn.vcom.edu and at foxbren@auburn.edu.

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